In an educational session delivered during APhA2018 titled, "Your Annual Immunization Update," leading experts in pharmacy-based immunization delivery covered the latest news in vaccination practice and described what is on the horizon. The practice of immunization is constantly evolving. With vaccine recommendations and immunization schedules updated frequently and new vaccines continually emerging, it can be difficult for pharmacists and other healthcare practitioners to keep up to date.
The current Advisory Committee on Immunization Practices (ACIP) herpes zoster vaccine advisory, the speakers reported, indicates that recombinant zoster vaccine (RZV) is preferred over zoster vaccine live (ZVL) for the prevention of herpes zoster and related complications. In addition, RZV is recommended for the prevention of herpes zoster and related complications for immunocompetent adults aged ≥50 years, as well as for the prevention of herpes zoster and related complications for immunocompetent adults who previously received zoster vaccine live (ZVL).
With regard to the ACIP recommendation for mumps, persons previously vaccinated with two doses of a mumps-containing vaccine who are identified by public health as at increased risk for mumps because of an outbreak should receive a third dose of a mumps-containing vaccine to improve protection against mumps disease and its complications.
Regarding the effectiveness of the influenza vaccines, interim results for the 2017–2018 season (through February 3, 2018) indicate that vaccination reduced influenza medically attended illness by 36%. In addition, the speakers report these specific efficacy figures by age groups: 25% vaccine effectiveness (VE) against A(H3N2) for all ages; 51% VE in children aged 6 months to 8 years; 67% VE against A(H1N1)pdm09; and 42% VE against B (mostly B/Yamagata, not in IIV3).
For the 2018-2019 Northern Hemisphere influenza season, vaccines are recommended to protect against the following strains: A/Michigan/45/2015 (H1N1)pdm09-like virus; A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus; a B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage); and a B/Phuket/3073/2013-like virus (B/Yamagata/16/88 lineage).
On the pneumococcal disease front, the ACIP recommended routine use of 13-valent pneumococcal conjugate vaccine (PCV13) in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) for adults aged ≥65 years in 2014. Invasive pneumococcal disease among adults and children plateaued in 2014-2016, with reductions driven by types 19A and 7F. The session presenters indicated that the ACIP will continue monitoring changes in serotype distribution to inform future vaccine policy, and expects expanded indications for adults <65 years old.
Data collected over a recent period indicate that vaccine-administration techniques in pharmacies could benefit from improvement. Stephen Foster, PharmD, FAPhA, Professor, University of Tennessee College of Pharmacy Liaison for APhA, ACIP, said that according to VAERS reports from 2010 to 2016, 40% of reported cases of shoulder dysfunction following IIV occurred in pharmacies/stores compared with 32% in doctor’s offices and hospitals and 12% in the workplace.
The ACIP defined as shoulder pain and restricted range of motion following injection of IIV into the upper arm; the affected shoulder must be of same arm in which IIV was administered alone; onset <48 hours after IIV vaccination; and symptoms lasting longer than 1 week (to differentiate from injection-site reactions).
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Published March 27, 2018