2020 U.S. Adult Immunization Schedule
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GUIDELINE WATCH | GENERAL MEDICINE, INFECTIOUS DISEASES
February 11, 2020
2020 U.S. Adult Immunization Schedule
Abigail Zuger, MD reviewing Freedman M et al. Ann Intern Med 2020 Feb 4
We might be giving fewer pneumococcal vaccinations and more HPV vaccinations in the future; it all depends on “shared clinical decision making.”
Sponsoring Organization: Advisory Committee on Immunization Practices (ACIP)
Background: The ACIP has made a few tweaks to its annual vaccine guidelines. Some recommended schedules and ages for various vaccines have been modified.
What's Changed
Indications for hepatitis A (HepA) vaccination have been broadened to include all people with HIV infections, as well as those with homelessness, chronic liver disease, and possible situational exposures.
“Catch-up” human papillomavirus (HPV) vaccination now is recommended for all inadequately vaccinated adults through age 26 (previously, it was recommended for men to age 21 and women to age 26). In addition, catch-up vaccination should be considered for adults of both sexes through age 45 if they have ongoing risk for new infection.
Vaccinated people at risk for group B meningococcal infection because of immune deficiency or occupation (e.g., microbiologists) should receive regular boosters, and more frequent boosters should be considered during local outbreaks.
The 13-valent conjugate pneumococcal vaccine “Prevnar” is no longer recommended for all adults older than 65; it should be given to those with immunocompromising conditions and can be considered for others, depending on patient and physician preference.
Either tetanus/diphtheria or tetanus/diphtheria/pertussis vaccine can be used for routine prophylaxis.
What has not changed: The live attenuated influenza vaccine (given by nasal spray) remains a viable option for immunocompetent adults younger than 50.
COMMENT
This schedule grows more complex every year, and the increasing number of situations to be adjudicated by “shared clinical decision making” doesn't help. The good news? The footnotes to the immunization schedules give clinicians some very useful points to consider when approaching these shared decisions.
EDITOR DISCLOSURES AT TIME OF PUBLICATION
Disclosures for Abigail Zuger, MD at time of publication
Nothing to disclose
CITATION(S):
Freedman M et al. Recommended adult immunization schedule, United States, 2020. Ann Intern Med 2020 Feb 4; [e-pub]. (Δεν είναι ορατοί οι σύνδεσμοι (links).
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27 Οκτωβρίου 2012, 19:06:29