On the vaccine front: Good news, mostly

June 1, 2004

The Recommended Childhood and Adolescent

The Recommended Childhood and Adolescent Immunization Schedule for the second six months of 2004 was published last month (Morbidity & Mortality Weekly Reports 2004;53[16]). The updated schedule differs from the one issued for the first six months of the year in only one way: it recommends influenza immunization, now calling for yearly vaccination of healthy children 6 to 23 months old, emphasizing the vulnerability of children in this age group and their close contacts, and pushing harder for yearly immunization of health-care workers. The schedule for catch-up immunizations remains unchanged. The new schedule is at www.cdc.gov/mmwr/preview .

The news about the pneumococcal conjugate vaccine (PCV7) continues to be impressive. Data reported at the Society for Pediatric Research meeting last month offered strong evidence that immunization of young children has induced herd protection in unvaccinated adults and older children. And a just-published study by researchers at the Centers for Disease Control and Prevention (CDC) indicates that PCV7 immunization has reduced racial disparities in the incidence of invasive pneumococcal disease among young children (JAMA 2004;291:2197). There is bad news, however: A shortage of PCV7 persists, with supplies adequate for only two—rather than the recommended four—shots.

News about the inhaled influenza vaccine (FluMist) is also good; new studies released at the Society for Pediatric Research meetings last month show it is just as safe and considerably more effective than the injectable version. Bad news, too, however: Wyeth had such difficulty making the nasal spray vaccine profitable that it gave up, leaving MedImmune, the original developer, free to seek FDA approval of a reformulated product on its own.

Last, the rotavirus vaccine (RotaShield) withdrawn from the market in the 1990s—when some studies showed a connection between its administration and a rise in the incidence of intussusception—may make a comeback. In the wake of accumulating doubts about the validity of the intussusception connection, the National Institute of Allergy and Infectious Disease (NIAID) has licensed the vaccine again—to BIOVIRx, which will take the necessary steps to secure FDA approval and market the vaccine. Whether a rotavirus vaccine will sell in the United States or in developing countries, where infant diarrhea is a more serious concern, remains to be seen.