August 2, 2024
Regarding the introduction of the hexavalent vaccine (DPT-Hib-HBV-IPV):
The CNAV unanimously recommends the incorporation of the hexavalent whole-cell vaccine into the regular schedule of the National Immunization Program (PNI) starting in 2025, using the multilateral mechanism of the PAHO Revolving Fund. The choice of a vaccine with a whole-cell component is considered an appropriate measure for its initial introduction. The commission also notes that, although the rate of Events Supposedly Attributable to Vaccination or Immunization (ESAVI), with the presentation of hypotonic hyporesponsive syndrome (HHS), related to the Bordetella pertussis component is low compared to what has been reported internationally, and in order to reduce the occurrence of such ESAVI, it is recommended to transition to the use of a vaccine platform that uses the acellular component, as soon as it is available through the Revolving Fund or other access mechanisms.
Regardless of the vaccine selected, the commission considers it essential to implement an active surveillance plan for vaccine-preventable diseases (VPD) and ESAVI during the first year of vaccine implementation. In addition, it is recommended to carry out a detailed analysis of the cases of hepatitis B infection in the pediatric population, mentioned during the session.
Regarding the update of the HPV vaccination schedule in populations included and not included in systematic vaccination:
After analyzing the available evidence, the CNAV unanimously recommends extending vaccination with the quadrivalent anti-HPV vaccine for risk groups not included in systematic vaccination up to 45 years of age inclusive. In addition, specific recommendations are included for new risk populations, not previously considered. In all cases, it is considered that the medical prescription should specify the number of doses according to the individual condition of the user, without the need to detail diagnoses (see Annex I).
Regarding the possible implementation of a single-dose HPV schedule in immunocompetent people aged 11 to 26 years within the regular schedule, the CNAV decides to postpone the discussion. This is because several regional clinical trials are underway, and their results are expected to consolidate the evidence for future deliberations.
Likewise, the CNAV recommends that, depending on the availability of acquisitions through multilateral funds to which Uruguay has access, the decision should be made to transition to the 9-valent vaccine, considering the benefits it offers in terms of the viral genotypes included.
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