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Prevention of RSV, Pneumococcal Disease, and Influenza in Pediatric Patients

In 3 articles, the American Academy of Pediatrics summarizes recommendations of the Advisory Committee on Immunization Practices (ACIP) for the use of vaccines for the prevention and control of respiratory syncytial virus (RSV), pneumococcal disease, and influenza in children during the 2023–2024 season.

The ACIP is recommending the monoclonal antibody nirsevimab for the prevention of RSV disease in all infants, AAP reported. The use of the new RSV vaccine in pregnant women is under consideration at FDA; the product is already approved for use in older adults. Recommendations for “pneumococcal vaccines for children include the pneumococcal 13-valent conjugate vaccine (PCV13), the 23-valent pneumococcal polysaccharide vaccine (PPSV23), and the 15-valent pneumococcal conjugate vaccine (PCV15) that was approved for children in June 2022 (containing the additional serotypes 22F and 33F),” AAP writes. “The 20-valent pneumococcal conjugate vaccine (PCV20), which contains PCV13 serotypes + 7 additional (8, 10A, 11A, 12F, 15B, 22F, and 33F), was licensed for use in children in April 2023. The current PCV schedule is at 2, 4, 6, and 12-15 months of age (‘3+1’), and additional PPSV23 vaccination is recommended for immunocompromised children and adults and those with specific chronic medical conditions.”

An updated statement describes the routine use of influenza vaccine and antiviral medications in pediatric patients. AAP recommends “annual influenza vaccination of all children without medical contraindications starting at 6 months of age. Children are at risk for hospitalization and death from influenza. Influenza vaccination is an important strategy for protecting children and the broader community, as well as reducing the overall burden of respiratory illnesses when other viruses are cocirculating. Any licensed influenza vaccine appropriate for age and health status can be administered, ideally as soon as possible in the season, without preference for one product or formulation over another.”

A technical report supports the influenza recommendations by summarizing “recent influenza seasons, morbidity and mortality in children, vaccine effectiveness, and vaccination coverage, and provides detailed guidance on vaccine storage, administration, and implementation. The report also provides a brief background on inactivated and live-attenuated influenza vaccines, available vaccines this season, vaccination during pregnancy and breastfeeding, diagnostic testing for influenza, and antiviral medications for treatment and chemoprophylaxis. Strategies to promote vaccine uptake are emphasized.”

Source: Pediatrics