II. Precautions

  1. Adults are under-vaccinated
    1. As of 2014, only 17% of U.S. adults have had a Tdap
  2. References
    1. (2015) Presc Lett 22(3): 13

III. Protocol: Age 18 to 60 years (or 65 years old)

  1. Influenza Vaccine
    1. Offer annual Vaccination in all patients and especially high risk groups
  2. Tetanus Vaccine
    1. At least one Tdap (Adacel)
  3. HPV Vaccine (Gardasil)
    1. Women for catch-up under age 26 years (typically vaccinated at age 11-12 years old)
    2. Men for catch-up under age 22 years old, and in high risk groups up to age 26 years
  4. Hepatitis B Vaccine
  5. MMR Vaccine
    1. One MMR Vaccine if born in 1957 or later
    2. Two MMR Vaccine if a college student, health care worker or travelers to certain regions
  6. Meningococcal Vaccine
    1. Required by many colleges (those in 36 U.S. states)
    2. However, Meningitis cases are sporadic and of serotype B (not covered by U.S. meningoccal Vaccine)

IV. Protocol: Age 60 years (or 65) and older

  1. Influenza Vaccine
    1. Annual Vaccination in all patients
  2. Tetanus Vaccine
    1. Repeat every 5-10 years
    2. Consider giving at hospital discharge
    3. At least one Tdap (Adacel) even for over age 65 years
  3. Pneumococcal Vaccine (after age 65 years)
    1. Additional doses needed earlier for other indications (e.g. Asplenic, immunosuppressed, Tobacco abuse)
    2. Consider giving at hospital discharge
    3. No prior Pneumovax 23
      1. Prevnar 13 after age 65 year birthday AND
      2. Pneumovax 23 at 6-12 months after Prevnar 13 dose
    4. Prior Pneumovax 23 after age 65 year birthday
      1. Prevnar 13 after age 65 year birthday (at least 12 months after Pneumovax)
      2. No further Pneumovax 23 needed
    5. Prior Pneumovax 23 before age 65 year birthday
      1. Prevnar 13 after age 65 year birthday AND
      2. Pneumovax 23 at 6-12 months after Prevnar 13 dose AND 5 years after last Pneumovax 23
    6. References
      1. (2014) Presc Lett 21(11): 63-64
  4. Zoster Vaccine (Zostavax)
    1. Give one dose
    2. Offer for age 50 years and older (especially over age 60 years old)

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Ontology: Vaccines (C0042210)

Definition (NCI) Preparations containing substances with antigenic properties administered to activate the immune system, thereby inducing an immune response. Vaccines range from inactivated or attenuated microorganisms (bacteria and viruses), enhanced autologous tumor cells, tumor antigens or epitopes that are used to elicit host immune responses. Vaccines are used for the prevention, amelioration, or treatment of infectious diseases and cancer.
Definition (NCI_NCI-GLOSS) A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. A vaccine can help the body recognize and destroy cancer cells or microorganisms.
Definition (MSH) Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases.
Definition (CSP) prophylactic or therapeutic preparation given to produce immune response to pathogenic organisms or substances; vaccines are used not only in infectious disease prevention and treatment, but in neoplastic and autoimmune disease treatment, control of fertility, drug abuse control etc.
Concepts Pharmacologic Substance (T121) , Immunologic Factor (T129)
MSH D014612
SnomedCT 71181003, 398827000
LNC LP30374-0, MTHU014526, LA20283-0
Swedish Vacciner
Czech vakcíny
Finnish Rokotteet
English vaccines (medication), vaccines, [IM100] VACCINES, Vaccines [Chemical/Ingredient], vaccine, vaccine product, VACCINES, Vaccine (product), Vaccine (substance), Vaccine, Vaccine, NOS, Vaccines
Croatian CJEPIVA
Polish Szczepionki
Spanish vacuna (producto), vacuna (sustancia), vacuna, Vacunas
French Vaccins
German Impfstoffe, Vakzine
Italian Vaccini
Portuguese Vacinas

Ontology: Adult Immunization (C1456566)

Concepts Therapeutic or Preventive Procedure (T061)
English Adult Immunization