Adult Immunizations

THE CDC ADVISORY COMMITTEE ON IMMUNIZAtion Practices routine immunization recommendations for adults are below.

Tetanus, Diphtheria & Pertussis Vaccine (Td/ Tdap): protects against three bacterial diseases. Tetanus bacteria poisons can cause lockjaw and muscle spasms. Respiratory diphtheria initially causes a sore throat, fever and chills. Pertussis (whooping cough) causes severe coughing spasms that can last for weeks.
Adults should have completed a three-dose primary series of tetanus- and diphtheria-containing vaccine as a child, and subsequently should get Td every 10 years starting at age 11-12 years. A dose of Tdap should replace one dose of Td, preferably at the 11-12 year old visit. Even if it has only been 2 years since the last Td shot, a Tdap dose is recommended for women who just had a baby; people in close contact with infants younger than 1 year; and all healthcare personnel with direct patient contact.
Adults with no record of vaccination against tetanus- and diphtheria- containing vaccine should receive two doses of Td and one dose of Tdap over a 6-month period.

Human Papillomavirus Vaccine (HPV): protects against four types of HPV that cause 70 percent of cervical cancers and 90 percent of genital warts. Women 19-26 years of age should receive three doses over a 6-month period. This vaccine is not given during pregnancy.

Measles, Mumps, Rubella Vaccine (MMR): protects against three viruses. Measles cause a rash, fever, cough, runny nose and eye irritation. Mumps cause fever, headache and swollen glands. Rubella (German measles) causes a rash and fever. Rubella infection in the first 3 months of pregnancy can lead to fetal death or serious birth defects.
Adults born before 1957 can generally be considered immune to measles, mumps and rubella. Adults born in 1957 or after should receive one dose of MMR, if they are not already immune or vaccinated. Some adults will need a second dose of MMR vaccine.
Women of childbearing age, should have evidence of rubella immunity or vaccination. Women who do not have a reliable history of rubella vaccination, or who lack evidence of immunity, should receive one dose of MMR. This vaccine is not given during pregnancy.

Varicella (Chickenpox) Vaccine: protects against a very contagious virus that causes fever and an itchy rash.

Adults born in the U.S. before 1980 (except healthcare personnel and pregnant women) can be considered immune to chickenpox.

All other adults who do not have proof of immunity to chickenpox (including healthcare personnel and women of child-bearing age) should receive two doses of varicella vaccine separated by 4-8 weeks. This vaccine is not given during pregnancy.

Flu (Influenza) Vaccine: protects against three influenza viruses that infect the lungs and can cause fever, headache, body aches, fatigue, loss of appetite and a dry cough.
Adults 50 and older and anyone with a chronic health condition (e.g., asthma, diabetes, or heart and lung disease) should receive flu vaccine each fall, as the vaccine changes each year.

Pneumococcal Polysaccharide Vaccine (PPV23): protects against 23 types of pneumococcus bacteria that can infect the blood (bacteremia), the lungs (pneumonia) and the fluid around the spinal cord and brain (meningitis).
Adults 65 or older, and anyone with a chronic health condition (e.g., heart or lung disease, sickle cell or immunosuppression) that increases their risk for pneumococcal disease, should be vaccinated.

Hepatitis A Vaccine (Hep A): protects against a virus that causes liver disease.
Adults at increased risk for infection (e.g., people with chronic liver disease or clotting factor disorder, illegal drug users, men who have sex with men and many international travelers) should receive two doses of hep A vaccine at least 6 months apart

Hepatitis B Vaccine (Hep B): protects against a virus that causes liver disease, liver scarring or even cancer of the liver. Adults at increased risk for infection (e.g., people with chronic liver disease or clotting factor disorder, people who inject illegal drugs, people on dialysis, sexually active persons with more than one partner in 6 months, people with sexually transmitted diseases, household and sex partners of someone infected with hep B, some international travelers and healthcare personnel) should receive three doses of hepatitis B vaccine over a 6-month period.

Meningococcal Vaccine (MPSV4 or MCV4): protects against four types of meningococcal bacteria that can infect the blood (septicemia) or the fluid around the spinal cord and brain (meningitis).
Adults at increased risk for meningococcal disease (e.g., military recruits, some international travelers and first-year college students in a dormitory) should receive one dose of meningococcal vaccine. MCV4 vaccine is preferred for adults under 55. MPSV4 should be used for older adults, or if MCV4 is not available.

Resources

http://www.immunize.org/catg.d/p4030a.pdf

Compiled by Donna L. Weaver, MN, RN, nurse educator, National Immunization Program, CDC, Atlanta

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