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Pediatricians Highlight Role Of Immunization Committee During COVID-19 Pandemic

The Advisory Committee on Immunization Practices (ACIP) plays a crucial role in how the Centers for Disease Control and Prevention (CDC) sets vaccination schedules for children and adults. This work was particularly critical during the COVID-19 pandemic with the remarkable advancement of vaccines amid growing public distrust of those vaccine recommendations.

To highlight the ACIP's work during this challenging time, committee members are sharing their insights and experiences with a focus on pediatrics.

A paper, authored by Katherine A. Poehling, M.D., professor of pediatrics at Wake Forest University School of Medicine and Grace Lee, M.D., professor of pediatric infectious diseases at Stanford University School of Medicine, appears online in Academic Pediatrics.

"By reflecting on the work of ACIP, its decision-making and dedication to transparency, we hope to build trust among families and communities," said Poehling, the paper's corresponding author. "We also believe pediatricians and primary care providers can benefit in better understanding the role that the ACIP plays in reducing vaccine-preventable diseases."

When the pandemic began, ACIP transitioned its meetings to a virtual format, which allowed for more frequent emergency meetings as needed. Typically, the committee would meet three times a year, in person.

Poehling said these emergency meetings enabled the group to meet for timely discussions and evidence review following FDA authorization of COVID-19 vaccines, typically within 24 hours.

"By pivoting to these virtual meetings, we were able to respond to public health needs to ensure transparent decision-making," Poehling said.

In December 2020, the committee also held two public meetings to discuss the allocation of vaccines following the FDA's emergency use authorizations of the Moderna and Pfizer vaccines.

Poehling said these virtual meetings received intense attention, with one of the public meetings recording more than 50,000 people in attendance.

"With such a large and diverse audience, we had the unique opportunity to clearly explain key points of the critical issues that were being discussed," Poehling said.

Vaccine safety was a primary focus in all phases—vaccine development, evaluation, approval and use. The ACIP created vaccine safety work groups, which served as a hub for safety data and real-time safety surveillance.

Poehling said these work groups evaluated safety data from multiple sources across the nation and around the world and met at least once a week to interpret the data as quickly as possible.

One early topic of discussion was ensuring that clinical trials included underrepresented and diverse groups that were disproportionately affected by COVID-19.

"One of the primary lessons we learned is that clinical trials can efficiently include diverse populations when prioritized," Poehling said.

However, improving equity by age, sex, race, ethnicity, existing medical conditions and socioeconomic status is an ongoing challenge in vaccine development, highlighted by the pandemic. For example, COVID-19 vaccines became available for ages 16 and older in less than one year while a vaccine for children under the age of 5 was delayed by nearly 18 months.

Poehling noted that a key equity opportunity is to shorten the time in vaccine availability between adults and children.

"This experience underscores the importance of prioritizing equitable access for children," Poehling said. "As pediatricians, we must continue to advocate for the needs of children to ensure faster development and access to immunizations."

Poehling also said that the insights gained during the COVID-19 pandemic will only strengthen the role of ACIP and other federal advisory committees in addressing future pandemics.

"Transparency is a key element in our efforts to safeguard public health and to maintain public trust," Poehling said.

More information:Katherine A. Poehling et al, Reflections on the Advisory Committee on Immunization Practices During the COVID-19 Pandemic, Academic Pediatrics (2024). DOI: 10.1016/j.Acap.2024.06.019

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Citation: Pediatricians highlight role of immunization committee during COVID-19 pandemic (2024, September 10) retrieved 13 September 2024 from https://sciencex.Com/wire-news/487441022/pediatricians-highlight-role-of-immunization-committee-during-co.Html

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ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES

CDC panel votes to expand HPV vaccine recommendations

The CDC's recommendation that children start receiving two doses of the HPV vaccine around 11 or 12 years old has not changed. The committee holds three meetings every year to review the most recent scientific data and vote on making possible updates to vaccine recommendations. In some cases, HPV infection can lead to six types of cancer: cervical, anal, penile, vaginal, vulvar and oropharyngeal (mouth and throat). The vaccine can protect against cancers since it works by preventing HPV infection -- and while most people think of HPV's relation to cervical cancer, "parents often don't know that HPV oropharyngeal cancers will outnumber cervical cancer" in around five years, she said. About 10% of men and 3.6% of women have oral HPV, according to the CDC, and HPV is thought to cause 70% of oropharyngeal cancers in the United States.


Guide To 2024 Fall Vaccines: When To Get Your COVID, Flu, And RSV Shots

  • Vaccines for the Fall and Winter 2024–2025 season are now available.
  • Generally, experts recommend COVID-19 and flu vaccines for most people and RSV vaccines for some.
  • The vaccines are all safe to get together at the same time.
  • As the weather cools down and seasonal illnesses start circulating, now is the time to start thinking about vaccines. This fall, health experts recommend getting certain shots to protect against viruses that can cause serious illness, especially as people begin spending more time indoors.

    Staying up-to-date on vaccines is crucial for reducing the risk of severe illness, which could lead to hospitalization, long-term health issues, or even death in some cases, according to Michael Chang, MD, infectious disease physician at UTHealth Houston.

    "Unfortunately, to date, respiratory virus infectious such as flu and COVID-19 change enough year to year that we still need seasonal immunizations," Chang told Health. "The wider uptake of immunizations, the greater the mitigation of the impacts of contagious infections even beyond the direct health consequences, to potentially include socioeconomic benefits across all age groups and walks of life."

    Here's a guide breaking down the shots you might need this season and how to determine which ones are right for you.

