The document provides recommendations for vaccinations for adults aged 19 years and older in the United States. It includes two figures: 1) a table outlining recommended vaccinations by age group and vaccine type, and 2) a table describing vaccinations recommended for certain medical conditions. It also provides 11 footnotes that provide additional details on vaccination schedules, recommendations, and considerations. The overall recommendations are aimed at preventing serious diseases and complications from vaccine-preventable infections in adults through safe and effective vaccination programs.
This document provides the recommended adult immunization schedule for vaccines in the United States for 2014. It includes 2 figures: Figure 1 lists recommended vaccines by age group from 19-21 years to 65 years and older. Figure 2 lists vaccines that may be indicated based on medical conditions and other risk factors. Footnotes provide additional guidance on vaccination recommendations, vaccine types, doses and intervals. The schedule aims to provide healthcare professionals with up-to-date information on immunizations for adults 19 years and older.
The document provides recommendations for adult immunization schedules in the United States for 2014. It includes two figures: Figure 1 lists recommended vaccines by age group, and Figure 2 lists vaccines that may be indicated based on medical conditions and risk factors. Footnotes provide additional details on vaccine recommendations, including dosages, intervals between doses, and coverage by the Vaccine Injury Compensation Program. The schedule aims to provide guidance on which vaccines are commonly recommended for adults 19 years and older.
The document summarizes the 2014 recommended adult immunization schedule approved by several medical organizations in the United States. It provides the schedule by vaccine and age group, with footnotes providing additional details on vaccines and recommendations. The schedule includes vaccines for influenza, tetanus/diphtheria/pertussis, varicella, HPV, herpes zoster, MMR, pneumococcal, meningococcal, hepatitis A&B, and Hib. It also lists medical conditions or other indications when certain vaccines are recommended and provides links for more information.
The document summarizes the 2014 recommended adult immunization schedule approved by several medical organizations in the United States. It provides the schedule which lists recommended vaccines for adults ages 19 years and older grouped by age range. It also lists additional vaccines that may be indicated based on medical conditions and other risk factors. Footnotes provide additional details on vaccine recommendations including dosing intervals, contraindications and special populations.
The document provides recommendations for adult immunization for various vaccines. It includes:
1) Which vaccines are recommended for adults over 19 years of age, including influenza, pneumococcal, MMR, varicella, zoster, hepatitis A, and hepatitis B vaccines.
2) The schedule for administering each vaccine, including recommended doses and timing.
3) Contraindications and precautions for each vaccine, such as previous allergic reactions, pregnancy, immunosuppression, or moderate/severe illness.
GUIDELINES ON COVID VACCINATION IN PREGNANCY IN INDIA : Dr. Sharda Jain Lifecare Centre
This document provides guidelines for COVID vaccination in pregnancy in India. It recommends that all pregnant women should be vaccinated in any trimester, with high-risk mothers receiving Covaxin. Low-risk mothers should receive Covishield. It provides guidance on vaccination for various at-risk groups and medical conditions. The COVID vaccine can be given on the same day as other vaccines at different sites. Pregnant mothers should be counseled on vaccination and their vaccination status recorded in their RCH card.
- Vaccination is one of the most important preventative measures against infectious diseases. It has succeeded in preventing some diseases and reducing the risk of some cancers. Vaccination has played a major role in eradicating smallpox and controlling the spread of many childhood diseases.
- Elderly people now make up a large percentage of the population in many countries worldwide. They are more susceptible to infectious diseases and associated mortality compared to younger people due to weaker immune systems.
- There are vaccines that can help reduce rates of disease and death among elderly populations by protecting against common infectious diseases that pose health risks. People should speak to their doctor about appropriate vaccination options for later life.
This document provides an overview and updates on various adult vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). It discusses vaccines for influenza, pneumococcal disease, herpes zoster, Tdap, HPV, meningococcal disease, hepatitis A, and varicella. For each vaccine, it outlines the populations recommended to receive it, dosing schedules, and special considerations for immunocompromised individuals. The presentation emphasizes the importance of adult vaccinations in preventing disease and highlights changes to recommendations for the 2013-2014 season.
This document provides the recommended adult immunization schedule for vaccines in the United States for 2014. It includes 2 figures: Figure 1 lists recommended vaccines by age group from 19-21 years to 65 years and older. Figure 2 lists vaccines that may be indicated based on medical conditions and other risk factors. Footnotes provide additional guidance on vaccination recommendations, vaccine types, doses and intervals. The schedule aims to provide healthcare professionals with up-to-date information on immunizations for adults 19 years and older.
The document provides recommendations for adult immunization schedules in the United States for 2014. It includes two figures: Figure 1 lists recommended vaccines by age group, and Figure 2 lists vaccines that may be indicated based on medical conditions and risk factors. Footnotes provide additional details on vaccine recommendations, including dosages, intervals between doses, and coverage by the Vaccine Injury Compensation Program. The schedule aims to provide guidance on which vaccines are commonly recommended for adults 19 years and older.
The document summarizes the 2014 recommended adult immunization schedule approved by several medical organizations in the United States. It provides the schedule by vaccine and age group, with footnotes providing additional details on vaccines and recommendations. The schedule includes vaccines for influenza, tetanus/diphtheria/pertussis, varicella, HPV, herpes zoster, MMR, pneumococcal, meningococcal, hepatitis A&B, and Hib. It also lists medical conditions or other indications when certain vaccines are recommended and provides links for more information.
The document summarizes the 2014 recommended adult immunization schedule approved by several medical organizations in the United States. It provides the schedule which lists recommended vaccines for adults ages 19 years and older grouped by age range. It also lists additional vaccines that may be indicated based on medical conditions and other risk factors. Footnotes provide additional details on vaccine recommendations including dosing intervals, contraindications and special populations.
