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At the 43rd National Conference on Pediatric Healthy Care for nurse practitioners, one clinician shares what pediatric health care providers should know about the 2022 Advisory Committee on Immunization Practices schedule updates.
“Stay-at-home and shelter-in-place orders have resulted in declines in outpatient pediatric visits and fewer vaccines,” stated Mary Koslap-Petraco, DNP, PPCNP-BC, CPNP, FAANP, clinical assistant professor, Stony Brook University School of Nursing in New York. “For this reason, nurse practitioners need to identify children who have missed recommended vaccines, contact children to schedule in person appointments, and start with newborns, infants up to 24 months, and young children, then extending through adolescence.”
Koslap-Petraco looked at the most immediate updates to the pediatric vaccine schedule, which included:
--adding dengue vaccine to the child and adolescent schedule
--adding an appendix listing the contraindications and precautions for each vaccine type
--adding a QR code to the cover page, which links to the online version of the schedule.
The dengue vaccination was added to provide guidance for areas with endemic dengue (such as the US Virgin Islands, Micronesia, and Puerto Rico). A practitioner must have laboratory documentation of previous dengue infection before administering the vaccine, with a schedule at 0, 6, and 12 months.
There were other vaccine updates as well. The haemophilus influenzae type B vaccine was revised to include recommendations for using Vaxelis for routine and catch-up vaccination. Vaxelis can be used in catch-up vaccination in children aged less than 5 years; here, Koslap-Petraco underscored that a different Hib-containing vaccine should be used for the booster dose.
With hepatitis A vaccine, updates included clarification of recommended age for routine vaccination (2-dose series, administered at 12-23 months, with a minimum interval of 6 months between doses, while unvaccinated persons through age 18 years should complete the 2-dose series, also at a minimum interval of 6 months.) For hepatitis B, updates were made to clarify recommendation for post-vaccination serologic testing and revaccination, including post-vaccination serology for infants born to HBsAg-positive mothers, hemodialysis patients, and other immunocompromised persons. For the human papillomavirus vaccine, number of doses were revised. Immunocompromising conditions, including HIV infection, should be a 3-dose series, even for those who initiate vaccination at age 9 through 14 years.
The session continued to include updates to the influenza, meningococcal ACWY, MMR, and Varicella vaccines. Topics of vaccine hesitancy were also discussed (make the case for vaccines through science, corroboration, explanation, and advisement) and peer-to-peer vaccine advocacy was encouraged, through social media, family engagement, first-person vaccine stories, etc. “Immunize.org is the premier source of information for education and advocacy in support of frontline professionals,” reminded Koslap-Petraco. “It re-affirms our mission to work alongside nonprofit advocacy, health care, and pharmaceutical industry partners…to provide free access to comprehensive vaccination education resources and to advocate for policies that better protect the public from all vaccine-preventable diseases.”
Petraco, MK. CDC immunization update 2022-ACIP schedule updates. 43rd National Conference on Pediatric Health Care. March 23, 2022; Dallas, Texas.