Categories: HEALTH

New consensus on adolescent vaccination schedules

On July 20, the Spanish Academy of Pediatrics (AEP), the Spanish Society of Adolescent Medicine (SEMA) and the Spanish Association of Vaccinology (AEV) released a consensus document “Adolescent Vaccination Schedule” and was recently updated. The new document details new recommendations for vaccination schedules for adolescents, without losing a global perspective on immunization.

AEP, SEMA and AEV update Adolescent Vaccination Calendar with new recommendations for adolescent immunization

In recent years, the yearbook has become even richer with the authorization of new vaccines: two triple bacterial vaccine (standard antigen load tetanus, adult reduced load diphtheria and pertussis three-component and five-component reduced antigen load acellular component; Tdpa3-VPI combination vaccine); Four virus vaccines (measles, rubella, mumps, and chickenpox); human papilloma virus (HPV); Quadrivalent influenza drugs (parenteral inactivation and intranasal attenuation); Vaccines against five Neisseria meningitidis serogroups (compared to MenB and tetravalent MenACWY) and SARS-CoV-2. In fact, some of these doses are already included in the funded schedule, while others are currently recommended individually or through clinical decisions made jointly by professionals, adolescents, and their parents.

Vaccination for healthy adolescents or in special circumstances

To improve vaccination coverage, the document distinguishes between two groups Within this age range: Healthy adolescents or adolescents with special circumstances (chronic, immune disorder or pregnancy) and Unvaccinated or underimmunized adolescents. For vaccinations of healthy teenagers or those with special circumstances such as chronic illness, immune disorders or pregnant teenagers, the document states that they must adhere to the same recommendations and standards as other age groups. Therefore, vaccination recommendations, such as post-exposure prophylaxis for sexually transmitted infections and traveler immunizations, should also be considered at this stage of life.

Unvaccinated adolescents are under-vaccinated or under-immunized

On the other hand, regarding the immunization of unvaccinated or underprotected adolescents, the document is dedicated to updating their vaccination status through so-called “vaccination.” “Rescue or Speed Guide”. despite this, You don’t have to restart the guides, just continue and complete them, regardless of the interval since the last dose. When filling it out, you must always take into account the number of vaccinations, the minimum age for each vaccine and the minimum interval between vaccinations, as well as the general principle of vaccinology: “a dose administered, an effective dose”.

Adolescence coverage

In fact, the latest data on vaccination coverage among adolescents in Spain reflect Coverage with the Td dose was 81% at 14 years of age; the first HPV vaccine was 90.3% effective, the full regimen was 80.8% effective, and MenACWY was 89.6% effective at 12 years of age.

Spain’s latest adolescent vaccination coverage rates for pertussis, HPV and MenACWY are all above 80%

Therefore, this document advocates Vaccination at school and provision of pre-vaccination information Vaccination services are provided to parents and adolescents by paediatricians and nursing staff, as well as all health professionals, with the aim of increasing vaccination coverage in this age group. For this purpose, it refers to a specific series of vaccinations: Invasive meningococcal disease (IMD); HPV; pertussis; influenza; COVID-19; vaccines for adolescents at risk and adolescent travellers.

Invasive meningococcal disease (IMD)

Adolescents are the second group most at risk for IMD, in fact Following the SARS-CoV-2 pandemic, the number of cases has increased since 2021, especially due to serogroup B.In Spain, so far in the 2022-2023 season, with data up to week 32, cases have doubled compared to the same period in the previous season (MenB – 91 vs. 47; MenW – 21, MenY -15 to 5). Many European countries (including Spain, South America, the United States, Canada, and Australia) have established systematic vaccination of male ACWY adolescents. In fact, MenB sponsors teenagers in the Czech Republic, some regions of Italy and South Australia.

Human papillomavirus (HPV)

In our country we have two vaccine preparations: one Bivalent, targeting genotypes 16 and 18, and nonvalent, containing 5 additional carcinogenic types and providing protection against genital warts. It is important to vaccinate them before sexual relations begin. The vaccination schedule consists of two doses if started between the ages of 9 and 14 years and three doses if started at the age of 15 years or older. For immunocompromised patients, regardless of age, this regimen always contains 3 doses.

pertussis

In Spain, 76% of pertussis cases between 2005 and 2020 occurred in children under 14 years old.However in the remaining groups The proportion of whooping cough cases has increased, with the incidence increasing 50-fold among people aged 15 to 49 years.

The vaccines available in our setting are Low antigen load Tdpa triple bacterial vaccine (Bodetella pertussis is three-component or five-component), Tdpa-IPV combined vaccine (three components of Bordetella pertussis) and DTPa-VPI combined vaccine (two or three components of Bordetella pertussis). Low-load vaccine (Tdpa) Recommended for primary vaccination and as a booster dose in adults.

IMD cases increase in adolescents following SARS-CoV-2 pandemic

influenza

In Spain, for the 2022-2023 season, according to data from the New Surveillance System for Influenza and Other Respiratory Infections (SiVIRA), as of week 14 of 2023, the group aged 5 to 14 years is the group with the highest incidence.However, this season there are Five quadrivalent influenza vaccine formulations authorized for use in children and adolescents under 17 years of age, four plus one attenuated intranasal injection.

Coronavirus disease

Three monovalent vaccines with the original strain are authorized for use in children and adolescents in our country (Pfizer’s Comirnaty, Moderna’s Spikevax and Novavax’s Nuvaxovid), and another monovalent vaccine with the XBB strain has recently been approved by the European Commission License 1.5 (Comirnaty XBB 1.5). Two bivalent vaccines are also authorized: Comirnaty and Spikevax Original/Ómicron (BA.1 or BA.4-5).

risk groups

Evaluating vaccine coverage for at-risk groups within this population should be prioritized. Being a teenager and belonging to a high-risk group may present a double negative when it comes to underwriting. In fact, you can review vaccination recommendations for these individuals in the AEP Online Vaccine Handbook, the CISNS Risk Groups Calendar for Children Under 18, and CC. AA.

traveling boy

It’s crucial that they realize this The importance of protecting yourself and planning aheadthis Advice must be personalized and will be based on your age, previous vaccinations, the area you will be visiting, the duration of your trip, the time of year and the type of activities you will be undertaking.On the other hand, there are Mandatory vaccines Enter some countries like: Yellow Fever, MenACWY and Polio.Likewise, there are Recommended vaccines Depending on the country of destination, such as cholera, Central European encephalitis, Japanese encephalitis, typhoid, hepatitis A and rabies. Advice for teenagers who want to travel is not in vain and can be found in the AEP online brochure and on the Ministry of Health website.