Latest ACIP immunization schedule updates guidance on COVID-19, pneumococcal vaccines

The annual immunization schedule consolidates and summarizes updates to the recommendations of the Advisory Committee on Immunization Practices (ACIP).

The Advisory Committee on Immunization Practices (ACIP) published its 2023 immunization schedule, which includes updates to recommendations on vaccines against COVID-19 and pneumonia.

The vaccine schedule was approved by ACIP in October 2022 and published by Annals of Internal Medicine and MMWR on Feb. 9.

For COVID-19, mRNA and protein-based vaccines are included but viral vector vaccines are not. The recommendations now include links to help decision making around COVID-19 boosters. They also note that while the initial vaccine series and boosters are recommended, this does not mean they are federally mandated.

The new schedule includes new options for pneumococcal vaccination that incorporate the now available higher-valent PCV20 vaccine, should patients meet certain criteria. The schedule also has a link to a new pneumococcal vaccination app to help with pneumococcal vaccination recommendations for patients.

While routine poliovirus vaccination of adults residing in the United States isn't needed, the 2023 schedule now includes a new poliovirus vaccination section that describes the use of inactivated poliovirus vaccine (IPV) in adults with increased risk of exposure to polioviruses. Adults who have completed a three-dose polio vaccination series but are at increased risk for infection may receive one lifetime booster. Those who are at increased risk of exposure to poliovirus without documentation of a completed polio vaccination series should talk to their doctor about how many doses they should receive to complete a three-dose series, the recommendations say.

Physicians should pay careful attention to the details found in the vaccine notes section, as they clarify who needs what vaccine, when, and at what dose, the authors noted.

“ACIP recommendations can be complex and challenging to implement,” they wrote. “The purpose of the immunization schedule, published annually, is to consolidate and summarize updates to ACIP recommendations on vaccination of adults and to assist providers in implementing current ACIP recommendations.”

ACP offers a series of videos by Sandra Adamson Fryhofer, MD, MACP, explaining ACIP's process, how to use the schedule, and changes to specific vaccines, including flu.