National Immunization Awareness Month (NIAM) is an annual observance held in August to highlight the importance of routine vaccination for people of all ages. Last year’s post highlighted select immunization guidelines. This year we are focusing on the changes and updates made by the Centers for Disease Control and Prevention (CDC) to the updated 2023 immunization schedule.

2023 Immunization Schedule Changes

VaccineChildren & AdolescentsAdults
General• Added COVID-19 vaccines, Priorix®, and 15-valent pneumococcal conjugate vaccine (PCV15) to the schedule.

• Added new abbreviations for the COVID-19 vaccine products. These abbreviations contain information on the vaccine’s valency (i.e., monovalent versus bivalent, indicated by “1v” and “2v,” respectively) and vaccine platform (mRNA versus acellular protein subunit, or “aPS”). 

• Revised the text for vaccine injury compensation to include the Countermeasures Injury Compensation Program (CICP) for COVID-19 vaccines.
• Added COVID-19 vaccines, PreHevbrio™ and Priorix® to the schedule. 

• Added new abbreviations for the COVID-19 vaccine products. These abbreviations contain information on the vaccine’s valency (i.e., monovalent versus bivalent, indicated by “1v” and “2v,” respectively) and vaccine platform (mRNA versus acellular protein subunit, or “aPS”). 

• Added American Pharmacists Association as an approving partner. Revised the text for vaccine injury compensation to include the Countermeasures Injury Compensation Program (CICP) for COVID-19 vaccines.
COVID-19• Note added to provide guidance for use of COVID-19 vaccines. View All Changes & Updates• Note added to provide guidance for use of COVID-19 vaccines. View All Changes & Updates 
Dengue• Clarified that dengue vaccine is recommended for seropositive children living in endemic areas, not for children traveling/visiting endemic dengue areas.N/A
Hepatitis B• Highlighted the recommendations for infants born to mothers who are hepatitis B surface antigen (HBsAg) positive, or whose HBsAg status is unknown. View All Changes & Updates

• Heplisav-B® and PreHevbrio® vaccines were added to the catch-up vaccination section for persons aged 18 years.
• Added PreHevbrio™ to the description of the 3-dose series, and information on the 4-dose series for persons on hemodialysis was moved to the “Special situations” section.

• Language added stating that persons aged ≥ 60 years with known risk factors for hepatitis B virus infection should complete a HepB vaccine series, while persons aged ≥ 60 years without known risk factors for hepatitis B virus infection may complete a HepB vaccine series.
Influenza• Updated to add recommendations for the 2022-23 influenza season. 

• Clarified that live attenuated influenza vaccines should not be administered to close contacts of immunosuppressed persons who require a protected environment. 

• Moved from appendix the recommendation for persons with egg allergy with symptoms other than hives.
• Updated to add recommendations for the 2022-23 influenza season.

• Clarified that any one of quadrivalent high-dose inactivated influenza vaccine, quadrivalent recombinant influenza vaccine, or quadrivalent adjuvanted inactivated influenza vaccine is preferred for adults aged 65 years or older. However, if none of these three vaccines is available, then any other age-appropriate influenza vaccine should be used for this age group. 

• Clarified that live attenuated influenza vaccines should not be administered to close contacts of immunosuppressed persons who require a protected environment. 

• Moved from appendix the recommendation for persons with egg allergy with symptoms other than hives.
MMR• Updated with recommendations for additional MMR doses in a mumps outbreak setting.
View All Changes & Updates
• Updated with recommendations for additional MMR doses in a mumps outbreak setting. 
View All Changes & Updates
Meningococcal• MenACWY was updated to include language stating the newly licensed Menveo® one-vial (all liquid) formulation should not be administered before age 10 years.• Added guidance stating that if the third dose of Trumenba® is administered earlier than 4 months after the second dose, a fourth dose should be administered at least 4 months after the third dose. 
MenB• The “Special situations” section was updated to add guidance stating that if the second dose is administered ≥ 6 months after the first dose, the third dose is not needed. Also, if the third dose of Trumenba® is administered earlier than 4 months after the second dose, a fourth dose should be administered at least 4 months after the third dose. N/A
Pneumococcal• Revised to include the recommendations for the use of 15-valent pneumococcal conjugate vaccine (PCV15).  View All Changes & Updates• Updated to reflect ACIP’s new recommendations for the use of PCV15 and PCV20 in persons who previously received pneumococcal vaccines.
View All Changes & Updates
Poliovirus• Added recommendations for adolescents aged 18 years who are at increased risk of exposure to polioviruses. 
View All Changes & Updates
• Updated to address recommendations for adults who are at increased risk of exposure to poliovirus although routine poliovirus vaccination of adults residing in the United States is not necessary. 
View All Changes & Updates
ZosterN/A• Updated to provide guidance for patients with serologic evidence of prior varicella susceptibility, and guidance for persons with immunocompromising conditions who do not have a documented history of prior varicella infection, varicella vaccination, or prior herpes zoster. View All Changes & Updates
Appendix• The header of the “Contraindications” column was changed to “Contraindicated or not recommended.”  

• Dengue: added language stating lack of laboratory confirmation of previous dengue virus infection is a contraindication.  

• Hepatitis B: revised to state Heplisav-B® and PreHevbrio® are not recommended during pregnancy; other hepatitis B vaccine products should be used. Weblinks to the Heplisav-B® and PreHevbrio™ pregnancy registries collecting data on inadvertent administration are provided.  

• Human papillomavirus: added language stating that HPV vaccine is not recommended during pregnancy.  

• MMR: added MMRV to this row. In addition, precaution was updated to state personal or family history of seizure of any etiology is a precaution for using MMRV. 
 
• Varicella: added language stating if MMRV is used, the precautions for MMR/MMRV should be reviewed.
• The header of the “Contraindications” column was changed to “Contraindicated or not recommended.”
  
• Hepatitis B: revised to state Heplisav-B® and PreHevbrio™ are not recommended during pregnancy; other hepatitis B vaccine products should be used. Weblinks to the Heplisav-B® and PreHevbrio® pregnancy registries collecting data on inadvertent administration are provided.  

• Human papillomavirus: added language stating that HPV vaccine is not recommended during pregnancy.

These immunizations guidelines and updates can help you discuss routine vaccinations with your patients and their families.


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