ACIP recommends second varicella shot

The Advisory Committee on Immunization Practices issued recommendations to add a second dose of the varicella vaccine and a series of shots providing protection against the human papillomavirus to the childhood and adolescent immunization schedule, according to statements issued after its June 29 meeting.

The committee, which is convened quarterly by the Dept. of Health and Human Services to advise the Centers for Disease Control and Prevention, took action on the varicella vaccine in response to several reports of outbreaks among immunized children. These events suggested that one shot may not be enough to provide immunity for some. The initial immunization should still be given at 12 to 18 months, with the second administered to children when they are between 4 and 6 years old. Older children, adolescents and adults who only received one dose should also be given a second.

"This recommendation will further reduce outbreaks of chicken pox and provide better individual protection," said Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases.

The committee also voted in favor of routinely administering three doses of the human papillomavirus vaccine to girls 11 to 12 years old, although the shot can be given to those as young as 9. It can also be given to those age 13 to 26.

"The availability of the HPV vaccine is the start of a wonderful new day in women's health," said John M. Clymer, president of the national nonprofit Partnership for Prevention.

One version of this vaccine was approved in June by the Food and Drug Administration, and another is expected to follow before the end of the year. Both protect against four variants of the virus that lead to 70% of cervical cancers. Experts warned that while this shot is expected to make a significant dent in disease rates, screening will still be necessary.

"Although an effective vaccine is a major advance ... women should continue to get Pap tests," said Dr. Schuchat.

These recommendations are provisional and will not become CDC policy until accepted by the agency's director and published in the Morbidity and Mortality Weekly Report.