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NOVEMBER 8, 2023

Register today to attend our next Discovery Session on Monday, November 27, from 4 to 5 p.m. ET. During this session, you will get an overview of the Immunization Information Systems Annual Report (IISAR).

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Once you have registered, you will receive a confirmation email which contains links to add the meeting to your calendar.

If you’re unable to attend, this session will be recorded and available in the AIRA Repository.

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Background
The Advisory Committee on Immunization Practices (ACIP) met on October 25–26 to discuss meningococcal, mpox, RSV for adults, influenza, chikungunya, dengue, COVID-19, and pneumococcal vaccines; 2024 immunization schedules; and an update on COVID-19 and influenza vaccine safety. 

Summary of Votes
Below is a summary of the votes that took place.

MenABCWY Vaccine

• Pfizer’s MenABCWY vaccine may be used when both MenACWY and MenB are indicated at the same visit. This applies to:
  • Healthy individuals aged 16–23 years (routine schedule) when shared clinical decision-making favors administration of MenB vaccination
  • Individuals aged 10 years and older at increased risk of meningococcal disease due for both vaccines

Mpox Vaccine

• ACIP recommends vaccination with the two-dose JYNNEOS vaccine series for persons aged 18 years and older at risk for mpox (dose two to be administered 28 days after dose one). This is an interim recommendation that ACIP will revisit in two to three years.

Vaccines for Children (VFC) Resolutions

• VFC program resolutions were passed for meningococcal and mpox vaccines.

2024 Child/Adolescent and Adult Immunization Schedules

• ACIP voted to approve the 2024 child/adolescent and adult immunization schedules.
• The schedules will be published online in November 2023 and in the MMWR and Annals of Internal Medicine reports in December 2023 or January 2024.

Additional Discussion

Over the course of the two-day meeting, other topics were discussed, including:

• Adult RSV Vaccine: ACIP discussed data demonstrating that vaccine efficacy for a single dose of RSVPreF3 (Arexy, GSK) in adults 50–59 years with and without chronic medical conditions is similar to that demonstrated in adults 60 and older. Next steps include the review of post-marketing data on the use of RSV vaccines in adults 60 years and older, considerations for shared clinical decision-making in adults 50–59 years, and an updated policy question for RSV vaccination in adults.
• Vaccine Safety: Data was shared on the risk of ischemic stroke following bivalent COVID-19 vaccination, simultaneous bivalent COVID-19 and influenza vaccination, and influenza vaccination alone. Interpretation of this data concluded that there is a lack of consistency in findings and that the most common findings across studies show no association. Detection and assessment of the ischemic stroke signal indicates that the vaccine safety monitoring process is working.
• Influenza Vaccines: Data were shared on the safety and efficacy of flu vaccination during pregnancy, co-administration of flu with other vaccines, and safety of LAIV4 in children with asthma.
• Chikungunya Vaccine: The expected licensure date for Valneva’s chikungunya vaccine is November 2023. Proposed policy options for chikungunya vaccine use among U.S. adults traveling abroad and laboratory workers were discussed. If the vaccine is approved by the FDA, an ACIP vote is expected in February 2024.
• Dengue Vaccines: Takeda Dengue Vaccine (TAK-003) has been under review by the FDA since November 2022. In July 2023, Takeda voluntarily withdrew its application with the FDA. The dengue workgroup will be paused until TAK-003 is resubmitted to FDA or a new vaccine is submitted for approval.
• COVID-19 Vaccines: Upcoming policy discussions include consideration of additional COVID-19 vaccine doses in older adults (anticipated in February 2024), preparations for future COVID-19 formula updates (to be discussed in June 2024), and monitoring of COVID-19 vaccine effectiveness, safety, and epidemiology.
• Pneumococcal Vaccines: The workgroup will review evidence on the use of 21-valent pneumococcal conjugate vaccine (V116) for adults. An FDA application for V116 is anticipated in Q4 of 2023, with a projected FDA approval in the first half of 2024. An ACIP vote is expected shortly after FDA approval.

Impact on IIS

• Clinical decision support for immunization (CDSi) rules are regularly developed and reviewed. Updates are typically available shortly after the publication of ACIP recommendations in the Morbidity and Mortality Weekly Report.

The next scheduled ACIP meeting will be on February 28–29, 2024. For a more detailed summary, view the November 1 issue of IZ Express.

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