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1.
MMWR Morb Mortal Wkly Rep ; 73(15): 345-350, 2024 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-38635488

RESUMO

Meningococcal disease is a life-threatening invasive infection caused by Neisseria meningitidis. Two quadrivalent (serogroups A, C, W, and Y) meningococcal conjugate vaccines (MenACWY) (MenACWY-CRM [Menveo, GSK] and MenACWY-TT [MenQuadfi, Sanofi Pasteur]) and two serogroup B meningococcal vaccines (MenB) (MenB-4C [Bexsero, GSK] and MenB-FHbp [Trumenba, Pfizer Inc.]), are licensed and available in the United States and have been recommended by CDC's Advisory Committee on Immunization Practices (ACIP). On October 20, 2023, the Food and Drug Administration approved the use of a pentavalent meningococcal vaccine (MenACWY-TT/MenB-FHbp [Penbraya, Pfizer Inc.]) for prevention of invasive disease caused by N. meningitidis serogroups A, B, C, W, and Y among persons aged 10-25 years. On October 25, 2023, ACIP recommended that MenACWY-TT/MenB-FHbp may be used when both MenACWY and MenB are indicated at the same visit for the following groups: 1) healthy persons aged 16-23 years (routine schedule) when shared clinical decision-making favors administration of MenB vaccine, and 2) persons aged ≥10 years who are at increased risk for meningococcal disease (e.g., because of persistent complement deficiencies, complement inhibitor use, or functional or anatomic asplenia). Different manufacturers' serogroup B-containing vaccines are not interchangeable; therefore, when MenACWY-TT/MenB-FHbp is used, subsequent doses of MenB should be from the same manufacturer (Pfizer Inc.). This report summarizes evidence considered for these recommendations and provides clinical guidance for the use of MenACWY-TT/MenB-FHbp.


Assuntos
Infecções Meningocócicas , Vacinas Meningocócicas , Neisseria meningitidis Sorogrupo B , Neisseria meningitidis , Humanos , Estados Unidos/epidemiologia , Comitês Consultivos , Vacinas Combinadas , Imunização , Infecções Meningocócicas/prevenção & controle
3.
J Fam Pract ; 72(9): E17-E20, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37976341

RESUMO

In addition to 3 vaccines, there's also a new monoclonal antibody for prevention of respiratory syncytial virus. Learn how each can be used in infants and children, adults, and pregnant people.


Assuntos
Infecções por Vírus Respiratório Sincicial , Vacinas contra Vírus Sincicial Respiratório , Vírus Sincicial Respiratório Humano , Lactente , Gravidez , Feminino , Humanos , Adulto , Criança , Infecções por Vírus Respiratório Sincicial/prevenção & controle , Vacinas Atenuadas , Anticorpos Monoclonais , Anticorpos Antivirais
4.
J Fam Pract ; 72(8): 340-347, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37862624

RESUMO

Although there are few changes from last year, there is a new approach to administering egg-based vaccine to those with a history of egg allergy.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Vacinas contra Influenza , Influenza Humana , Humanos , Lactente , Influenza Humana/prevenção & controle , Vírus da Influenza A Subtipo H3N2 , Vacinação , Esquemas de Imunização
6.
MMWR recomm. rep ; RR-3(1-39): 1-39, 20230905. tab
Artigo em Inglês | BIGG - guias GRADE | ID: biblio-1512305

RESUMO

his report compiles and summarizes all published recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) for use of pneumococcal vaccines in adults aged ≥19 years in the United States. This report also includes updated and new clinical guidance for implementation from CDC. Before 2021, ACIP recommended 23-valent pneumococcal polysaccharide vaccine (PPSV23) alone (up to 2 doses), or both a single dose of 13-valent pneumococcal conjugate vaccine (PCV13) in combination with 1­3 doses of PPSV23 in series (PCV13 followed by PPSV23), for use in U.S. adults depending on age and underlying risk for pneumococcal disease. In 2021, two new pneumococcal conjugate vaccines (PCVs), a 15-valent and a 20-valent PCV (PCV15 and PCV20), were licensed for use in U.S. adults aged ≥18 years by the Food and Drug Administration. ACIP recommendations specify the use of either PCV20 alone or PCV15 in series with PPSV23 for all adults aged ≥65 years and for adults aged 19­64 years with certain underlying medical conditions or other risk factors who have not received a PCV or whose vaccination history is unknown. In addition, ACIP recommends use of either a single dose of PCV20 or ≥1 dose of PPSV23 for adults who have started their pneumococcal vaccine series with PCV13 but have not received all recommended PPSV23 doses. Shared clinical decision-making is recommended regarding use of a supplemental PCV20 dose for adults aged ≥65 years who have completed their recommended vaccine series with both PCV13 and PPSV23. Updated and new clinical guidance for implementation from CDC includes the recommendation for use of PCV15 or PCV20 for adults who have received PPSV23 but have not received any PCV dose. The report also includes clinical guidance for adults who have received 7-valent PCV (PCV7) only and adults who are hematopoietic stem cell transplant recipients.


