Wednesday, July 29, 2009

The ACIP Committee Recommendations

 

 

# 3560

 

 

 

It has been a long, but at times interesting, day of video  and press conferences on the pandemic H1N1 vaccination recommendations.  The bulk of today was taken up by the ACIP (Advisory Committee On Immunization Practices) conference, which ran nearly 7.5 hours.


At 4pm, Dr. Anne Schuchat held a CDC press conference which summarized some of the findings.

 

ACIP, which is a panel of 15 vaccine experts, usually meets three times a year to discuss and give advice to the CDC and HHS on routine vaccination matters.    Today was a special session to deal with the fall pandemic vaccination program, and to decide on which groups should be targeted to receive the pandemic vaccine first.

 

The morning was taken up by a series of presentations, with Q&A sessions following each, and this afternoon the panel discussed . . . and eventually voted on recommendations that now go to the CDC. 

 

The votes were not always unanimous, and there were concerns expressed by some of the panelists over the lack of data behind some of their recommendations.  

 

Nevertheless, two major recommendations came out of the ACIP meeting, which are now forwarded for approval and action by the CDC.  

These recommendations are for UNADJUVANTED Vaccines.

 

First, 5 high risk groups were selected to be targeted to receive the vaccine first.   These groups make up nearly 160 million Americans, and consist of:


Pregnant women  (4 Million)

Household contacts and caregivers of children under 6 mos (who cannot receive a vaccination themselves) (5 Million)

Health Care Workers & Medical Service Personnel (14 million)

Children and adolescents aged 6mos –24yrs (102 Million)

Persons aged 25-64 years of age with certain Medical Conditions (34 million)

 

Assuming that adequate supplies of vaccine are available in October or November, these five groups would all be targeted for vaccination first.  If 2 shots are required, then they would need roughly 300 million doses of vaccine.


While that  exceeds the amount of vaccine expected to be available in October and November, the expectation is that the uptake or percentage of those targeted who will take the vaccine – will be far less than 100%.

 

 

As a fallback position, in the event of a major shortfall of vaccine, a smaller `subgroup’ was identified who would received prioritization for the vaccine.   It was roundly hoped, however, that this would not be needed:

 

Pregnant women  (4 million)

Household contacts of Infants < 6mos (5 Million)

Health Care Workers With Direct Patient Contact (9 Million)

Children aged 6mos – 4 yrs (18 million)

Children under 19 with chronic medical conditions (6 Million)

 

Only after these high risk groups have been offered a vaccine, and sufficient vaccine supplies are on hand, would healthy adults between the ages of 25 and 64 be offered the vaccine.


Those over the age of 64 would be among the last to receive the H1N1 vaccine, although they are still strongly urged to get the seasonal vaccination. 

 

I’ll  have a bit more on the information we got from today’s ACIP meeting in my next blog, along with some thoughts regarding the challenges that lay ahead.