The document provides recommendations for adult immunization for various vaccines. It includes:
1) Which vaccines are recommended for adults over 19 years of age, including influenza, pneumococcal, MMR, varicella, zoster, hepatitis A, and hepatitis B vaccines.
2) The schedule for administering each vaccine, including recommended doses and timing.
3) Contraindications and precautions for each vaccine, such as previous allergic reactions, pregnancy, immunosuppression, or moderate/severe illness.
GUIDELINES ON COVID VACCINATION IN PREGNANCY IN INDIA : Dr. Sharda Jain Lifecare Centre
This document provides guidelines for COVID vaccination in pregnancy in India. It recommends that all pregnant women should be vaccinated in any trimester, with high-risk mothers receiving Covaxin. Low-risk mothers should receive Covishield. It provides guidance on vaccination for various at-risk groups and medical conditions. The COVID vaccine can be given on the same day as other vaccines at different sites. Pregnant mothers should be counseled on vaccination and their vaccination status recorded in their RCH card.
- Vaccination is one of the most important preventative measures against infectious diseases. It has succeeded in preventing some diseases and reducing the risk of some cancers. Vaccination has played a major role in eradicating smallpox and controlling the spread of many childhood diseases.
- Elderly people now make up a large percentage of the population in many countries worldwide. They are more susceptible to infectious diseases and associated mortality compared to younger people due to weaker immune systems.
- There are vaccines that can help reduce rates of disease and death among elderly populations by protecting against common infectious diseases that pose health risks. People should speak to their doctor about appropriate vaccination options for later life.
This document provides an overview and updates on various adult vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). It discusses vaccines for influenza, pneumococcal disease, herpes zoster, Tdap, HPV, meningococcal disease, hepatitis A, and varicella. For each vaccine, it outlines the populations recommended to receive it, dosing schedules, and special considerations for immunocompromised individuals. The presentation emphasizes the importance of adult vaccinations in preventing disease and highlights changes to recommendations for the 2013-2014 season.
The document discusses adult immunization and summarizes recommendations for various vaccines. It provides an overview of the history and pioneers of immunization like Jenner and Pasteur. Data is presented showing the success of vaccines in reducing cases of diseases like smallpox, diphtheria, and invasive pneumococcal disease. Recommendations are outlined for vaccines including influenza, pneumococcal, hepatitis A/B, meningococcal, MMR, HPV, Tdap, herpes zoster and others. Contraindications and special populations are also mentioned.
The document provides clinical considerations for use of the Pfizer-BioNTech COVID-19 vaccine based on information submitted to the FDA for Emergency Use Authorization. It discusses administration of the two-dose vaccine schedule, considerations for special populations including pregnant and breastfeeding women, importance of completing the two-dose series, and contraindications.
Vaccination as a health prevention strategy for elderlyMarc Evans Abat
Vaccination plays an important role in health promotion and disease prevention for the elderly population. Common recommended vaccines include annual influenza, one-time pneumococcal and herpes zoster vaccines. Studies show that influenza and pneumococcal vaccines reduce illness, hospitalizations and deaths in the elderly. Challenges to vaccination uptake in the elderly include improving awareness, access, affordability and addressing resource allocation issues across individual, provider, research and policy levels.
Vaccination of healthcare workers, Dr. V. Anil Kumarohscmcvellore
This document discusses immunization recommendations for healthcare workers. It recommends that healthcare workers receive vaccines for hepatitis B, influenza, measles/mumps/rubella, varicella, tetanus/diphtheria/pertussis, and meningococcal in order to protect themselves, patients, and prevent transmission of infectious diseases. It provides details on each recommended vaccine including disease information, vaccination schedules and guidance on determining immunity and booster doses. It addresses common questions and situations that may arise regarding vaccination requirements and testing for healthcare workers.
This document discusses adult immunization. It defines active and passive immunization. Adult immunization is recommended to build on childhood immunization programs and target new vaccines. It recommends several vaccines for adults in India including Tdap, MMR, varicella, HPV, hepatitis A&B, pneumococcal, influenza, and meningococcal vaccines. It provides details on vaccine types, schedules, indications, and administration practices. Adult immunization can help prevent disease and build upon India's success in eradicating smallpox and reducing other diseases through childhood immunization.
Guidelines On COVID-19 Vaccination In Pregnancy And Breastfeeding, Version 2 (23rd June 2021)
By Ministry of Health, Malaysia
Update: Addendum added in 10th Aug 2021 - https://www.slideshare.net/ICRInstituteForClini/updated-guidelines-on-covid19-vaccination-for-pregnant-and-breastfeeding-mothers
This document provides information on immunizations for women in 2014. It discusses myths versus facts about vaccines, explains that vaccines do not cause autism or the diseases they protect against. It addresses safety and effectiveness of the influenza and Tdap vaccines during pregnancy. It recommends that all pregnant women receive the inactivated influenza vaccine each year from 27-36 weeks of pregnancy and the Tdap vaccine in each pregnancy. Minor and temporary side effects are common with vaccines while severe reactions are extremely rare.
This document provides guidance on COVID-19 vaccinations for oncology patients. It discusses the history and effectiveness of vaccines. It states that most oncology patients are eligible for COVID-19 vaccination, even those receiving active cancer treatment, though their immune response may be weaker. Guidelines recommend vaccination for cancer patients and survivors, with only a few exceptions. It provides tips on timing vaccinations around cancer treatment.
Vaccination of pregnant women and health care workers - Slideset by Professor...WAidid
Professor Lopalco suggests the vaccines to be considered for pregnant women and the ones recommended for health care workers (Influenza, HBV, dTap, MMR-V, meningococcal).
