II. Precautions
- Adults are under-vaccinated
- As of 2014, only 17% of U.S. adults have had a Tdap
- References
- (2015) Presc Lett 22(3): 13
III. Protocol: Age 18 to 50 years
- Periodic Boosters
- Influenza Vaccine
- Offer annual Vaccination in all patients and especially high risk groups
- Tetanus Vaccine
- Influenza Vaccine
- Catch-Up Vaccines to consider
- HPV Vaccine (Gardasil)
- Boys and girls should be vaccinated with 2 doses as part of Primary Series at age 11-12 years
- Age 15 years and older are vaccinated with 3 doses
- Recommended for age up to 26 years (and may consider for ages 27 to 45 years)
- Varicella Vaccine
- Two doses (4-8 weeks apart) if born after 1980 and no evidence of Immunity
- Hepatitis B Vaccine
- Hepatitis A Vaccine
- MMR Vaccine
- One MMR Vaccine if born in 1957 or later
- Two MMR Vaccine if a college student, health care worker or travelers to certain regions
- Meningococcal Vaccine
- Menactra (MenACWY) is part of Primary Series, given as 2 doses (age 11 and 16 years)
- Required by many colleges (those in 36 U.S. states)
- However, Meningitis cases are sporadic and of serotype B (covered by MenB, not MenACWY Vaccine)
- HPV Vaccine (Gardasil)
IV. Protocol: Age 50 years and older
-
Influenza Vaccine
- Annual Vaccination in all patients (esp. over age 65 years)
- Tetanus Vaccine
-
Pneumococcal Vaccine (after age 65 years)
- Additional doses needed earlier for other indications (e.g. Asplenic, immunosuppressed, Tobacco Abuse)
- Consider giving at hospital discharge
- No prior Pneumovax 23
- Prevnar 13 after age 65 year birthday AND
- Pneumovax 23 at 6-12 months after Prevnar 13 dose
- Prior Pneumovax 23 after age 65 year birthday
- Prevnar 13 after age 65 year birthday (at least 12 months after Pneumovax)
- No further Pneumovax 23 needed
- Prior Pneumovax 23 before age 65 year birthday
- Prevnar 13 after age 65 year birthday AND
- Pneumovax 23 at 6-12 months after Prevnar 13 dose AND 5 years after last Pneumovax 23
- References
- (2014) Presc Lett 21(11): 63-64
- Zoster Vaccine
- Zoster Recombinant (Shingrix) - preferred
- Two dose series (2-6 months apart)
- Zoster Live (Zostavax)
- Live Vaccine with contraindications (e.g. pregnancy, AIDS)
- Single dose
- Zoster Recombinant (Shingrix) - preferred
V. Resources
- CDC Immunization Schedules (last accessed 10/28/2020)
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Related Studies
| Concepts | Therapeutic or Preventive Procedure (T061) |
| English | Adult Immunization |
