Vaccination adult immunization schedule

Most vaccines are administered in two- to four-shot series in order to elicit the best protection. Childhood and adult immunization schedules are revised frequently and published annually by the CDC Advisory Committee on Immunization Practices. Current immunization schedules can be found at www.cdc.gov/nip/. The childhood schedule is published in January and the adult schedule in October of each year. Recommendations will be published throughout the year in the Morbidity and Mortality Weekly Report (MMWR) as new vaccines are licensed or new information necessitates a change in previous recommendations. 

Figure 1. Recommended adult immunization schedule, by vaccine and age group United States, October 2007-September 2008...

In the 1940s, diphtheria toxoid was combined with tetanus toxoid and whole cell pertussis vaccines, and later with the acellular pertussis vaccine. The diphtheria toxoid, tetanus toxoid, and acellular pertussis vaccine are part of the routine childhood immunization schedule. Diphtheria toxoid is also combined with tetanus toxoid and is commonly used as a booster vaccine. The pediatric product (DT) has a higher amount of diphtheria toxoid than does the adult product (Td). Diphtheria toxoid is not available as an individual vaccine. 

Adults with HIV infection should be vaccinated with the 23-valent pneumococcal polysaccharide and hepatitis B vaccines as early in the course of the disease as possible. Inactivated influenza vaccine should be given yearly. Children should continue to receive vaccinations on the standard childhood immunization schedule. The individual may experience a transient elevation in HIV viral load following vaccination.17... 

Solid organ transplant recipients have a blunted immune response to vaccines because the immunosuppressive regimens used to prevent organ rejection inhibit both T- and B-cell proliferation. Many of these patients will also have secondary hypogammaglobulinemia post-transplantation. Prior to transplant, children should complete primary immunization schedules if possible accelerated schedules may be used. Adults should have all vaccinations updated prior to transplantation.16... 

Appendices 122-1 and 122-2 show the recommended schedules for routine immunization of children and adults. Many states require children to be fuUy immunized prior to entering elementary school however, optimal protection is achieved by immunizing at the recommended ages, which requires special attention to children younger than 2 years of age. Adults and adolescents also require vaccination and often are unaware of this need. Adults should receive routine tetanus-diphtheria boosters and be immune to measles, mumps, rubella, and varicella by either immunization or history of infection. Certain individuals with conditions or lifestyles that put them at high risk for vaccine-preventable diseases also should be immunized as described in the text that follows and outlined in the immunization schedules in the appendices. 

Children with SCD should receive the required immunizations as recommended by the American Academy of Pediatrics and the Advisory Committee on Immunization Practices.15 Additionally, influenza vaccine should be administered yearly to SCD patients 6 months of age and older, including adult patients. Any SCD patient who is scheduled for splenectomy should receive the vaccine for meningococcal disease if over 2 years of age.16... 

These schedules indicate the recommended age groups and medical indications for which administration of currently licensed vaccines is commonly indicated for adults ages 19 years and older, as of October 1,2007, Licensed combination vaccines maybe used whenever any components of toe combination are indicated and when the vaccine s other components are not contraindicated. For detailed recommendations on all vaccines, including those used primarily for travelers or that are issued during toe year, consult the manufacturers package inserts and the complete statements from toe Advisory Committee on Immunization Practices (wmcdc.gov/vaccines/pubs/acip-list.htm). ... 

Hepatitis B Vaccine (Engerix-B, Recombivax HB) [Vaccine/ Inactivated] Uses Prevent Hep B Action Active immunization recombinant DNA Dose Adults. 3 EM doses 1 mL each 1st 2 doses 1 mo apart the 3rd 6 mo after the 1st Peds. 0.5 mL EM adult schedule Caution [C, +] 1 effect w/ immunosuppressives Contra Yeast allergy Disp Engerix-B Inj 20mcg/mL peds inj 10 mcg/0.5 mL Recombivax HB Inj 10 40 mcg/mL peds inj 5 mcg/0.5 mL SE Fever, inj site pain Interactions i Immune response W/ corticosteroids, immunosuppressants EMS None OD Unlikely... 

Hepatitis B. Although Hepatitis B (Hep B > is not an infant disease, it is recommended for infant immunization to better control spread, because compliance widi vaccine immunization programs is easier to achieve in an infant population, Infants receive immunizations at birth, 1 -2 months, and a third dose at 6 months. Other schedules are available for immunization of adolescents and adults who have not previously received die vaccine. 

Usual schedules Infants Three doses given at birth, at 1 to 2 months, and at 6 to 18 months of age or, for infants, with other routine immunizations at 1 to 2 months, 4 months, and 6 to 18 months of age. Older children and adults Three doses given at 0-, 2-, and 6-month or, at 0-, 2-, and 4-month intervals. Higher titers of HBsAg are achieved with the last two doses of vaccine being spaced at least 4 months apart. 

The two recombinant hepatitis B vaccine products available in the United States (Recombivax HB, Merck Engerix-B, SmithKline Beecham) have comparable immune responses and safety profiles. The vaccines contain 5 to 40 meg HBsAg protein per milliliter adsorbed onto aluminum. Neither brand of hepatitis B vaccine contains thimerosal. The recent availability of a combined HAV and HBV vaccine allows for a more accelerated schedule for immunization. For a more detailed comparison of the potential vaccination schedules refer to the cited reference. These vaccines are some of the safest available. Side effects of the vaccine are soreness at the injection site, headache, fatigue, irritability, and fever. The number of patients experiencing adverse reactions decreases with each vaccine dose, and adverse reactions are less common in infants and children than in adults. There is no association between Guillain-Barre syndrome and the recombinant vaccine, and the vaccine does not transmit HIV. The hepatitis B vaccine is contraindicated for patients with anaphylaxis to... 

Hepatitis B vaccine is highly immunogenic. Protective levels of antibody are present in approximately 50% of young adults after one dose of vaccine in 85%, after two doses and >90%, after three doses. The third dose is required to provide long-term immunity. The most often used schedule is vaccination at 0, 1-2, and 4-6 months. The first and second doses of vaccine must be administered at least 1 month apart, and the first and third doses at least 4 months apart. If the vaccination series is interrupted after the first or second dose of vaccine, the missing dose should be administered as soon as possible. The series should not be restarted if a dose has been missed. The vaccine should be administered IM in the deltoid, not in the buttock. 

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