The pediatric vaccination schedule generally does not change much from year to year, but the past couple of years, particularly with COVID-19 vaccines, have brought us frequent change. And this is a good thing, as the changes have meant that more and more children can be protected by the COVID-19 vaccine.
This year, there is more change, and in more than just the COVID-19 vaccine schedule. This week, Pediatrics is early releasing a Special Article by Dr. Sean O’Leary from the University of Colorado and colleagues from Children’s National Hospital, University of South Florida, University of Alabama at Birmingham, and University of Cincinnati, entitled “Summer 2023 ACIP Update: RSV Prevention and Updated Recommendations on Other Vaccines” (REF).
This article is the first of regular updates that we will be publishing that take us “behind the scenes” of meetings of the Advisory Committee on Immunization Practices (ACIP), which is a committee of medical and public health experts who advise the Centers for Disease Control and Prevention about what should be recommended for vaccination.
Here are takeaways about some of the new vaccines that are coming:
Respiratory syncytial virus (RSV) “vaccine” for infants: Nirsevimab is a long-acting monoclonal antibody that has been FDA-approved for prevention of serious RSV disease. Dr. Cody Meissner from Geisel School of Medicine at Dartmouth, in an invited commentary, notes that Nirsevimab is a “breakthrough” that has only been made possible through many years of research into the basic molecular biology of the virus (10.1542/peds.2023-063955).
- Nirsevimab is not a traditional “vaccine,” in that it provides passive immunity (since the premade antibody is given) rather than the active immunity (the particles of the pathogen teach the body to make antibodies) that vaccines provide, but it is likely that we will be talking about it as a vaccine. I am already having parents ask about the “RSV vaccine.”
- Nirsevimab is given as a single dose to infants who are <8 months old at the beginning of the RSV season. It can be given at the same time as other vaccines. It can be given during the birth hospitalization.
- Studies show 79% efficacy against RSV lower respiratory tract infection that requires a medical visit, 81% efficacy against RSV hospitalization, and 90% efficacy against RSV intensive care admission.
A new 20-valent pneumococcal conjugate vaccine will largely replace the 13-valent pneumococcal conjugate vaccine that is given to infants.
The influenza vaccine has been updated for the 2023-2024 season. Of note, those with egg allergy can receive egg-based influenza vaccines without any additional measures (such as giving the vaccine in an allergy clinic).
Although there is public concern about the safety of vaccines, there is no evidence from the Vaccine Safety Datalink that vaccines “overwhelm” the immune system or increase the risk of autoimmune or allergic diseases.
Finally, there was also discussion about a new pentavalent meningococcal vaccine (to replace the MenACWY and MenB vaccines), mpox vaccines (formally known as monkey pox), the RSV vaccine for pregnant persons, and the possibility of simplifying the COVID-19 vaccine schedule. Please read the article to learn more about these vaccines.
I am personally excited that this will be a regular feature in Pediatrics! I very much appreciated this concise update of what we can expect with regards to vaccines. I’m sure that you will find that the information is helpful to have for your discussions with families.