ACCP Unveils Updated Thrombosis Guidelines

AT L A N TA — All adults with asthma should now receive pneumococcal immunization, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention voted June 25 at its summer meeting. The vote adds adults aged 1864 years with asthma to the list of individuals considered at increased risk for invasive pneumococcal disease (IPD). Current Advisory Committee on Immunization Practices (ACIP) recommendations call for use of the 23-valent polysaccharide pneumococcal vaccine (PPSV23) in all adults age 65 years and older and in highrisk individuals age 2-64 years. Among the latter group are those with chronic pulmonary conditions including chronic obstructive pulmonary disease (COPD) and emphysema (MMWR 1997;46[RR-8]:1-24). Asthma was not included at the time that recommendation was made because not enough data were available about the risk of IPD among individuals with asthma, except for those with long-term use of systemic corticosteroids. Such data have since become available, and were reviewed for the committee by Dr. Pekka Nuorti of the CDC’s National Center for Immunization and Respiratory Diseases. In a nested case-control study of persons age 2-49 years enrolled in Tennessee’s Medicaid program (TennCare) for at least 1 year during 1995-2002, each