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Japanese Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices.

Publication ,  Journal Article
Hills, SL; Walter, EB; Atmar, RL; Fischer, M; ACIP Japanese Encephalitis Vaccine Work Group
Published in: MMWR Recomm Rep
July 19, 2019

This report updates the 2010 recommendations from the CDC Advisory Committee on Immunization Practices (ACIP) regarding prevention of Japanese encephalitis (JE) among U.S. travelers and laboratory workers (Fischer M, Lindsey N, Staples JE, Hills S. Japanese encephalitis vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2010;59[No. RR-1]). The report summarizes the epidemiology of JE, describes the JE vaccine that is licensed and available in the United States, and provides recommendations for its use among travelers and laboratory workers.JE virus, a mosquitoborne flavivirus, is the most common vaccine-preventable cause of encephalitis in Asia. JE occurs throughout most of Asia and parts of the western Pacific. Approximately 20%-30% of patients die, and 30%-50% of survivors have neurologic, cognitive, or behavioral sequelae. No antiviral treatment is available.Inactivated Vero cell culture-derived JE vaccine (Ixiaro [JE-VC]) is the only JE vaccine that is licensed and available in the United States. In 2009, the U.S. Food and Drug Administration (FDA) licensed JE-VC for use in persons aged ≥17 years; in 2013, licensure was extended to include children aged ≥2 months.Most travelers to countries where the disease is endemic are at very low risk for JE. However, some travelers are at increased risk for infection on the basis of their travel plans. Factors that increase the risk for JE virus exposure include 1) traveling for a longer period; 2) travel during the JE virus transmission season; 3) spending time in rural areas; 4) participating in extensive outdoor activities; and 5) staying in accommodations without air conditioning, screens, or bed nets. All travelers to countries where JE is endemic should be advised to take precautions to avoid mosquito bites to reduce the risk for JE and other vectorborne diseases. For some persons who might be at increased risk for JE, the vaccine can further reduce the risk for infection. The decision about whether to vaccinate should be individualized and consider the 1) risks related to the specific travel itinerary, 2) likelihood of future travel to countries where JE is endemic, 3) high morbidity and mortality of JE, 4) availability of an effective vaccine, 5) possibility (but low probability) of serious adverse events after vaccination, and 6) the traveler's personal perception and tolerance of risk.JE vaccine is recommended for persons moving to a JE-endemic country to take up residence, longer-term (e.g., ≥1 month) travelers to JE-endemic areas, and frequent travelers to JE-endemic areas. JE vaccine also should be considered for shorter-term (e.g., <1 month) travelers with an increased risk for JE on the basis of planned travel duration, season, location, activities, and accommodations and for travelers to JE-endemic areas who are uncertain about their specific travel duration, destinations, or activities. JE vaccine is not recommended for travelers with very low-risk itineraries, such as shorter-term travel limited to urban areas or outside of a well-defined JE virus transmission season.

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Published In

MMWR Recomm Rep

DOI

EISSN

1545-8601

Publication Date

July 19, 2019

Volume

68

Issue

2

Start / End Page

1 / 33

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Travel-Related Illness
  • Pregnancy
  • Middle Aged
  • Male
  • Japanese Encephalitis Vaccines
  • Infant
  • Immunization Schedule
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hills, S. L., Walter, E. B., Atmar, R. L., Fischer, M., & ACIP Japanese Encephalitis Vaccine Work Group. (2019). Japanese Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep, 68(2), 1–33. https://doi.org/10.15585/mmwr.rr6802a1
Hills, Susan L., Emmanuel B. Walter, Robert L. Atmar, Marc Fischer, and ACIP Japanese Encephalitis Vaccine Work Group. “Japanese Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices.MMWR Recomm Rep 68, no. 2 (July 19, 2019): 1–33. https://doi.org/10.15585/mmwr.rr6802a1.
Hills SL, Walter EB, Atmar RL, Fischer M, ACIP Japanese Encephalitis Vaccine Work Group. Japanese Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2019 Jul 19;68(2):1–33.
Hills, Susan L., et al. “Japanese Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices.MMWR Recomm Rep, vol. 68, no. 2, July 2019, pp. 1–33. Pubmed, doi:10.15585/mmwr.rr6802a1.
Hills SL, Walter EB, Atmar RL, Fischer M, ACIP Japanese Encephalitis Vaccine Work Group. Japanese Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2019 Jul 19;68(2):1–33.

Published In

MMWR Recomm Rep

DOI

EISSN

1545-8601

Publication Date

July 19, 2019

Volume

68

Issue

2

Start / End Page

1 / 33

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Travel-Related Illness
  • Pregnancy
  • Middle Aged
  • Male
  • Japanese Encephalitis Vaccines
  • Infant
  • Immunization Schedule
  • Humans