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ACIP Roundup: Changes to the 2023 Immunization Schedule (Oct 2022)

February 15, 2023

It’s tough to keep up with all of the changes happening in the world of vaccines.

That’s why, as a service to our partners (and any other interested parties, welcome!), we’re going to start providing a regular summary of the changes and additions to the 2023 immunization schedule from the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) meeting, the most recent of which was held in October 2022.

Child and Adolescent Immunization Schedule Changes

In October 2022, the ACIP made changes to the 2023 immunization schedule for children and adolescents that include new or updated recommendations for the COVID-19 vaccine and pneumococcal conjugate vaccine. 

Updated Recommendations for Pneumococcal Vaccine
(The CDC’s VaxAdvisor app is a great resource for figuring out which pneumo vaccine to give your patients and when.)

  • PCV15 has been added to the routine immunization schedule: language was added stating that 13-valent pneumococcal conjugate vaccine (PCV13) and PCV15 can be used interchangeably in both healthy children and those with any risk for invasive pneumococcal disease.
  • Language for the minimum interval between doses 3 and 4 has been revised to clarify when a fourth dose is indicated. The text now reads “This dose is only necessary for children aged 12–59 months regardless of risk, or aged 60–71 months with any risk, who received 3 doses before age 12 months.”

Updated Recommendations for COVID-19 Vaccine

  • A new row has been added with the columns for age 6 months–18 years highlighted in yellow to indicate the recommended age for COVID-19 vaccine (available here).
  • A new section was added to provide additional details on the use of COVID-19 vaccines. The Routine Vaccination section describes the recommendations for primary series in the general population, and the Special Situations section describes the recommendations for primary series in persons who are moderately or severely immunocompromised. For booster dose vaccination in all populations, and guidance for Janssen (Johnson & Johnson) COVID-19 vaccine recipients, hyperlinks are included referring healthcare providers to the latest guidance. In addition, hyperlinks to the current COVID-19 vaccination schedules, use of COVID-19 preexposure prophylaxis in persons who are moderately or severely immunocompromised, as well as Emergency Use Authorization indications for COVID-19 vaccines, have been added.

Adult Immunization Schedule Changes

In October 2022, the ACIP made changes to the 2023 immunization schedule for adults that include new or updated recommendations for influenza vaccines and pneumococcal vaccines.

Updated Recommendations for Influenza Vaccine

  • Information was added to the routine vaccination section for persons aged ≥65 years stating that any one of quadrivalent high-dose inactivated influenza vaccine, quadrivalent recombinant influenza vaccine, or quadrivalent adjuvanted inactivated influenza vaccine is preferred for this age group.

Updated Recommendations for Pneumococcal Vaccine
The section has been substantially updated to reflect ACIP’s new recommendations for the use of PCV15 and PCV20 in persons who previously received pneumococcal vaccines. (The CDC’s VaxAdvisor app is a great resource for figuring out which pneumo vaccine to give your patients and when.)

  • For those who have not previously received a dose of PCV13, PCV15, or PCV20 or whose previous vaccination history is unknown: 1 dose PCV15 OR 1 dose PCV20. If PCV15 is used, this should be followed by a dose of PPSV23 given at least 1 year after the PCV15 dose. A minimum interval of 8 weeks between PCV15 and PPSV23 can be considered for adults with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak to minimize the risk of invasive pneumococcal disease caused by serotypes unique to PPSV23 in these vulnerable groups.
  • For those who have previously received both PCV13 and PPSV23, AND PPSV23 was received at age 65 years or older, based on shared clinical decision-making, 1 dose of PCV20 should be administered at least 5 years after the last pneumococcal vaccine dose.
  • For those who have previously received only PCV13, 1 dose PCV20 at least 1 year after the PCV13 dose OR complete the recommended PPSV23 series as described here.

February 15, 2023