ACIP 2023 Vaccination Schedule Update, At-a-Glance

This article orginally ran on Patient Care Online on Jan. 2, 2023

On October 19 and 20, 2022, the Advisory Committee on Immunization Practices (ACIP) met to discuss the 2023 vaccination schedule and offer recommended updates. These recommendations included adding COVID-19 vaccination to the routine childhood and adult vaccination schedules, updates for flu vaccines in pregnant individuals, discussion of progress in developing respiratory syncytial virus (RSV) vaccines, several pneumococcal vaccine administration changes, and more.

John D. Grabenstein, RPh, PhD, managing editor of IZ Express for Immunize.org spoke with Patient Care® partner web site Drug Topics® on the updates and provided a summary of the ACIP recommendations.

COVID-19 Vaccines

Of note, ACIP unanimously voted to recommend adding COVID-19 to the regular schedules of childhood and adult vaccinations. The Committee also added the COVID-19 vaccine to the Vaccines for Children program. This will ensure access to the vaccine if and when the federal government ends the public health emergency for COVID-19. Despite circulating misinformation, nothing the ACIP has done mandates the COVID-19 vaccine for children.

ACIP highlighted the safety and efficacy of COVID-19 vaccines for pregnant people and their infants. It stressed the importance of pregnant people being vaccinated for COVID-19, as pregnancy is considered a high-risk condition. However, only 43% of pregnant people have had the primary series and a monovalent booster, according to 2022 data.

“COVID-19 vaccines appearing in the routine schedules for children and for adults reflects the continuing burden of COVID in hospitalizing and killing people of all ages,” said Grabenstein. He added that COVID-19 vaccines should be considered routine and essential, with an accumulated experience of more than 630 million doses. “COVID infection can seriously harm kids, and they can avoid infection by vaccination and boosting,” he emphasized.

Influenza Vaccines

ACIP said that the quadrivalent recombinant influenza vaccine (RIV4) was added as an option for pregnant women after the first randomized clinical trial showed it was as safe as the quadrivalent, egg-based inactivated influenza vaccines (IIV4).

ACIP also reported low to no protection from the 2021-2022 flu vaccine against the A/H3N2 predominant strain. The 2022-2023 flu vaccine seems to be a better match based on early reports of the southern hemisphere flu season.

RSV Vaccines

Both GlaxoSmithKline and Pfizer adult vaccines for respiratory syncytial virus (RSV) are being evaluated after phase 3 clinical trials. Jointly, Sanofi and AstraZeneca are developing a long-acting monoclonal antibody for infants, which is designed to protect babies up to 5 months after a single dose. The FDA may license these products at some point in 2023 and recommendations from ACIP will come following licensure.

Pneumococcal Vaccines

For patients with prior pneumococcal 13-valent conjugate vaccine (PCV13; Prevnar-13) vaccination ACIP said that there is a benefit from being vaccinated for the 7 additional strains of pneumonia found in the 20-valent vaccine (pneumococcal 20-valent conjugate vaccine [PCV-20]; Prevnar-20). For patients who received PCV13 updated recommendations are:

• For adults aged ≥19 years who were previously recommended to receive PCV13 followed by pneumococcal polysaccharide vaccine (PPSV23), but who have received only PCV13, ACIP recommends either PCV20 at least 1 year after the PCV13 dose, or PPSV23 as previously recommended.
• For adults aged ≥65 years who have previously had PCV13 and PPSV23, ACIP advises that PCV20 may be given at least 5 years after the most recent pneumococcal vaccine dose based on shared clinical decision-making.
• For adults who are immunocompromised, who have cerebrospinal fluid leak, or who have cochlear implants who have had PCV13 and ≥1 PPSV23 doses (before age 65) but who have not completed all previously recommended doses of PPSV23, ACIP advises either PCV20 at least 5 years after the most recent pneumococcal vaccine dose or PPSV23 as previously recommended.