New, and Some Not-so-New, Vaccines for Adolescents and Diseases They Prevent

Abstract

Adolescents in the United States now have the opportunity to receive new vaccines that prevent invasive meningococcal infections, pertussis (whooping cough), and cervical cancer. Except for their potential to cause serious illness, these infections could not be more different. Their incidence ranges from extremely low to quite high. Early clinical manifestations of infection range from none to life-threatening illness. Two of the vaccines are similar to those already in use, whereas 1 is completely new. In conjunction with the 4 vaccines previously recommended for adolescents (the tetanus and diphtheria booster, hepatitis B, measles-mumps-rubella, and varicella), the 3 new vaccines (meningococcal, human papillomavirus, and the tetanus-diphtheria-pertussis booster [which replaced the tetanus-diphtheria booster]) bring the number recommended for adolescents to 6. In this article, we describe key characteristics of the 3 new vaccines and infections they were designed to prevent. We also briefly discuss other vaccines recommended for all adolescents who have not already received them and new vaccines that are still under development. B EFORE 2005, THE only vaccine routinely recommended for healthy adolescents who had received all recommended childhood vaccinations was the tetanus and diphtheria toxoids (Td) booster. 1 Three other vaccines (measles-mumps-rubella [MMR], hepatitis B, and varicella) were used as "catch-up vaccinations" for adolescents who did not receive these vaccines as children (and, in the case of varicella, had not had chickenpox). The second dose of MMR vaccine was first recommended for adolescents by the American Academy of Pediatrics (AAP) in 1989, 2 whereas hepatitis B and varicella vaccines were first recommended for this age group in 1995 and 1996, respectively. 3,4 These recommendations were consolidated in 1996, when the Advisory Committee on Immunization Practices (ACIP), AAP, American Academy of Family Physicians, and American Medical Association harmonized their recommendations. These organizations suggested that the recommended immunizations and other preventive services be delivered at a routine preventive visit at 11 to 12 years of age. 1 Three new vaccines intended primarily for adolescents are now available. The first of these, a new vaccine effective for the prevention of disease caused by Neisseria meningitidis, was licensed in the United States in 2005 and officially recommended for use when the ACIP recommendations were published in May of that year. 5,6 Two vaccines for adolescents, both of which prevent infections with Bordetella pertussis, tetanus, and diphtheria, were licensed in May and June of 2005, respectively, and recommendations were published in early 2006. 7 A vaccine that prevents human papillomavirus (HPV), the cause of cervical cancer, was licensed in May 2006, and recommendations for its use were published in March 2007. 8 All the diseases against which these new vaccines offer protection are potentially serious, but the clinical course for each could...

Role of HrpA in Biofilm Formation of Neisseria meningitidis and Regulation of the hrpBAS Transcripts

“…The genes encoding the HrpA proteins are found in virtually all strains of N. meningitidis (42,48). Since the HrpA paralog FHA is a component of the acellular B. pertussis vaccine, future research should determine if HrpA undergoes antigenic variation, which could limit the usefulness of HrpA in a broadly reactive meningococcal vaccine (12). In addition, investigations of the cellular or self receptors accounting for HrpA protein involvement in bacteria-cell or bacteria-bacteria interactions should be undertaken.…”

How Can We Communicate About Vaccines With Adolescents and Their Parents?

“…As new vaccines are added to the adolescent vaccination regimen,1,2 it has become especially important to overcome the challenges of communicating about risks and benefits of vaccines with adolescents and their families. These challenges are particularly prominent in light of publicity about both real and perceived risks of vaccination3–5 and because some vaccines are associated with the stigma of preventing sexually transmitted infections 1,2,6.…”

Increasing Adolescent Vaccination: Barriers and Strategies in the Context of Policy, Legal, and Financial Issues

“…New adolescent vaccines provide opportunities to reduce the burden of adolescent and adult disease [1]. According to recent recommendations by the Advisory Committee on Immunization Practices all adolescents should receive one dose of tetanus-diphtheria toxoid-acellular pertussis vaccine and one dose of conjugate meningococcal vaccine between 11 and 12 years of age.…”