Clinical Guideline on COVID-19 Vaccination for Adolescents (12 – 17 years)
Prepared by Dr Nik Khairulddin Nik Yusoff, Paediatrician at Hospital Raja Perempuan Zainab II
Infections and vaccines in Pregnancy : An Overview, Dr. Sharda Jain Lifecare...Lifecare Centre
This document discusses infections and vaccines in pregnancy, with a focus on influenza. It notes that pregnant women are more severely affected by some infections like influenza. Influenza vaccination is recommended for all pregnant women in any trimester to protect both mother and infant. While some vaccines can be given before or after pregnancy, influenza and Tdap vaccines are specifically recommended during pregnancy. Proper management of influenza in pregnancy includes isolation, antiviral treatment, and supportive care. Routine influenza vaccination of pregnant women can help reduce ICU admissions and mortality from this infection.
The document discusses adult immunization, including defining immunization and providing rationales for adult immunization programs. It reviews the disease burden of vaccine-preventable diseases in the US and India and provides recommendations for adult immunization schedules in both countries. Challenges to adult immunization are also discussed.
Maternal Immunization with Tdap Vaccine Dr. Sharda Jain Lifecare Centre
Maternal
Immunization
with Tdap Vaccine
Agenda
Pertussis:Key facts & Epidemiology
Who is at risk?
Source of Pertussis infection
What is Tdap vaccine?
Recommendations for Maternal Immunization with Tdap vaccine
Safety data on Maternal Immunisation with Tdap vaccine
Summary
This document provides guidance on immunization schedules and recommendations for adults ages 19 years and older. It includes:
1) A table outlining the routine vaccines recommended by age, including influenza, tetanus/diphtheria/pertussis, measles/mumps/rubella, and others.
2) A table listing additional vaccines recommended for adults with specific medical conditions or other risk factors.
3) Notes on vaccination schedules, doses, intervals and considerations for special situations for various vaccines.
The document is intended to help healthcare providers determine the recommended vaccines for adult patients based on their age, medical conditions, and other risk factors.
The document discusses vaccine recommendations for pregnant women. It recommends that routinely recommended vaccines like Tdap be administered between 27-36 weeks of gestation to protect both the mother and fetus. It also recommends the flu vaccine during any trimester. Live vaccines like MMR are generally not recommended in pregnancy due to theoretical risks, but may be considered if the woman is at high risk of exposure to the disease. The timing and types of vaccines recommended vary according to trimester and disease risk factors. The overall goals are to provide protection to both mother and baby through vaccination and passive immunity.
Version 10th August 2021.
Addendum to Ministry of Health, Malaysia's Guidelines Version 2, Dated 23rd June 2021 For the full list of updates, please visit https://cutt.ly/c19vak
FOGSI POSITION STATEMENT COVID VACCINATION FOR PREGNANT & BREASTFEEDING WOMENNARENDRA C MALHOTRA
This document discusses recommendations and guidelines regarding COVID-19 vaccination for pregnant and breastfeeding women. It provides information on the current COVID-19 situation globally and in India, the different types of COVID vaccines available in India, benefits of vaccination for the general population and pregnant women, safety of the vaccines for pregnant women, and international recommendations that vaccination should be offered to pregnant women similar to non-pregnant individuals based on risk-benefit analysis. The document concludes by stating current recommendations in India do not support vaccination of pregnant or breastfeeding women due to lack of safety data, but international organizations support vaccination for pregnant women.
This document discusses issues related to transparency and liability regarding COVID-19 vaccines. It notes that SARS-CoV-2 likely originated from a zoonotic transmission and/or ecological imbalance and climate change. It calls for improved livestock management, increasing biodiversity, forest growth, agro-ecology, and bans on gain-of-function research to address future pandemics. Regarding India's vaccination program, it summarizes strategies around population-wide vaccination and emergency authorization of vaccines. It also discusses pricing of different vaccines, costs of vaccinating 3 crore individuals, and what is required like data on vaccine safety, a public database to track adverse effects, and compensation for any adverse reactions.
This document discusses vaccinations that are recommended, not recommended, and sometimes recommended during pregnancy. It provides information on several common vaccines including measles, mumps, rubella, polio, yellow fever, influenza, rabies, and hepatitis B. For vaccines using live viruses, the risks of potentially infecting the fetus are weighed against the risks of the disease. Inactivated virus vaccines like influenza, rabies, and hepatitis B are generally considered safe during pregnancy.
This document provides a recommended adult immunization schedule by vaccine and age group for the United States from October 2004 to September 2005. It lists various vaccines including tetanus, diphtheria, influenza, pneumococcal, hepatitis A & B, measles/mumps/rubella, varicella, and meningococcal vaccines. It provides guidance on dosage amounts and time intervals for administration of these vaccines to adults aged 19 and older, based on their age group and risk factors. Footnotes provide additional details on specific vaccine recommendations.
This document provides guidance on adult immunization schedules and vaccine recommendations for individuals ages 19 years and older. It includes 5 tables:
1. The recommended adult immunization schedule by age group, listing which vaccines are recommended for individuals ages 19-26 years, 27-49 years, 50-64 years, and 65 years and older.
2. Additional vaccine recommendations for certain medical conditions or other indications.
3. Additional information on vaccine schedules, intervals, travel vaccines, and immunocompromised individuals.
4. Information on the National Vaccine Injury Compensation Program and COVID-19 vaccination recommendations for routine and high-risk individuals.
5. A reference list of ACIP approved organizations
The document discusses adult immunization and summarizes recommendations for various vaccines. It provides an overview of the history and pioneers of immunization like Jenner and Pasteur. Data is presented showing the success of vaccines in reducing cases of diseases like smallpox, diphtheria, and invasive pneumococcal disease. Recommendations are outlined for vaccines including influenza, pneumococcal, hepatitis A/B, meningococcal, MMR, HPV, Tdap, herpes zoster and others. Contraindications and special populations are also mentioned.
The document provides clinical considerations for use of the Pfizer-BioNTech COVID-19 vaccine based on information submitted to the FDA for Emergency Use Authorization. It discusses administration of the two-dose vaccine schedule, considerations for special populations including pregnant and breastfeeding women, importance of completing the two-dose series, and contraindications.
