ACIP Oct-2019 / Adult Immunization Schedule

Live blogging personal notes while viewing Oct-2019 ACIP meeting. My thoughts/opinions are in this color. 

Topic: Adult Immunization Schedule

Hunter: trying to harmonize child/adolescent/adult schedule. 

Friedman: reviewed updates to Adult Immunization Schedule, mostly the notes.

Sanchez asked for clarification of why LAIV is not rec for persons with cochlear implants. Not labeled contraindication or precaution because there is no data on safety in use with this population. Talbot: LAIV is used for HCW who refuse to get needles. Discussion around the complexity of the document and trying to keep it from getting further complex. Contraindication is not the same as not recommended is not the same as should not be used is not the same as precaution.

Hunter commented wanting specialist clinicians should do more vaccination and their difficulty around doing so.

Bernstein commented on language about pneumococcal vacs and order of bullet points (I think he had a valid points – this is likely around safety, the formatting of the comments can help or hurt busy clinicians quickly referring to these recs while caring for patients). 

Topic: Childhood Immunization Schedule

ACNM added as an approving org. You never get a seat at the table without compromise. 

Men ACWY – no reason to withhold vac in pregnancy (!) 

Messonier brought in subject matter expert about cochlear implants and use of LAIV – why it is not rec … persistent communication between nasal mucous membranes and brain (sorry, could not type fast enough to get down her exact language – I will try to go back once the vid is posted on the CDC website and revise this). Cochlear implant and persistent CSF – oral pharyngeal communications? Incidence reported to be 1-5% in cochlear implants – per Romero this is generally a problem with the original implants, not cochlear implants now in use. 








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