14 July 2022

Please find highlights below from the Vaccine Advisory Committee (VAC) meeting that took place on 7/14/2022. Note that the Washington State Department of Health is about to announce a new Director of Immunization.

MonkeyPox VaccineThe federal government is working to make additional MonkeyPox Vaccination. There has been some available for people who have been direct contacts or had occupational exposure. They are currently working to broaden vaccine availability to settings and communities where we know there is substantial risk. Right now, there are a total of 391 courses of vaccine. There have been 20 cases of MonkeyPox in Washington State, most of which are in King County. The early cases were acquired through travel, but more recent cases have been acquired through the community. The CDC is working with the FDA on clearance for more vaccination. We already have an FDA cleared vaccination which was cleared in 2019. Right now, the MonkeyPox vaccination is coming through the federal stockpile but is not available through our normal channels of ordering vaccination. If providers have questions about what is happening in their communities or have any suspected cases, they should be working with their local health jurisdiction.

COVID-19 VaccineAt present, over 80% of the population 5 years and older have received at least 1 dose of COVID-19 vaccine. As of late June, babies age 6 months and older are eligible to receive Covid-19 vaccine. A vaccine finder tool is available to help parents find vaccines and there are translation tools available. As of July 13, the CDC authorized an Emergency Use Authorization (EUA) for Novavax as a 2 dose series for people aged 18 years and older. The VRBPAC met on June 28 to discuss the inclusion of omicron variants in boosters this fall. The next step is for the CDC to meet to discuss the recommendations from the VRBPAC.

Some children will transition from one age group to another part way through their COVID-19 vaccine series. The CDC has provided guidance for providers on management in this situation in the below links:

  • MODERNA: https://www.cdc.gov/vaccines/covid-19/downloads/Moderna-Child-Age-Transition-508.pdf
  • PFIZER: https://www.cdc.gov/vaccines/covid-19/downloads/Pfizer-Child-Age-Transition-508.pdf

The different presentations of COVID vaccination can be confusing for providers. Here is a chart provided by DOH to outline the different presentations and how to use them:

HPV Vaccine ~ Dr. Sherri Zorn
There are numerous robust studies demonstrating that HPV Vaccination prevents cancers. The older the patient is when they get vaccinated against HPV, the less protection they have and there is benefit to getting it done younger. The HPV vaccine has been available in the US for >15 years. HPV vaccination lags behind other adolescent vaccines (TDaP and MCV) and the COVID-19 pandemic has caused decreased rates in Washington State. While HPV vaccine is routinely recommended at age 11-12 years, it can be started as early as 9 years. HPV vaccination beginning at age 9 is supported by the Washington Chapter of the American Academy of Pediatrics (AAP). On-time HPV vaccine means receiving the vaccination between ages 9-12 years. If the child starts at age 15, they also need an additional dose (3 total doses vs 2 if they start before age 15).

The current recommendation is to focus on the HPV vaccine for its role in cancer prevention, not as a sexual activity-related vaccine.

Recommendations for practices/providers wanting to implement HPV vaccination at age 9 years:
→Education for clinicians and staff
→Visual cues in clinic (posters, que cards, patient information)
→If possible, use your EHR as a reminder at 9 year well-child check (WCC)

Remember that the strength of the provider recommendation is one of the single most important factors in patients getting vaccinated.

The DOH sent out a letter to providers in January outlining the benefits of HPV vaccination. The VAC is unanimously requesting Secretary Dr. Shaw request IIS changes the forecast age to 9 years to help improve HPV vaccination rates.

~Mary Koehnke, ND - WANP Liaison to WA DOH VAC