ACIP Releases 2021 Child/Adolescent Vaccine Schedule

Marcia Frellick

Disclosures

February 11, 2021

The Centers for Disease Control and Prevention (CDC) today released the 2021 Childhood and Adolescent Immunization Schedule. It includes relatively few changes from last year's schedule but adds guidance on the COVID-19 vaccines.

Among the changes this year are updated language regarding the influenza vaccine, guidance on the COVID-19 vaccines, and changes regarding the prevention of disease attributable to meningococcal serogroups A, C, W, and Y, according to the CDC's Morbidity and Mortality Weekly Report (MMWR).

The updated schedule, which is revised each year by the Advisory Committee on Immunization Practices (ACIP) of the CDC, was published online on the CDC website and will be published on Friday in Pediatrics.

In the February 12 MMWR report released today, authored by A. Patricia Wodi, MD, with the CDC's Immunization Services Division, and colleagues, the "special situations" section was updated with guidance for providing the influenza vaccine to people who have egg allergy with symptoms other than hives: "[I]f using an influenza vaccine other than Flublok or Flucelvax, administer in a medical setting under the supervision of a health care provider who can recognize and manage severe allergic reactions."

In addition, the abbreviation for live attenuated influenza vaccine, LAIV, was changed to LAIV4.

The schedule now notes that children younger than 2 years are included among those who should not receive LAIV4.

The 2021 guidance also has new information on the quadrivalent meningococcal tetanus toxoid conjugate vaccine, MenACWY-TT, for use in preventing disease attributable to meningococcal serogroups A, C, W, and Y.

Instruction for catch-up vaccination was added for infants who received one dose of MenACWY-CRM at age 3 to 6 months.

ACIP recommends using COVID-19 vaccines within the scope of the Emergency Use Authorization or Biologics License Application for each vaccine.

Guidance this year adds interim recommendations for use of Pfizer-BioNTech COVID-19 vaccine for people at least 16 years old and the Moderna vaccine for people aged 18 years and older.

In a press release last week, the American Academy of Pediatrics (AAP) urged that all eligible adults and teens receive one of the COVID-19 vaccines as soon as the vaccines are available. The AAP highlights that the vaccine is safe and effective and urges clinical trials to include younger children.

"It is critical that pediatric patients of all ages be included in trials as quickly as possible," AAP President Lee Savio Beers, MD, said in a statement. "We are especially concerned about children who belong to racial, ethnic, and cultural groups that have been disproportionately affected by the pandemic or who have underlying conditions that place them at increased risk for developing severe COVID-19 infection."

The updated 2021 ACIP-recommended childhood and adolescent immunization schedules have been approved by the CDC, the AAP, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Nurse Midwives, the American Academy of Physician Assistants, and the National Association of Pediatric Nurse Practitioners. The schedules are revised every year to align with current recommendations for the use of vaccines licensed by the US Food and Drug Administration.

The CDC recommends that every child continue to receive all routine vaccinations during the pandemic.

As Medscape Medical News reported last month, a study from Colorado found that the number of children who have received routine vaccinations may have decreased. In that study, researchers evaluated data from the Colorado Immunization Information System that were collected from January 5 to May 2, 2020. After March 15, the average weekly number of vaccinations dropped by 31% for babies, 78% for 3- to 9-year-olds, and 82% for older children.

Morb Mortal Wkly Rep. Published online February 11, 2021. Full text

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune and Nurse.com and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick.

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