Vaccination as a health prevention strategy for elderlyMarc Evans Abat
Vaccination plays an important role in health promotion and disease prevention for the elderly population. Common recommended vaccines include annual influenza, one-time pneumococcal and herpes zoster vaccines. Studies show that influenza and pneumococcal vaccines reduce illness, hospitalizations and deaths in the elderly. Challenges to vaccination uptake in the elderly include improving awareness, access, affordability and addressing resource allocation issues across individual, provider, research and policy levels.
Vaccination of healthcare workers, Dr. V. Anil Kumarohscmcvellore
This document discusses immunization recommendations for healthcare workers. It recommends that healthcare workers receive vaccines for hepatitis B, influenza, measles/mumps/rubella, varicella, tetanus/diphtheria/pertussis, and meningococcal in order to protect themselves, patients, and prevent transmission of infectious diseases. It provides details on each recommended vaccine including disease information, vaccination schedules and guidance on determining immunity and booster doses. It addresses common questions and situations that may arise regarding vaccination requirements and testing for healthcare workers.
This document discusses adult immunization. It defines active and passive immunization. Adult immunization is recommended to build on childhood immunization programs and target new vaccines. It recommends several vaccines for adults in India including Tdap, MMR, varicella, HPV, hepatitis A&B, pneumococcal, influenza, and meningococcal vaccines. It provides details on vaccine types, schedules, indications, and administration practices. Adult immunization can help prevent disease and build upon India's success in eradicating smallpox and reducing other diseases through childhood immunization.
Guidelines On COVID-19 Vaccination In Pregnancy And Breastfeeding, Version 2 (23rd June 2021)
By Ministry of Health, Malaysia
Update: Addendum added in 10th Aug 2021 - https://www.slideshare.net/ICRInstituteForClini/updated-guidelines-on-covid19-vaccination-for-pregnant-and-breastfeeding-mothers
This document provides information on immunizations for women in 2014. It discusses myths versus facts about vaccines, explains that vaccines do not cause autism or the diseases they protect against. It addresses safety and effectiveness of the influenza and Tdap vaccines during pregnancy. It recommends that all pregnant women receive the inactivated influenza vaccine each year from 27-36 weeks of pregnancy and the Tdap vaccine in each pregnancy. Minor and temporary side effects are common with vaccines while severe reactions are extremely rare.
This document provides guidance on COVID-19 vaccinations for oncology patients. It discusses the history and effectiveness of vaccines. It states that most oncology patients are eligible for COVID-19 vaccination, even those receiving active cancer treatment, though their immune response may be weaker. Guidelines recommend vaccination for cancer patients and survivors, with only a few exceptions. It provides tips on timing vaccinations around cancer treatment.
Vaccination of pregnant women and health care workers - Slideset by Professor...WAidid
Professor Lopalco suggests the vaccines to be considered for pregnant women and the ones recommended for health care workers (Influenza, HBV, dTap, MMR-V, meningococcal).
Clinical Guideline on COVID-19 Vaccination for Adolescents (12 – 17 years)
Prepared by Dr Nik Khairulddin Nik Yusoff, Paediatrician at Hospital Raja Perempuan Zainab II
Infections and vaccines in Pregnancy : An Overview, Dr. Sharda Jain Lifecare...Lifecare Centre
This document discusses infections and vaccines in pregnancy, with a focus on influenza. It notes that pregnant women are more severely affected by some infections like influenza. Influenza vaccination is recommended for all pregnant women in any trimester to protect both mother and infant. While some vaccines can be given before or after pregnancy, influenza and Tdap vaccines are specifically recommended during pregnancy. Proper management of influenza in pregnancy includes isolation, antiviral treatment, and supportive care. Routine influenza vaccination of pregnant women can help reduce ICU admissions and mortality from this infection.
The document discusses adult immunization, including defining immunization and providing rationales for adult immunization programs. It reviews the disease burden of vaccine-preventable diseases in the US and India and provides recommendations for adult immunization schedules in both countries. Challenges to adult immunization are also discussed.
Maternal Immunization with Tdap Vaccine Dr. Sharda Jain Lifecare Centre
Maternal
Immunization
with Tdap Vaccine
Agenda
Pertussis:Key facts & Epidemiology
Who is at risk?
Source of Pertussis infection
What is Tdap vaccine?
Recommendations for Maternal Immunization with Tdap vaccine
Safety data on Maternal Immunisation with Tdap vaccine
Summary
This document provides guidance on immunization schedules and recommendations for adults ages 19 years and older. It includes:
1) A table outlining the routine vaccines recommended by age, including influenza, tetanus/diphtheria/pertussis, measles/mumps/rubella, and others.
2) A table listing additional vaccines recommended for adults with specific medical conditions or other risk factors.
3) Notes on vaccination schedules, doses, intervals and considerations for special situations for various vaccines.
The document is intended to help healthcare providers determine the recommended vaccines for adult patients based on their age, medical conditions, and other risk factors.
The document discusses vaccine recommendations for pregnant women. It recommends that routinely recommended vaccines like Tdap be administered between 27-36 weeks of gestation to protect both the mother and fetus. It also recommends the flu vaccine during any trimester. Live vaccines like MMR are generally not recommended in pregnancy due to theoretical risks, but may be considered if the woman is at high risk of exposure to the disease. The timing and types of vaccines recommended vary according to trimester and disease risk factors. The overall goals are to provide protection to both mother and baby through vaccination and passive immunity.
Version 10th August 2021.
