GNN monthly update: August' 22

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Dear all,

 

I hope everyone enjoyed a break over the summer/winter depending on where you are in the world.

 

COVID-19 vaccines

Novavax:

  • On July 19, 2022, the ACIP made an interim recommendation for use of the Novavax vaccine in persons aged ≥18 years as a primary 2-dose series vaccination for the prevention of COVID-19, available here along with the GRADE and EtR tables.
  • STIKO now recommends primary immunization with Nuvaxovid for children and adolescents aged 12-17 years.

 

Booster vaccination:

  • STIKO recommends a further booster vaccination for people aged 60-69 and for people aged 5 and over who are at increased risk of contracting severe COVID-19. In addition to vaccination, the STIKO recommends pre-exposure prophylaxis with SARS-CoV-2 -neutralizing monoclonal antibodies to defined groups of people. More here.

 

ACIP is holding an online COVID-19 meeting on September 1st. The meeting can be webcast. The full agenda is available here.

 

HPV:

  • the JCVI issued a statement on a one-dose schedule for the routine HPV immunisation programme, available here. Of note, the first major review of a one-dose schedule took place in June 2020 and after a further review of the latest evidence on one-dose schedules in December 2021 the committee issued an interim statement for consultation on 10 February 2022.
  • The CNAV (NITAG in Uruguay) agreed at its August meeting to recommend HPV vaccination for both women and men aged 11 to 26 years inclusive, in a two doses schedule ( 6 months apart). The vaccination should be universal and free without requirement or medical prescription. For Immunocompromised aged 9 to 26 years inclusive, the schedule is 3 doses given at 0, 2 and 6 months and a medical prescription is needed.

 

Monkeypox:

  • NIAC (Irish NITAG) issued recommendations for the use of Monkeypox Modified Vaccinia Ankara Vaccines, Imvanex or Jynneos, by the intradermal route, available here.

 

SAGE:

  1. SAGE recommends the Valneva vaccine for adults between 18 and 50 years, in a two-dose schedule with a spacing of 28 days.Due to limited data on the immunogenicity of this vaccine in persons aged 50 and above, the Valneva vaccine is not recommended for adults older than 50 years. The full recommendation is available here, along with the comprehensive background document here.  Of note, SAGE reviewed data from the UK COV-BOOST study, a study that was conducted independently from the manufacturer, and concluded that the Valneva vaccine should not be used as a heterologous booster post primary vaccination with a mRNA vaccine as immunogenicity was low. However, Valneva can be considered as a heterologous booster following primary vaccination with the AstraZeneca vaccine (ChAdOx1-S)
  2. SAGE published a good practice statement on the use of a second booster doses for COVID-19 vaccines, available here. The statement speaks to the need for a second booster dose in the context of Omicron to restore VE. This guidance does not discuss future variants nor variant-updated vaccines. The rationale for a second booster is to restore protection in the most vulnerable populations. This includes protection from COVID-19 severe disease, and serious exacerbation of co-morbidities. Key recommendations from the good practice statement include:
  3. It is acknowledged that the additional benefit from a second booster may more limited than the first booster.
  4. To reduce the risk of severe disease, deaths and disruptions of health services, WHO recommends countries should consider a second booster dose for:
  5. All older adults (age cut-off to be defined by countries);
  6. All persons with moderate or severe immunocompromising conditions (effectively, the fifth dose);
  7. Adults with comorbidities that put them at higher risk of disease;
  8. Pregnant women;
  9. Health workers.
As VE wanes over a period of 4-6 months, a second booster dose should be offered 4-6 months after the last dose, or –if this time period is missed- as soon as possible thereafter. Individuals at highest risk should receive a second booster dose in this time interval and should not delay boosting in anticipation of variant-updated vaccines.
 
SAGE also updated the Pfizer and Moderna vaccines interim recommendations to capture data on vaccine performance against Omicron sublineages, and paediatric studies. Pfizer paediatric studies were in children 5-11 years age (2 dose schedule, 10 µg each), and in children 6 months to 4 years of age (3dose schedule, 3 µg each), and Moderna paediatric studies in children 6-11 years age (2 dose schedule, 50 µg each), and in children 6 months to 5 years of age (2 dose schedule, 25 µg each).The update also includes data on the administration of a second booster dose. 2nd booster doses (or fourth dose) is recommended 4-6 months after the last dose in certain subpopulations at high risk in accordance with the good practice statement. SAGE issued an Interim statement on COVID-19 vaccination for children, available here.
 
WHO issued an updated interim guidance, developed with the advice and support of the Strategic Advisory Group of Experts (SAGE) Working Group on smallpox and monkeypox vaccines. It provides the first WHO recommendations on vaccines and immunization for monkeypox, available here.
Partners: ECDC published a guidance entitled: Long-term qualitative scenarios and considerations of their implications for preparedness and response to the COVID-19 pandemic in the EU/EEA. The document sets out a number of scenarios that are intended to be plausible, internally consistent, and coherent descriptions of possible futures. It is available here.
 
CALL FOR APPLICATION: The 23rd ADVAC will take place at Les Pensières, Annecy, France from 8 to 19 May 2023. The applications are open until November 15th. We highly encourage NITAG members to apply as this is a great learning and networking opportunity. More on the ADVAC website: https://www.advac.org/
 
 
Best wishes to all.
 
Louise  

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