On Wednesday, June 26th the ACIP (Advisory Committee on Immunization Practices), the committee within the Centers for Disease Control and Prevention (CDC) that provides guidance regarding vaccine-preventable diseases in the U.S., made new HPV and pneumonia vaccine recommendations*:
HPV vaccine: (Human Papillomavirus 9-valent Vaccine, HPV Vaccine, Gardisil-9)
-The ACIP changed the maximum recommended age of men who should receive the vaccination to age 26. Previously, it was age 21, except under very specific circumstances. This brings the recommended maximum age of men in-line with the recommended age for women. Now, they are both 26.
-They voted that both men and women can get the vaccine up until and including age 45. They leave it up to you and your physician to decide if the vaccine is appropriate, rather than making it an outright recommendation to give the shot until age 45. Their reasoning is that, as we get older (beyond our mid 20’s), you are more likely to have been exposed to HPV. If you have already been exposed to some of the nine strains in the shot, the shot will be less effective. Previously, the HPV vaccine was “approved” by the FDA up to age 45, but not “recommended” by the ACIP in anyone over age 26.
Pneumonia 13 vaccine: (Pneumococcal Conjugate Vaccine 13-valent, Prevnar 13, PCV-13)
-The ACIP had previously recommended that all people age 65 and over receive PCV-13. Then, a year or more later, those people would be given the other pneumonia vaccine (Pneumococcal Polysaccharide Vaccine 23-valent, Pneumovax 23, PPV-23). Now, the decision regarding administering the PCV-13 vaccine is left up to you and your doctor. This change is in response to the decreasing risk in the US of being infected by pneumococcal pneumonia, the bacterial infection PVC-13 and PPV-23 protect against. Since we started routinely vaccinating children in 2010 with PCV-13 and adults age 65 and over in 2014, this bacteria is causing fewer infections!
In our NYC Travel Medicine clinic, we will consider the above recommendations for our travelers on a case-by-case basis. Regarding HPV vaccine, it will depend upon the traveler and his or her planned activities abroad. With respect to Prevnar 13 (PCV-13), we will likely continue to recommend the vaccination to nearly everyone 65 and over, since pneumococcal pneumonia exposure risk may be higher, in most cases, outside the United States.
*Please note: The CDC has not yet formally adopted these new recommendations. Approval from the CDC director is pending as of the writing of this blog post (June 26th, 2019)