Addendum to Ministry of Health, Malaysia's Guidelines Version 2, Dated 23rd June 2021 For the full list of updates, please visit https://cutt.ly/c19vak
FOGSI POSITION STATEMENT COVID VACCINATION FOR PREGNANT & BREASTFEEDING WOMENNARENDRA C MALHOTRA
This document discusses recommendations and guidelines regarding COVID-19 vaccination for pregnant and breastfeeding women. It provides information on the current COVID-19 situation globally and in India, the different types of COVID vaccines available in India, benefits of vaccination for the general population and pregnant women, safety of the vaccines for pregnant women, and international recommendations that vaccination should be offered to pregnant women similar to non-pregnant individuals based on risk-benefit analysis. The document concludes by stating current recommendations in India do not support vaccination of pregnant or breastfeeding women due to lack of safety data, but international organizations support vaccination for pregnant women.
This document discusses issues related to transparency and liability regarding COVID-19 vaccines. It notes that SARS-CoV-2 likely originated from a zoonotic transmission and/or ecological imbalance and climate change. It calls for improved livestock management, increasing biodiversity, forest growth, agro-ecology, and bans on gain-of-function research to address future pandemics. Regarding India's vaccination program, it summarizes strategies around population-wide vaccination and emergency authorization of vaccines. It also discusses pricing of different vaccines, costs of vaccinating 3 crore individuals, and what is required like data on vaccine safety, a public database to track adverse effects, and compensation for any adverse reactions.
This document discusses vaccinations that are recommended, not recommended, and sometimes recommended during pregnancy. It provides information on several common vaccines including measles, mumps, rubella, polio, yellow fever, influenza, rabies, and hepatitis B. For vaccines using live viruses, the risks of potentially infecting the fetus are weighed against the risks of the disease. Inactivated virus vaccines like influenza, rabies, and hepatitis B are generally considered safe during pregnancy.
This document provides a recommended adult immunization schedule by vaccine and age group for the United States from October 2004 to September 2005. It lists various vaccines including tetanus, diphtheria, influenza, pneumococcal, hepatitis A & B, measles/mumps/rubella, varicella, and meningococcal vaccines. It provides guidance on dosage amounts and time intervals for administration of these vaccines to adults aged 19 and older, based on their age group and risk factors. Footnotes provide additional details on specific vaccine recommendations.
This document provides guidance on adult immunization schedules and vaccine recommendations for individuals ages 19 years and older. It includes 5 tables:
1. The recommended adult immunization schedule by age group, listing which vaccines are recommended for individuals ages 19-26 years, 27-49 years, 50-64 years, and 65 years and older.
2. Additional vaccine recommendations for certain medical conditions or other indications.
3. Additional information on vaccine schedules, intervals, travel vaccines, and immunocompromised individuals.
4. Information on the National Vaccine Injury Compensation Program and COVID-19 vaccination recommendations for routine and high-risk individuals.
5. A reference list of ACIP approved organizations
The document provides recommendations for adult immunization schedules in the United States for 2014. It includes 2 figures: Figure 1 lists recommended vaccines by age group from 19-21 years to 65 years and older. Figure 2 lists medical indications when additional vaccines may be recommended. Key recommendations include an annual influenza vaccine for all adults, a one-time Tdap booster followed by Td every 10 years, HPV vaccination through age 26, and consideration of PCV13, PPSV23, and hepatitis B vaccines for adults with certain medical conditions.
The document summarizes WHO recommendations for routine childhood vaccinations. It provides a table outlining the recommended vaccines for children, adolescents, and sometimes adults. For each vaccine, it lists the number of doses recommended and any special considerations. Some key recommendations include BCG vaccination for all newborns in high tuberculosis burden countries, 3 doses of hepatitis B vaccine for all children worldwide, and a primary series of 3 doses of oral polio vaccine (OPV) plus 2 doses of inactivated polio vaccine (IPV) for polio immunization.
Dr. Pradeep Katwal presented on adult immunization. He discussed how vaccines have led to the eradication of smallpox and near eradication of diseases like diphtheria. He reviewed the immunological basis of vaccines and highlighted various vaccines recommended for adults including influenza, pneumococcal, hepatitis A/B, HPV and herpes zoster vaccines. Adult immunization is important to reduce the burden of vaccine-preventable diseases and protect high risk groups.
This document summarizes the WHO's position on vaccination recommendations for children. It includes:
1) A table outlining the recommended ages, doses, and intervals for various routine childhood vaccines.
2) Footnotes providing details on booster considerations, co-administration, and catch-up schedules.
3) Clarification that national immunization schedules should be based on local epidemiological factors in addition to these guidelines. The document is intended to help countries develop appropriate vaccination schedules.
This document summarizes vaccination recommendations for various diseases in adults. It discusses vaccinations for diphtheria, tetanus and pertussis (Tdap), hepatitis A and B, herpes zoster, and human papillomavirus. For each disease, it describes the available vaccines, recommendations for who should be vaccinated, dosing schedules, precautions, and booster recommendations. The document provides guidance on adult immunization to help prevent morbidity and mortality from vaccine-preventable illnesses.
The document discusses adult immunization strategies in India. It notes there is a lack of consensus on optimal adult immunization strategies in developing countries like India due to a lack of reliable epidemiological data, efficacy and safety data of vaccination strategies, and data on monitoring immunization adequacy. The document provides guidance on recommended vaccines for different adult groups and schedules for vaccines including tetanus, diphtheria, pertussis, hepatitis A, hepatitis B, HPV, influenza, measles, mumps, rubella, varicella, herpes zoster and pneumococcal vaccines.
Dr Swati Rajagopal_ ADULT VACCINATION.pptxVandanaVats8
This document discusses adult immunization guidelines in India. It covers several common vaccines recommended for adults such as the influenza, tetanus/diphtheria/pertussis, pneumococcal, hepatitis A and B, herpes zoster, and HPV vaccines. For each vaccine, it describes the types available, indications for use, dosage, schedule, precautions, and high-risk groups. The document emphasizes that while childhood immunization is widespread in India, awareness and uptake of adult vaccines remains low despite the significant disease burden they can prevent.
