The Advisory Committee on Immunization Practices (ACIP) has released its 2024 Recommended Adult Immunization Schedule that includes four new vaccines. This year, the Schedule includes the respiratory syncytial virus (RSV) vaccine, the mpox vaccine, a new MenACWY-MenB combo vaccine, and updated versions of the COVID vaccine with both an mRNA and a protein-based adjuvanted formulation. The authors say this year’s Schedule is particularly important because many adults are not up-to-date on recommended vaccines. The complete schedule, including changes in the vaccine notes section, is published simultaneously in Annals of Internal Medicine and in the Center for Disease Control and Prevention (CDC)'s Morbidity and Mortality Weekly Report (MMWR).

Among notable changes in the 2024 schedule, RSV vaccine is a new addition. For pregnant persons, only Pfizer’s RSV vaccine (Abrysvo) is recommended and should be given to pregnant persons who are 32 weeks through 36 weeks gestation from September through January in most of the continental United States. For patients over the age of 60 years, any approved RSV vaccine can be administered and vaccination is based on shared decision-making. This means that for these patients, RSV vaccination is informed by whether the patient has any risk factors for severe RSV disease; a patient’s risk of exposure to RSV; a patient’s preferences for RSV vaccination; and the clinical discretion of the health care provider. As for COVID-19, all adults are now recommended to receive at least 1 dose of the updated (2023-2024 Formula) COVID-19 vaccine. The number of doses needed and intervals between doses may vary based on a patient’s prior vaccination history, immunocompromised status, and the vaccine product used. For the mpox vaccine, all adults in any age group at increased risk of becoming infected should get a 2-dose series of the vaccine. A complete list of risk factors for mpox is outlined in the notes section of the schedule. For polio vaccine, adults who are known or suspected to be unvaccinated or incompletely vaccinated should complete a 3-dose primary series. However, most adults who were born and raised in the United States can assume that they were vaccinated against polio as children unless there are specific reasons to believe they were not vaccinated.

The authors say this schedule is an important reference document for physicians who are struggling to increase vaccination rates in clinical practice. Currently, only 40.8 percent of adults have received an influenza vaccine and rates for the new COVID-19 and RSV vaccines are low at 17.2 percent and 15.9 percent, respectively. According to the authors of a commentary from City University of New York, too many adults are lost to misinformation and distrust of public health, in addition to the concept of “medical freedom” promoted by vaccine skeptics. The authors suggest that recommendations on how to communicate important vaccine messages to patients could be a useful and welcome addition to the schedule.

Source: ACIP