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ACIP Meeting Minutes DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION Advisory Committee on Immunization Practices June 27-28, 2007 Atlanta, Georgia Record of the Proceedings C O N T E N T S Day 1, June 27, 2007 WELCOME AND INTRODUCTION Dr. Abramson......................................……………………………………………. 1 Dr. Pickering.....................................……………………………………………… 1 Dr. Abramson......................................……………………………………………. 2 HEPATITIS A VACCINE Introduction: Dr. Lieu............................................................................................... 3 Postexposure and Travel Prophylaxis: Dr. Novak.................................................... 4 Vote...........................................................................................................................10 Travel Recommendations: Dr. Novak...................................................................... 11 Vote.......................................................................................................................... 11 VFC Vote: Dr. Calugar............................................................................................ 12 VACCINE FINANCING Underinsured Children: Dr. Lee............................................................................... 13 AMA/AAP Immunization Congress: Dr. Orenstein................................................. 16 NVAC Financing Working Group: Dr. Birkhead..................................................... 18 PROPOSED REVISIONS TO THE ADULT IMMUNIZATION SCHEDULE Introduction: Dr. Morse............................................................................................. 21 Information: Dr. Mootrey.......................................................................................... 21 Vote........................................................................................................................... 24 PROPOSED REVISIONS TO THE CHILDHOOD/ADOLESCENT SCHEDULE Information: Dr. Calugar........................................................................................... 24 CDC IMMUNIZATION SAFETY UPDATE Information: Dr. Broder............................................................................................. 27 HERPES ZOSTER (SHINGLES) VACCINE Introduction: Dr. Treanor........................................................................................... 30 Information: Dr. Chaves............................................................................................ 30 COMBINATION VACCINES Activities and Next Steps: Ms. Stinchfield................................................................. 32 MENINGOCOCCAL CONJUGATE VACCINE (MCV4) Introduction: Dr. Baker............................................................................................... 33 Epidemiology: Dr. Cohn............................................................................................. 33 Economic Model of Expansion: Dr. Ortega-Sanchez................................................. 34 Vaccine Supply, Private Sector: Mr. Hosbach............................................................ 38 Vaccine Supply, Public Sector: Dr. Wallace............................................................... 39 i Vaccine Safety: Dr. Iskander....................................................................................... 39 New Recommendations: Dr. Cohn.............................................................................. 41 Vote...............................................................................................................................45 ECONOMIC ANALYSES OF VACCINES Introduction: Dr. Lieu.................................................................................................. 45 Discussion: Dr. Mark Messonnier............................................................................... 45 VACCINE SUPPLY AND IMPLEMENTATION Information: Dr. Wallace............................................................................................. 47 PNEUMOCOCCAL VACCINES Working Group Information: Dr. Morita..................................................................... 49 VACCINES DURING PREGNANCY/BREAST-FEEDING Introduction: Dr. Neuzil............................................................................................... 50 Information: Dr. Schrag............................................................................................... 50 Information: Dr. Skoff................................................................................................. 50 Day 2, June 28, 2007 INFLUENZA VACCINES Introduction and Update on LAIV: Dr. Fiore.............................................................. 53 FluMist Safety Monitoring: Dr. Broder....................................................................... 57 National Influenza Vaccine Summit: Dr. Mootrey...................................................... 60 USE OF VACCINES IN PERSON WITH HIV/AIDS Children and Adolescents: Dr. Seward.........................................................................62 Vote.............................................................................................................................. 66 Adults: Dr. Mootrey..................................................................................................... 66 UPDATE: ROTAVIRUS VACCINES Introduction: Dr. Treanor............................................................................................. 67 VAERS and VSD: Dr. Haber....................................................................................... 67 Data Interpretation: Dr. Patel....................................................................................... 68 RotaTeq and Kawasaki Disease: Dr. Izurieta.............................................................. 69 UPDATE: HPV VACCINES Introduction: Dr. Gilsdorf............................................................................................ 72 Safety Update: Dr. Iskander........................................................................................ 73 Quadrivalent Safety Update: Dr. Dubin...................................................................... 74 Future Considerations: Dr. Markowitz....................................................................... 79 UPDATE: VARICELLA Arkansas Outbreak: Ms. Lopez................................................................................... 82 ii AGENCY UPDATES............................................................................................................. 85 PUBLIC COMMENT..............................................................................................................87 List of Participants and Attendees…………………………………………………………...89 List of Acronyms…………………………………………………………………………….94 iii DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES June 27-28, 2007 Atlanta, Georgia Minutes of the Meeting The Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD) convened a meeting of the Advisory Committee on Immunization Practices (ACIP). The meeting was held on June 27-28, 2007 at CDC’s Global Communications Center in Atlanta, Georgia. The list of participants is appended to the minutes as Attachment 1. [Note: the list only includes persons who introduced themselves for the record, presented, made public comments, or registered prior to the meeting.] Day One, June 27, 2007 WELCOME AND INTRODUCTION Dr. Abramson welcomed attendees to the June 2007 ACIP meeting. Dr. Pickering introduced several international visitors, including Dr. Christine Ding-Ping Liu, Director of the Vaccine Center for the Centers of Disease Control in Taiwan, and members of the Turkish Adult Immunization Advisory Board. In addition, he welcomed the new liaison representative from Canada's National Advisory Committee on Immunization Practices, Dr. Joanne Langley from the Division of Infectious Diseases of the Department of Pediatrics, the Canadian Center for Vaccinology at Dalhousie University in Nova Scotia, and thanked Dr. Monika Naus, who was replaced by Dr. Langley. He noted several people who could not attend the meeting, including ACIP member Dr. Robin Womeodu. Dr. Geoff Evans was not present, but Dr. Indira Jevaji took his place; Dr. Norm Baylor was not present, but Dr. Florence Houn attended on his behalf; Dr. Wayne Hatchey from the Department of Defense was represented by Dr. Ted Cieslak; and neither Dr. Paul McKinney from the Association of Teachers of Preventive Medicine nor Dr. David Salisbury from the Department of Health in London were able to attend. Finally, Dr. Pickering announced that Dr. Sam Katz had been awarded a 2007 Pollin Prize for his contributions to pediatric infectious diseases and vaccine development, particularly his role in developing the measles vaccine with Nobel laureate Dr. John Enders. Dr. Pickering noted that the CDC web site had been revised and that the ACIP site is updated frequently with the current version of the meeting agenda, meeting minutes and presentations, ACIP recommendations and other ACIP activities (http://www.cdc.gov/vaccines/recs/acip/default.htm ). Dr. Pickering explained that the goal in appointing members to the ACIP is to achieve the greatest level of expertise while minimizing the potential for actual or perceived conflicts of interest. To summarize conflict-of-interest provisions
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