    McKinsey Jordan / Stocksy

    While staying up to date on vaccines is important to protect yourself and those around you, determining which ones you should get depends on factors such as your age, health conditions, risk factors, life events, job, and travel plans. Here are some key vaccines to consider, including who they're recommended for and when to get the shots. Flu Vaccine  The flu virus changes each year, so getting vaccinated annually helps protect against the most common circulating strains and reduces the risk of severe illness, hospitalization, and flu-related deaths across multiple age groups, said Chang. According to the Centers for Disease Control and Prevention, everyone 6 months of age or older—with rare exceptions—should get an annual flu shot. The vaccine is particularly important for people at a higher risk of developing serious complications from the flu, including people who are over 65, pregnant women, and people who have chronic health conditions like diabetes, heart disease, and chronic kidney disease. While most people can get the standard dose flu shot, said Chang, adults over 65 and some immunocompromised people such as transplant recipients should opt for a high-dose flu vaccine for better protection. These preferentially recommended vaccines are the Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine, and Fluad Quadrivalent adjuvanted flu vaccine. Alternatively, younger people—those ages 2 through 49—with healthy immune systems may receive a nasal spray flu vaccine, said William Werbel, MD, PhD, assistant professor of medicine in the Division of Infectious Disease at Johns Hopkins University School of Medicine. Though flu season is technically year-round, flu activity peaks between December and February. In order to ensure protection during those months, the CDC recommends most people should be vaccinated in September or October—ideally before Halloween. "It takes a couple of weeks to get the full protection from most vaccines," said Chang. However, it's never too late to get a flu shot: Vaccinations are offered throughout flu season as influenza viruses circulate. COVID-19 Vaccine  Since its emergence in 2020, COVID-19 has continued to circulate, leading some experts to question whether it's become an endemic virus, like the flu. Because of that—and because the virus continues to mutate from its original strain—scientists continue to make updated vaccines that target newer variants and can reduce the risk of severe illness, hospitalization, and complications. "All the recent circulating variants, including the just-past summer wave, were Omicron variants, and the new vaccine targets an Omicron variant," Chang said. The vaccine also reduces the risk of catching COVID-19, and even if you do get infected, it can lessen the severity of symptoms. Staying vaccinated also helps limit the spread of COVID-19 to others, contributing to overall community protection. There are three new COVID vaccines for the 2024–2025 season, made by Moderna, Pfizer-BioNTech, and Novavax. The mRNA vaccines—made by Moderna and Pfizer-BioNTech—are approved for use in the U.S. And recommended for everyone ages 6 months and older. Novavax's protein subunit vaccine—a more traditional vaccine similar to the flu vaccine—is available for everyone ages 12 and older. It's a bit harder to determine when to get your new COVID vaccine since the virus doesn't have a distinct peak like the flu. Some experts say it's wise to get your flu and COVID vaccines at the same time for optimal protection in the winter months. That said, the CDC says that while anyone who has recently had COVID still needs to stay up to date with their vaccines, they may choose to delay their COVID vaccine by up to three months to make sure you get the most protection possible. RSV Vaccine Respiratory syncytial virus (RSV) is often associated with children, but it can cause serious illness in older adults, leading to thousands of hospitalizations and 6,000 to 10,000 deaths each year among those aged 65 and older. Vaccines are available for older adults to protect them from severe RSV and for pregnant women to protect infants from the virus. The CDC recommends an RSV vaccine—GSK's Arexvy, Moderna's mResvia, and Pfizer's Abrysvo—for all people ages 75 years and older. Adults ages 60–74 who are at an increased risk of RSV—including those who have a chronic heart or lung disease, a weakened immune system, or live in a nursing home—are also urged to get an RSV vaccine. When given to older adults, the RSV vaccine is not currently intended to be an annual vaccine. So far, the CDC says RSV vaccines offer older adults some protection for at least two RSV seasons. An initial RSV vaccine should be given in late summer or early fall, according to the CDC. For pregnant people, the CDC recommends one RSV vaccine (Pfizer's Abrysvo) given while the pregnant person is between 32 and 36 weeks pregnant, from September through January, so that infants will be protected against severe disease at birth. Children don't currently have an RSV vaccine option, but "vaccine-like" monoclonal antibody products—Beyfortus (nirsevimab) and Synagis (palivizumab)—can help protect infants and young children from RSV complications. CDC and the American Academy of Pediatrics recommend Beyfortus for most infants and children, though Synagis may be used in some cases. "This is a game changer for infants, particularly those born prematurely or with medical conditions," said Werbel. According to Werbel, it is generally safe to receive multiple vaccines simultaneously, and this approach is often more convenient for most people. Combining vaccines is associated with a slightly higher risk of mild reactions such as fatigue, aches, and pain at the injection site. There is no apparent reason not to get multiple vaccines on the same day, making "one-stop shopping" a practical option. However, individuals who have experienced a more intense reaction or side effects to vaccines in the past might consider spacing out certain "reactogenic" vaccines from each other, Werbel said. For example, it may be beneficial to separate the adjuvanted RSV vaccine [such as GSK] and the COVID-19 vaccine. "Regardless, reactions tend to be mild or moderate, lasting less than 3 days." Chang added that while we don't have safety data on every vaccine combination in adults or children, there is evidence supporting the safety of administering the COVID-19 and flu vaccines together. Similarly, there are data for flu and RSV vaccines to be received at the same time. "Currently, the recommendation is that all three can be given at the same time," Chang said. "But considering the recent huge summer wave of COVID-19, it may be possible to wait a week or two after flu and RSV vaccines to get a COVID-19 vaccine."

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    William Buoni, MD - Wexner Medical Center