Insight on the CDC's 2021 Immunization Update

The CDC’s update to the immunization schedule highlights 2 separate schedules—child and adolescent (birth through 18 years of age) and adult (19 years of age and older)—and includes updates to the influenza vaccine, meningococcal vaccine, and the new COVID-19 vaccine, according to a session at the virtual National Association of Pediatric Nurse Practitioners 2021 Annual Meeting.¹

Mary Beth Koslap-Petraco, DNP, PPCNP-BC, CPNP, FAANP, lead the discussion on specific vaccine changes that are important to bring to health care professionals’ attention. For example, in terms of the diptheria-tetanus-acellular pertussis (DTaP) vaccine, the notes were revised to include a “special situations” section containing information about the recommendation for use of DTaP in wound management.¹

In last year’s update, the Haemophilus influenzae B vaccine (HIB booster) was revised, which indicates that catch-up vaccination is not recommended for previously unvaccinated children who are 5 years of age and older. In this year’s HIB note, it is indicated that for catch-up vaccination, no further doses are recommended if a previous note was administered at 15 months of age and older.²

Further, the “birth dose” section of the HepB note contains additional text clarifying the recommendation for infants with a birth weight of less than 2000 grams who have HBsAg-negative mothers, according to Koslap-Petraco.¹

In terms of the pneumococcal vaccine, Koslap-Petraco reiterated the importance of administering PCV13 before PPSV23.

“PPSV23 turns off PCV13,” Koslap-Petraco said. “If you give a dose of PPSV23 and you give PCV13 too soon, it will be like you didn’t even give them the PCV13 because the way these vaccines work, they compete with each other because of their mechanisms of action, so you always want to be careful to give PCV13 first with the appropriate interval.” ¹

A major addition to this year’s immunization schedule is the COVID-19 section, which addresses the issue of vaccine coadministration. These vaccines should be administered alone, with a minimum interval of 14 days before or after administration of any other vaccines. As for vaccinating children, Koslap-Petraco mentioned the current ongoing studies from Pfizer, Moderna, and AstraZeneca that are focused on the 16 years and younger population.

“We should be seeing these results by the end of summer,” Koslap-Petraco said.¹

Keeping up with routine vaccines is an essential preventive service for children, adolescents, and adults, including pregnant people, that should not be delayed because of the COVID-19 pandemic, according to Koslap-Petraco. She emphasized the importance of assessing the vaccination status of all children and adolescents at each patient visit, avoiding missed opportunities for vaccination, and ensure timely vaccine catch-up.¹

“We have dropped off on vaccines, and one of our biggest fears we have is that we are going to see a vaccine preventable disease outbreak because children are just not getting their vaccines on time,” Koslap-Petraco said.¹

REFERENCES

• Koslap-Petraco MB. Immunization Update 2021- Focus on the Schedule. 2021 NAPNAP Virtual Conference.
• Murphy, Jill. CDC releases 2020 immunization update. Contemporary Clinic. Published June 11, 2020. Accessed March 26, 2021. https://www.contemporaryclinic.com/view/cdc-releases-2020-immunization-update