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The following changes were made to the ACIP Best Practice Guidelines for Immunization in July 2017
Table 3-1. (Recommended and minimum ages and intervals between vaccine doses)
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Footnote f has been clarified:
It now reads, “The minimum recommended interval between DTaP-3 and DTaP-4 is 6 months. However, DTaP-4 need not be repeated if administered at least 4 months after DTaP-3. This is a special grace period of 2 months which can be used if evaluating records retrospectively. An additional 4 days cannot be added to this grace period prospectively, but can be added retrospectively.”
This change is to accommodate a recent subject-matter expert email that allows double dipping of the grace period (adding 4 days to the 2 months) for retrospective validation of series WHOSE 4th DOSE WAS ADMINISTERED AT 12 months of age. This double dipping cannot be applied prospectively, meaning we will only allow a 4 day grace period added to a prospective 6 month interval, and we will only allow a four month interval prospectively (not four months plus four days) if the fourth dose would be administered after 12 months of age. CDSi has been updated to accommodate this.
TABLE 4-1. (Contraindications and precautions to commonly used vaccines)
- Added to LAIV contraindications: “LAIV4 should not be administered to persons who have taken influenza antivirals medications within the previous 48 hours.” This addition is to harmonize this table with the 2017-18 adult schedule.
- Serogroup B meningococcal vaccine has been added to the table.
- Added to MMR and Varicella contraindications: “Family history of altered immunocompetence.” To harmonize with the vaccine-specific statements in accommodating infants and toddlers with occult heritable congenital immunodeficiencies.
- Added to Varicella and Zoster precautions: “Receipt of specific antiviral drugs (acyclovir, famiciclovir, or valacyclovir) 24 hours before vaccination (avoid use of these antiviral drugs for 14 days after vaccination).”
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