August 11, 2006
To: Vaccines for Children (VFC) Provider Sites
(Please post and share with all vaccine providers)
Re: New ACIP Recommendations for Varicella Vaccine; HPV and Influenza Vaccine Updates
New Recommendations for Varicella Vaccine
On August 3, 2006, the Centers for Disease Control (CDC) and Prevention's Advisory Committee on Immunization Practices (ACIP) issued Provisional Recommendations for the Prevention of Varicella to further improve protection against disease. Changes include routine two-dose varicella vaccination of children and second dose catch-up varicella vaccination for children, adolescents, and adults who previously had received only one dose. The ACIP also expanded recommendations for varicella-containing vaccines to promote wider use of the vaccine for adolescents, adults, and HIV-infected children and approved new criteria for evidence of immunity to varicella. Review the recommendations in full.
Guidelines for Use of State-supplied Varicella-containing Vaccines (Varicella, MMRV)
For routine vaccination, give 2 doses at 12-15 months and 4-6 years. As vaccine supply permits, a second dose of varicella vaccine (catch-up) may be administered to children who previously received one dose. The minimum interval recommended between doses for children <13 years of age is 3 months. However, i f the second dose is administered at least 28 days following the first dose, the second dose will not need to be repeated. For children > 13 years, the recommended interval between doses is 4-8 weeks.
Providers may begin ordering additional varicella vaccine with your next regular monthly order. The Immunization Program asks that you please order enough varicella vaccine to offset your current inventory of MMR and use up those vaccines prior to switching over to MMRV vaccine. MMRV is licensed for children 12 months - 12 years of age and should be used only when both vaccines are indicated. We also recommend that you maintain a small quantity of MMR and varicella vaccines as regular inventory items for special situations. Your cooperation in this matter is greatly appreciated and will help to minimize vaccine and funding losses. Thank you for your continued support of the State-Supplied Vaccine (SSV) Program.
HPV Vaccine Update
The ACIP has issued recommendations for the newly licensed human papillomavirus virus (HPV) vaccine. The vaccine is given in a series of three injections over a six-month period and is recommended for routine vaccination of girls at 11-12 years of age. The ACIP recommendation also allows for vaccination of girls as early as nine years old as well as vaccination of girls and women 13-26 years old. The Immunization Program is in the process of working with CDC to make this vaccine available through the SSV Program and will notify providers when it is available to order. For more information about HPV vaccine go to: http://www.cdc.gov/nip/vaccine/hpv/default.htm .
Influenza Vaccine
ACIP has expanded routine childhood influenza vaccine recommendations to include children 6- 59 months of age. Please consider this increase in numbers when preparing your estimates for ordering flu vaccine. You will be receiving additional information about ordering flu vaccine in the next few weeks. To review the 2006-2007 influenza recommendations in full go to: http://www.cdc.gov/mmwr/PDF/rr/rr5510.pdf .
Questions? Contact Mark Francesconi at 222- 5988or mark.francesconi@health.ri.gov for questions about vaccine ordering and supply or Patricia Raymond, RN at 222-5921or patricia.raymond@health.ri.gov for questions about vaccine recommendations.
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