Assuntos
Humanos , Adulto , Pneumonia Pneumocócica/imunologia , Programas de Imunização , Vacinas Pneumocócicas , Cobertura Vacinal , Infecções Pneumocócicas/epidemiologia , Estados Unidos/epidemiologia
7.
J Fam Pract ; 72(6): 260-263, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37549402

RESUMO

The CDC recently issued guidance on screening for hepatitis B infection. Here's a look at how (and why) these recommendations differ from those of the USPSTF.


Assuntos
Hepatite B , Programas de Rastreamento , Humanos , Estados Unidos/epidemiologia , Hepatite B/diagnóstico , Hepatite B/prevenção & controle , Centers for Disease Control and Prevention, U.S.
8.
J Fam Pract ; 72(4): 179-182, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37224541

RESUMO

The US Preventive Services Task Force made 24 recommendations last year. But the ones highlighted here are most likely to affect your daily practice.


Assuntos
Comitês Consultivos , Radar , Humanos , Serviços Preventivos de Saúde
9.
J Fam Pract ; 72(2): 89-92, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36947790

RESUMO

Although COVID-19 vaccination remains at the forefront, ACIP has offered guidance on MMR, pneumococcal, influenza, and travel vaccines. Here's a round-up.


Assuntos
COVID-19 , Vacinas contra Influenza , Influenza Humana , Humanos , Estados Unidos , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Influenza Humana/prevenção & controle , Vacinas Pneumocócicas , Vacinação , Esquemas de Imunização , Comitês Consultivos
10.
J Fam Pract ; 71(8): 362-365, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36508557

RESUMO

Any one of the HD-IIV4, aIIV4, or RIV4 vaccines is recommended over the SD-IIV4 options for those ages ≥ 65 years. Flucelvax is now approved for those ages ≥ 6 months.


Assuntos
Vacinas contra Influenza , Influenza Humana , Humanos , Idoso , Lactente , Influenza Humana/prevenção & controle , Vacinas de Produtos Inativados , Anticorpos Antivirais
11.
PLoS One ; 17(12): e0278624, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36473010

RESUMO

In December 2020, an interim recommendation for the use of Pfizer-BioNTech COVID-19 vaccine in persons aged ≥16 years was made under Food and Drug Administration's Emergency Use Authorization. In preparation for Biologics License Application approval, we conducted a systematic review and meta-analysis to inform the U.S. Centers for Disease Control and Prevention's Advisory Committee for Immunization Practice's (ACIP) decision-making for a standard recommendation. We conducted a rapid systematic review and meta-analysis of Pfizer-BioNTech vaccine effectiveness (VE) against symptomatic COVID-19, hospitalization due to COVID-19, death due to COVID-19, and asymptomatic SARS-CoV-2 infection. We identified studies through August 20, 2021 from an ongoing systematic review conducted by the International Vaccine Access Center and the World Health Organization. We evaluated each study for risk of bias using the Newcastle-Ottawa Scale. Pooled estimates were calculated using meta-analysis. The body of evidence for each outcome was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. We identified 80 articles, selected 35 for full-text review, and included 26. The pooled VE of Pfizer-BioNTech COVID-19 vaccine was 92.4% (95% CI: 87.5%-95.3%) against symptomatic COVID-19 with moderate evidence certainty (eight studies), 94.3% (95% CI: 87.9%-97.3%) against hospitalization due to COVID-19 with moderate certainty (eight studies), 96.1% (95% CI: 91.5%-98.2%) against death due to COVID-19 with moderate certainty (four studies), and 89.3% (88.4%-90.1%) against asymptomatic SARS-CoV-2 infection with very low certainty (two studies). The Pfizer-BioNTech COVID-19 vaccine demonstrated high effectiveness in all pre-specified outcomes and extended knowledge of the vaccine's benefits to outcomes and populations not informed by the RCTs. Use of an existing systematic review facilitated a rapid meta-analysis to inform an ACIP policy decision. This approach can be utilized as additional COVID-19 vaccines are considered for standard recommendations by ACIP.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Estados Unidos , Humanos , Vacina BNT162 , COVID-19/epidemiologia , COVID-19/prevenção & controle , SARS-CoV-2 , Políticas
12.
MMWR recomm. rep ; 70(45): 1579-1583, Nov. 12, 2022. tab
Artigo em Inglês | BIGG - guias GRADE | ID: biblio-1397007