This document contains a screening checklist for contraindications to vaccines for adults. It includes 10 yes or no questions about the patient's health conditions and history that could preclude them from receiving certain vaccines. The questions address issues like allergies, previous adverse reactions, chronic illnesses, immunosuppression, recent medications/treatments, seizures, transfusions, pregnancy status, and timing of prior vaccinations. Answering yes to any question requires further discussion with the healthcare provider to determine vaccine eligibility or appropriate vaccines.
1Global Vaccination (attach this please with the previou.docxfelicidaddinwoodie
The document discusses vaccination programs and policies in Malaysia and Saudi Arabia. The Malaysian National Immunization Program provides vaccines for major childhood diseases free of charge at government clinics. Vaccine safety is monitored by the National Centre of Adverse Drug Reactions. Saudi Arabia's Ministry of Health operates vaccination programs through over 2,000 primary health centers, achieving over 90% childhood immunization coverage. Vaccination requirements include proof of meningitis vaccination for Hajj pilgrims. Both countries' programs aim to expand access and monitor vaccine safety.
The document provides guidance on vaccinations for adults ages 19 years and older. It includes:
1) A table outlining recommended vaccinations by age group, including COVID-19, influenza, tetanus/diphtheria/pertussis, measles/mumps/rubella, varicella, zoster, human papillomavirus, pneumococcal, hepatitis A&B, meningococcal, and Haemophilus influenzae type b vaccines.
2) A table listing additional vaccination recommendations for those with medical conditions or other indications, such as pregnancy, immunocompromised individuals, and health care workers.
3) Notes providing details on COVID-19 vaccination
This document provides vaccination schedules and guidelines for children from various health organizations. It begins by outlining the vaccination schedule for children in India from birth through age 18-19 months. It then discusses vaccination schedules from UNICEF and provides details on specific vaccines such as BCG, DTwP/DTaP, polio, hepatitis B, and others. The document discusses administration of vaccines, contraindications, side effects of the HPV vaccine, and more. It provides comprehensive information on vaccination of children.
This document provides guidelines for recommended vaccinations in Nepal. It begins with an introduction to immunization and vaccines. It then discusses the principles of immunization, including types of immunization, administration methods, safety considerations, and record keeping. The document provides detailed recommendations for various vaccines, including influenza, tetanus/diphtheria/pertussis, measles/mumps/rubella, varicella, zoster, HPV, pneumococcal, hepatitis A, hepatitis B, meningococcal, and Hib. It notes special vaccination considerations for certain high-risk groups. In conclusion, it discusses some challenges to adult immunization programs.
1. Implement a patient intake form to routinely assess vaccination status at every visit and identify which vaccines are needed.
2. Use standing orders and protocols to allow nurses and other staff to administer recommended vaccines.
3. Refer patients to pharmacies or health departments for vaccines not stocked in the practice and document referrals.
3. Enter administered vaccines and referrals into the state immunization registry to track rates and prevent missed opportunities.
The MMR vaccine is a live, attenuated vaccine given subcutaneously to provide protection against measles, mumps and rubella. It is recommended as a 2-dose series, with the first dose at 12-15 months and the second dose at 4-6 years. Common side effects include fever and rash. Certain high-risk groups should not receive this vaccine, including those with severe immunodeficiencies or egg allergies. There is no scientific evidence that MMR or other vaccines cause autism.
This document provides the recommended child and adolescent immunization schedule for ages 18 years and younger in the United States for 2023. It includes a table outlining the recommended vaccines by age from birth through 18 years, including COVID-19, influenza, measles, mumps, rubella and other routine childhood vaccines. It also provides catch-up schedules for children whose vaccinations have been delayed. The schedule is designed to help healthcare professionals determine which vaccines are recommended at each well-child visit.
This document discusses urinary tract injuries that can occur during laparoscopic gynecological surgery. It notes that bladder injury is the most common major complication. Prevention strategies include catheterization before trocar insertion, using the lowest effective power for electrosurgery, and identifying bladder boundaries. Injuries may be recognized intraoperatively through direct visualization, cystoscopy, or instilling dye. Postoperative recognition involves symptoms like pain and hematuria. Management often involves laparoscopic repair by a gynecologist or urologist to avoid additional morbidity of laparotomy.
This study retrospectively analyzed 65 cases of unusual ectopic pregnancies out of 1000 total ectopic pregnancy cases over a 10-year period. The study found that ovarian pregnancies were associated with intrauterine device placement and pelvic inflammatory diseases. Extratubal ectopic pregnancies like those in the ovaries, cervix, and abdomen presented more serious symptoms and had higher misdiagnosis rates than tubal pregnancies. Most unusual ectopic pregnancies required surgery for treatment, though some early cervical and corneal pregnancies were treated with conservative methods like mifepristone and methotrexate or curettage.
This document discusses the role of tubal patency tests and tubal surgery in the era of assisted reproductive techniques. It reviews evidence on various tubal patency tests like laparoscopy, hysterosalpingogram, hysterosalpingo contrast sonography, and their advantages and limitations. While laparoscopy is considered the gold standard, it requires general anesthesia and carries surgical risks. Hysterosalpingogram is widely available but less accurate and exposes patients to radiation. Hysterosalpingo contrast sonography provides images without radiation but may be limited in some patients. The document concludes that in vitro fertilization has largely replaced tubal surgery as it offers better success rates and can be done on an out
This document summarizes recent advances in endocrine therapy for breast cancer. Key findings from clinical trials show that aromatase inhibitors are superior to tamoxifen for postmenopausal women, 10 years of tamoxifen is better than 5 years for premenopausal women, and combining mTOR inhibitors like everolimus with hormonal therapies improves outcomes. New trials also found fulvestrant works as well as aromatase inhibitors for first-line metastatic disease. Combining fulvestrant and exemestane was more effective than single agents. Exemestane was also found to reduce invasive breast cancers in prevention settings.
