Advisory Committee on Immunization Practice Examines Vaccines
AAPA was in attendance at the October 2009 meeting of the Advisory Committee on Immunization Practice (ACIP), which looked a number of important issues relating to vaccines.
The Food and Drug Administration (FDA) licensed a bivalent HPV vaccine for use in females 10-25 years, bringing two products — Cervarix® (GlaxoSmithKline) and Gardasil® (Merck & Co.) — on the market. Although ACIP did recommend the routine use of the bivalent vaccine in girls 11-12 years and catch up for those ages 13-25 who were not previously vaccinated, they did not indicate a preference for either product. Instead, they highlighted the difference in the vaccines, leaving it to the practitioner to decide which product to use.
The bivalent vaccine is indicated for prevention of disease of cervical cancer, CIN grade 1 lesions, CIN grade 2 or worse, adenocarcinoma in situ, caused by HPV types 16 and 18. The HPV4 is indicated for prevention of cervical, vulvar and vaginal cancers caused by HPV types 16, 18 and genital warts caused by HPV types 6 and 11. Because there is currently no data on the interchangeability of the products, ACIP recommend completion of the vaccination series with the same HPV vaccine product whenever possible.
The HPV4 is also licensed in the U.S for the prevention of genital warts in males 9-26 years. Due to the cost effectiveness data (adding male vaccination to female only vaccination is not the most cost effective use of public health resources) and the lack of data on prevention of malignancies (anogenital cancers), ACIP members did not recommend the routine use of HPV 4 in this population; they gave a permissive recommendation for the use of the vaccine in males.
The committee voted to include HPV4 for boys in the federal Vaccines for Children (VFC) program, a significant move that triggers funding and makes the vaccine accessible to poor children. VFC provides free immunizations to those age 18 or under who are Medicaid eligible, are uninsured or underinsured, or are Native American or Alaska Native. The program also covers both vaccines for eligible girls.
An update on the vaccine supply of Hib, hepatitis A, hepatitis B, Tdap, DTap, DTap-IPV were given. A complete list of vaccine shortage and corrective measures can be found here. The minutes of the meeting and review of all items discussed will be posted here.
Doug Scott, This e-mail address is being protected from spambots. You need JavaScript enabled to view it