RESUMO

The Pfizer-BioNTech COVID-19 (BNT162b2) vaccine is a lipid nanoparticle­formulated, nucleoside-modified mRNA vaccine encoding the prefusion spike glycoprotein of SARS-CoV-2, the virus that causes COVID-19. On August 23, 2021, the Food and Drug Administration (FDA) approved a Biologics License Application (BLA) for use of the Pfizer-BioNTech COVID-19 vaccine, marketed as Comirnaty (Pfizer, Inc.), in persons aged ≥16 years (1). The Pfizer-BioNTech COVID-19 vaccine is also recommended for adolescents aged 12­15 years under an Emergency Use Authorization (EUA) (1). All persons aged ≥12 years are recommended to receive 2 doses (30 µg, 0.3 mL each), administered 3 weeks apart (2,3). As of November 2, 2021, approximately 248 million doses of the Pfizer-BioNTech COVID-19 vaccine had been administered to persons aged ≥12 years in the United States.* On October 29, 2021, FDA issued an EUA amendment for a new formulation of Pfizer-BioNTech COVID-19 vaccine for use in children aged 5­11 years, administered as 2 doses (10 µg, 0.2 mL each), 3 weeks apart (Table) (1). On November 2, 2021, the Advisory Committee on Immunization Practices (ACIP) issued an interim recommendation† for use of the Pfizer-BioNTech COVID-19 vaccine in children aged 5­11 years for the prevention of COVID-19. To guide its deliberations regarding recommendations for the vaccine, ACIP used the Evidence to Recommendation (EtR) Framework§ and incorporated a Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.¶ The ACIP recommendation for the use of the Pfizer-BioNTech COVID-19 vaccine in children aged 5­11 years under an EUA is interim and will be updated as additional information becomes available. The Pfizer-BioNTech COVID-19 vaccine has high efficacy (>90%) against COVID-19 in children aged 5­11 years, and ACIP determined benefits outweigh risks for vaccination. Vaccination is important to protect children against COVID-19 and reduce community transmission of SARS-CoV-2.


Assuntos
Humanos , Pré-Escolar , Criança , Programas de Imunização/normas , COVID-19/prevenção & controle , Vacina BNT162/uso terapêutico , Vacina BNT162/imunologia
13.
J Fam Pract ; 71(7): E1-E2, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36179136
14.
MMWR Morb Mortal Wkly Rep ; 71(37): 1174-1181, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36107786

RESUMO

The 13-valent pneumococcal conjugate vaccine (PCV13 [Prevnar 13, Wyeth Pharmaceuticals, Inc, a subsidiary of Pfizer, Inc]) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23 [Merck Sharp & Dohme LLC]) have been recommended for U.S. children, and the recommendations vary by age group and risk group (1,2). In 2021, 15-valent pneumococcal conjugate vaccine (PCV15 [Vaxneuvance, Merck Sharp & Dohme LLC]) was licensed for use in adults aged ≥18 years (3). On June 17, 2022, the Food and Drug Administration (FDA) approved an expanded usage for PCV15 to include persons aged 6 weeks-17 years, based on studies that compared antibody responses to PCV15 with those to PCV13 (4). PCV15 contains serotypes 22F and 33F (in addition to the PCV13 serotypes) conjugated to CRM197 (genetically detoxified diphtheria toxin). On June 22, 2022, CDC's Advisory Committee on Immunization Practices (ACIP) recommended use of PCV15 as an option for pneumococcal conjugate vaccination of persons aged <19 years according to currently recommended PCV13 dosing and schedules (1,2). ACIP employed the Evidence to Recommendation (EtR) Framework,* using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE)† approach to guide its deliberations regarding use of these vaccines. Risk-based recommendations on use of PPSV23 for persons aged 2-18 years with certain underlying medical conditions§ that increase the risk for pneumococcal disease have not changed.


Assuntos
Comitês Consultivos , Toxina Diftérica , Adolescente , Adulto , Criança , Humanos , Esquemas de Imunização , Vacinas Pneumocócicas , Estados Unidos/epidemiologia , Vacinação , Vacinas Conjugadas
15.
J Fam Pract ; 71(6): 262-264, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35994769

RESUMO

New evidence is reshaping the role of low-dose aspirin in primary prevention. More selective decisions are now urged.