This document summarizes a study that evaluated the effects of various maternal, fetal, and technical factors on the accuracy of sonographic fetal weight estimation (SFWE). The study analyzed over 9,000 SFWEs performed within a week of delivery. It found that several maternal factors, including higher weight, height, BMI, older age, diabetes, and multiparity were associated with underestimation of fetal weight. Fetal factors like male sex were also linked to underestimation, while breech presentation slightly improved accuracy. Experience level of the sonographer had little effect. Overall, the models assessed explained less than 10% of errors, suggesting most inaccuracy comes from limitations of SFWE formulas themselves.
This study examined the effects of mechanical cervical dilation using laminaria tents for women with premature rupture of membranes (PROM) at term. The study compared outcomes between women who received laminaria tent insertion for unfavorable cervical ripening prior to 2010 (group 1) and women managed without laminaria tents after 2010 (group 2). The results found no significant differences between the groups in maternal and neonatal outcomes such as infection rates, time to delivery, Apgar scores, or umbilical cord pH levels. Mechanical cervical dilation did not increase infection risks or improve perinatal prognosis, providing no clear benefits for women with PROM at term.
This document discusses selective progesterone receptor modulators (SPRM) and their uses in gynecology. It provides background on the initial development of mifepristone as a progesterone receptor antagonist in the 1980s. More recently, ulipristal acetate, a SPRM, has been licensed for emergency contraception and as a preoperative treatment for uterine fibroids. The document outlines the mechanism of action of SPRMs as having mixed agonist and antagonist effects on progesterone receptors. It also summarizes recent clinical trials showing ulipristal acetate to be an effective alternative to gonadotropin-releasing hormone analogues for preoperative treatment of uterine fibroids, with reduced side effect profiles compared to analogues.
This study assessed satisfaction in 89 women who underwent concurrent pelvic organ prolapse (POP) repair and midurethral sling placement to treat stress urinary incontinence (SUI). At the 1-year follow-up, 72% of patients had complete cure of both POP and SUI, while 17% and 10% had persistent SUI or POP respectively. Overall, 88% reported being satisfied. Patients who achieved complete cure of both conditions had a 95% satisfaction rate, while 40% were dissatisfied if SUI was not cured and 22% if POP was not cured. The only outcome measure correlated with satisfaction was improvement in vaginal bulge symptoms. The study highlights the complex relationship between surgical outcomes and patient
1) The document discusses retinoids, which are known to be teratogenic when used during pregnancy. Isotretinoin in particular is used to treat severe acne but has significant risks of causing fetal malformations.
2) When isotretinoin is prescribed to women of childbearing age, a pregnancy prevention programme is implemented to prevent exposure during treatment and for at least one month after. However, pregnancies still occasionally occur despite these measures.
3) The main teratogenic effects of isotretinoin exposure during pregnancy include craniofacial, central nervous system, cardiovascular and thymic abnormalities in the developing fetus. Management of pregnancies with recent isotretinoin exposure involves counseling and potential
This study assessed resilience, depressed mood, and menopausal symptoms in 169 postmenopausal women aged 48-68 years. 45% of women had depressed mood and 35% had severe menopausal symptoms. Women with less resilience had higher depressed mood scores and more severe menopausal symptoms. Multiple regression identified two models: 1) Resilience scores correlated inversely with depressed mood and positively with regular exercise. 2) Depressed mood scores correlated positively with somatic and psychological menopausal symptom scores and inversely with resilience. This study suggests depressed mood and menopausal symptoms are associated with lower resilience in postmenopausal women, while exercise is linked to higher resilience.
This document discusses risk factors for early childhood obesity from a prenatal care perspective. It identifies several risk factors that occur before or immediately after birth, including maternal obesity, excessive weight gain during pregnancy, smoking during pregnancy, and bottle feeding rather than breastfeeding. The document provides evidence from multiple studies on how each of these factors increases the risk of a child being overweight or obese. It emphasizes that prenatal care provides an opportunity for healthcare providers to educate mothers on these risks and support behaviors like maintaining a healthy weight, smoking cessation, limiting weight gain during pregnancy, and breastfeeding to help decrease the likelihood of early childhood obesity.
Nerve injuries are a common complication of gynaecological surgery, occurring in 1.1-1.9% of cases. The femoral, ilioinguinal, pudendal, obturator, lateral cutaneous, iliohypogastric and genitofemoral nerves are most commonly injured during surgery due to patient mal-positioning, incorrect retractor placement, haematoma formation, or direct nerve entrapment or transection. While most neuropathies resolve with conservative management, selective serotonin reuptake inhibitors or other medications may help manage painful neuropathies.
This document discusses progress towards Millennium Development Goal 4 (MDG4) of reducing child mortality. While overall progress has been made, neonatal mortality rates have declined more slowly. Simple, low-cost interventions like kangaroo mother care, neonatal resuscitation, and breastfeeding can significantly reduce neonatal deaths. However, implementation faces barriers like lack of healthcare workers, cultural practices, financial barriers to care, and poor quality of services. Political will is needed to fully achieve MDG4 targets through strengthened health systems and addressing inequities between regions.
This document discusses litigation in the field of gynaecology. It begins by noting that obstetrics and gynaecology has a reputation as a highly litigious specialty. It then discusses some of the common reasons why doctors are sued, including accountability, the need for explanation, concern over standards of care, and compensation. The document outlines the typical stages of a medical claim and summarizes several important legal cases that have influenced medico-legal rulings. It also discusses factors that commonly lead to claims in gynaecology, such as issues with consent, sterilization procedures, and laparoscopic surgeries.
