ACIP releases 2024 Adult Immunization Schedule featuring new vaccines

The Advisory Committee on Immunization Practices (ACIP) has released its 2024 Recommended Adult Immunization Schedule, which includes new vaccines for respiratory syncytial virus (RSV), mpox, COVID-19, and a combination meningococcal conjugate-serogroup B meningococcal vaccine.

The RSV vaccine is a new addition this year. For patients ages 60 years and older, any approved RSV vaccine can be administered, and vaccination should be based on shared decision making, considering any risk factors for severe RSV disease, risk of exposure to RSV, and preferences for RSV vaccination. In pregnant patients, ACIP notes that only Pfizer's RSV vaccine (Abrysvo) is recommended; it should be given during 32 through 36 weeks' gestation from September through January in most of the continental U.S, ACIP said.*

All adults are now recommended to receive at least one dose of the updated COVID-19 vaccine. The number of doses needed and intervals between doses may vary based on a patient's prior vaccination history and whether they are immunocompromised, along with the vaccine product used.

For the mpox vaccine, all adults in any age group at increased risk of becoming infected should get a two-dose series of the vaccine. A complete list of risk factors for mpox is outlined in the schedule. ACIP also made changes to recommendations regarding vaccines against hepatitis B, human papillomavirus, influenza, and polio. The complete schedule, including changes in the vaccine notes section, was published on Jan. 12 by Annals of Internal Medicine and also in the CDC's Morbidity and Mortality Weekly Report.

An accompanying editorial in Annals criticized the recommendations' presentation of information and bemoaned the lost opportunity to provide guidance on discussing the importance of vaccination with patients. It noted that in 2023 only 40.8% of adults had received an influenza vaccine and that immunization rates were 17.2% and 15.9% of the eligible populations for the new COVID-19 vaccine and RSV vaccines, respectively. The editorial continued that the problem of low vaccination rates among adults is exacerbated by misinformation and distrust of public health, in addition to the concept of “medical freedom” promoted by vaccine skeptics.

“We believe that CDC has the opportunity, the authority, and moreover, the duty to provide clinicians and the public with better communications to help adult Americans understand the value of vaccines and decide to accept them. Too many adults today are choosing to opt out of vaccinations that could enhance their quality of life and lower their costs of care,” the editorial stated.