Assuntos
Aspirina , Doenças Cardiovasculares , Aspirina/uso terapêutico , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/prevenção & controle , Humanos , Prevenção Primária
17.
MMWR Morb Mortal Wkly Rep ; 71(22): 734-742, 2022 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-35653347

RESUMO

Certain laboratorians and health care personnel can be exposed to orthopoxviruses through occupational activities. Because orthopoxvirus infections resulting from occupational exposures can be serious, the Advisory Committee on Immunization Practices (ACIP) has continued to recommend preexposure vaccination for these persons since 1980 (1), when smallpox was eradicated (2). In 2015, ACIP made recommendations for the use of ACAM2000, the only orthopoxvirus vaccine available in the United States at that time (3). During 2020-2021, ACIP considered evidence for use of JYNNEOS, a replication-deficient Vaccinia virus vaccine, as an alternative to ACAM2000. In November 2021, ACIP unanimously voted in favor of JYNNEOS as an alternative to ACAM2000 for primary vaccination and booster doses. With these recommendations for use of JYNNEOS, two vaccines (ACAM2000 and JYNNEOS) are now available and recommended for preexposure prophylaxis against orthopoxvirus infection among persons at risk for such exposures.


Assuntos
Exposição Ocupacional , Orthopoxvirus , Varíola , Vacinas , Comitês Consultivos , Humanos , Imunização , Varíola/prevenção & controle , Estados Unidos/epidemiologia , Vacinação , Vírus Vaccinia
18.
J Fam Pract ; 71(4): 170-175, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35730714

RESUMO

Offer pregnant women behavioral counseling to promote healthy weight gain. Screen for type 2 diabetes and prediabetes in adults ages 35 to 70 years who are overweight or obese.


Assuntos
Diabetes Mellitus Tipo 2 , Adulto , Idoso , Aconselhamento , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/prevenção & controle , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/prevenção & controle , Sobrepeso/diagnóstico , Gravidez , Aumento de Peso
19.
MMWR recomm. rep ; 71(11): 416-421, March 18, 2022. tab
Artigo em Inglês | BIGG - guias GRADE | ID: biblio-1397081

RESUMO

The mRNA-1273 (Moderna) COVID-19 vaccine is a lipid nanoparticle-encapsulated, nucleoside-modified mRNA vaccine encoding the stabilized prefusion spike glycoprotein of SARS-CoV-2, the virus that causes COVID-19. During December 2020, the vaccine was granted Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA), and the Advisory Committee on Immunization Practices (ACIP) issued an interim recommendation for use among persons aged ≥18 years (1), which was adopted by CDC. During December 19, 2020­January 30, 2022, approximately 204 million doses of Moderna COVID-19 vaccine were administered in the United States (2) as a primary series of 2 intramuscular doses (100 µg [0.5 mL] each) 4 weeks apart. On January 31, 2022, FDA approved a Biologics License Application (BLA) for use of the Moderna COVID-19 vaccine (Spikevax, ModernaTX, Inc.) in persons aged ≥18 years (3). On February 4, 2022, the ACIP COVID-19 Vaccines Work Group conclusions regarding recommendations for the use of the Moderna COVID-19 vaccine were presented to ACIP at a public meeting. The Work Group's deliberations were based on the Evidence to Recommendation (EtR) Framework,* which incorporates the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach† to rank evidence quality. In addition to initial clinical trial data, ACIP considered new information gathered in the 12 months since issuance of the interim recommendations, including additional follow-up time in the clinical trial, real-world vaccine effectiveness studies, and postauthorization vaccine safety monitoring. ACIP also considered comparisons of mRNA vaccine effectiveness and safety in real-world settings when first doses were administered 8 weeks apart instead of the original intervals used in clinical trials (3 weeks for BNT162b2 [Pfizer-BioNTech] COVID-19 vaccine and 4 weeks for Moderna COVID-19 vaccine). Based on this evidence, CDC has provided guidance that an 8-week interval might be optimal for some adolescents and adults. The additional information gathered since the issuance of the interim recommendations increased certainty that the benefits of preventing symptomatic and asymptomatic SARS-CoV-2 infection, hospitalization, and death outweigh vaccine-associated risks of the Moderna COVID-19 vaccine. On February 4, 2022, ACIP modified its interim recommendation to a standard recommendation§ for use of the fully licensed Moderna COVID-19 vaccine in persons aged ≥18 years.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Programas de Imunização/normas , COVID-19/prevenção & controle , Vacina de mRNA-1273 contra 2019-nCoV/administração & dosagem , Vacina de mRNA-1273 contra 2019-nCoV/imunologia
20.
J Fam Pract ; 71(2): 80-84, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35507818

RESUMO

Here are the latest recommendations on the hepatitis, pneumococcal, zoster, rabies, and dengue vaccines.


Assuntos
Herpes Zoster , Vacinas Pneumocócicas , Comitês Consultivos , Herpes Zoster/prevenção & controle , Humanos , Esquemas de Imunização , Estados Unidos , Vacinação
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