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Immunization Guidelines for Adult Patients: An Annual Update and a Challenge
- Gregory A. Poland, MD; and
- William Schaffner, MD
- From Mayo Vaccine Research Group, Mayo Clinic College of Medicine, Rochester, MN 55905, and Vanderbilt University School of Medicine, Nashville, TN 37232.
This issue includes the annual revision of the Adult Immunization Schedule (1) produced by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) and approved by the American College of Physicians (ACP), the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists. Each year sees advances in disease prevention by vaccines. This year, the updates involve expansions of the recommendations for pneumococcal polysaccharide vaccine and influenza vaccine.
The recommendations are summarized in 2 tables—one lists vaccines recommended across the age spectra, and the other lists vaccines recommended for different medical and lifestyle indications (such as health care workers). The full texts of the recommendations for each vaccine are available at http://www.cdc.gov/vaccines/pubs/ACIP-list.htm, and the full Adult Immunization Schedule is available at http://www.cdc.gov/nip/recs/adult-schedule.htm. New changes are discussed below.
Herpes Zoster
New language states that a previous episode of shingles is not a contraindication to zoster vaccination. We lack good evidence about the interval between the last episode of shingles and immunization. Most experts recommend at least a 12-month interval.
Human Papillomavirus
Occupational exposure does not increase health workers' risk for human papillomavirus. They should receive vaccine only for a standard indication.
Pneumococcal Polysaccharide Vaccine
The recommendations for use of this vaccine have undergone many revisions, including the following.
Asthma
The pneumococcal polysaccharide vaccine (PPV23) is recommended for all persons age 65 years or older, as well as for younger persons who have certain underlying medical conditions. There has been uncertainty about whether to vaccinate patients 19 …