This study examined the effects of adding estradiol valerate (EV) to clomiphene citrate (CC)-stimulated cycles on endometrial thickness. Thirty women received CC for ovulation induction in two treatment cycles, with one group also receiving a placebo and the other group receiving additional EV. While CC alone slightly reduced endometrial thickness, the addition of EV significantly increased thickness compared to CC with placebo. EV especially improved endometrial thickness in women where CC caused thinning, but had little effect where thickness was normal with CC alone. Other measures of folliculogenesis and ovulation were unaffected by EV. The study concluded EV prevents CC-induced endometrial thinning without disrupting the ovulation process.
This document reviews studies that have assessed the biomechanical properties of the uterine cervix during pregnancy using various quantitative methods. It discusses how elastography techniques have been applied to measure cervical deformability but have not demonstrated an ability to predict delivery timing. Measurement of maximum cervical deformability (cervical consistency index) provided more meaningful results, showing increased compliance with gestational age. Aspiration measurements also found a progressive decrease in cervical stiffness along gestation. Cervical consistency index and aspiration measurements are promising for quantitative assessment of changing cervical biomechanics during pregnancy.
This document discusses how functional echocardiography can assess cardiac function in fetuses with non-cardiac diseases or conditions that impact the fetus. It provides details on:
1) How ultrasound can evaluate various aspects of fetal cardiac function like cardiac output, size, contractility, and diastolic function.
2) Examples of conditions that can alter fetal hemodynamics like intrauterine growth restriction (IUGR), tumors, twin-twin transfusion syndrome, and maternal diabetes. In IUGR, changes in the umbilical artery and ductus venosus occur as placental function declines.
3) Insights from evaluating these conditions, such as how IUGR fetuses develop a dominant left
This document summarizes a presentation on whether incidental findings from prenatal testing should always be reported to patients. It discusses the case for reporting all incidental findings by defining what incidental findings are and outlining the purpose and goals of prenatal diagnosis. It then applies principles of medical ethics including autonomy, beneficence, non-maleficence, and justice to argue that incidental findings of known clinical significance that are actionable should be reported. It acknowledges the difficulty of incidental findings of unknown significance but still argues they should be shared with parents so they can make informed decisions. Finally, it addresses concerns about discovering late-onset untreatable diseases and risks of anxiety, but concludes that an ethical approach is to
This document discusses the potential for noninvasive prenatal DNA testing (NIDT) to become the standard screening test for Down syndrome in all pregnant women. It presents perspectives both for and against this proposition. Those in favor argue that NIDT has higher accuracy and lower risk than current invasive screening tests, so it respects patient autonomy and informed choice better. However, others are more cautious and want more data on costs and outcomes before widely implementing NIDT as the standard of care for all pregnancies. Overall the debate centers on whether NIDT should replace current screening paradigms or be offered as an additional option based on its advantages over existing tests.
This cross-sectional study examined gestational weight gain and perinatal outcomes in 1462 pregnant women in southern India. The study found that 37.41% of women gained less than the recommended weight based on IOM guidelines, while 21.41% gained more. Less than optimal weight gain was associated with a higher risk of preterm delivery (adjusted odds ratio 3.58). However, gestational weight gain was not significantly associated with other maternal or neonatal outcomes. This suggests the IOM guidelines may not be an appropriate standard for monitoring gestational weight gain in this population.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
1. Recommended Adult Immunization Schedule—United States - 2014
Note: These recommendations must be read with the footnotes that follow containing number of doses, intervals between doses, and other important information.
Figure 1. Recommended adult immunization schedule, by vaccine and age group1
VACCINE
AGE GROUP
19-21 years
22-26 years
27-49 years
Influenza 2,*
Tetanus, diphtheria, pertussis (Td/Tdap) 3,*
Varicella
50-59 years
60-64 years
≥ 65 years
1 dose annually
Substitute 1-time dose of Tdap for Td booster; then boost with Td every 10 yrs
2 doses
4,*
Human papillomavirus (HPV) Female 5,*
3 doses
Human papillomavirus (HPV) Male 5,*
3 doses
Zoster 6
1 dose
Measles, mumps, rubella (MMR)
1 or 2 doses
7,*
1 dose
Pneumococcal 13-valent conjugate (PCV13) 8,*
Pneumococcal polysaccharide (PPSV23) 9,10
Meningococcal
1 or 2 doses
Hepatitis A 12,*
Hepatitis B
2 doses
3 doses
13,*
Haemophilus influenzae type b (Hib) 14,*
1 or 3 doses
*Covered by the Vaccine Injury Compensation Program
For all persons in this category who
meet the age requirements and who lack
documentation of vaccination or have no
evidence of previous infection; zoster
vaccine recommended regardless of prior
episode of zoster
Recommended if some other risk factor
is present (e.g., on the basis of medical,
occupational, lifestyle, or other indication)
No recommendation
Report all clinically significant postvaccination reactions to the Vaccine Adverse Event Reporting System (VAERS). Reporting forms and instructions on filing a
VAERS report are available at www.vaers.hhs.gov or by telephone, 800-822-7967.
Information on how to file a Vaccine Injury Compensation Program claim is available at www.hrsa.gov/vaccinecompensation or by telephone, 800-338-2382.
To file a claim for vaccine injury, contact the U.S. Court of Federal Claims, 717 Madison Place, N.W., Washington, D.C. 20005; telephone, 202-357-6400.
Additional information about the vaccines in this schedule, extent of available data, and contraindications for vaccination is also available at
www.cdc.gov/vaccines or from the CDC-INFO Contact Center at 800-CDC-INFO (800-232-4636) in English and Spanish, 8:00 a.m. - 8:00 p.m. Eastern Time,
Monday - Friday, excluding holidays.
Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.
The recommendations in this schedule were approved by the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization
Practices (ACIP), the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), American College of Obstetricians and
Gynecologists (ACOG) and American College of Nurse-Midwives (ACNM).
Figure 2. Vaccines that might be indicated for adults based on medical and other indications1
VACCINE
Immunocompromising
conditions (excluding
human immunodeficiency
INDICATION Pregnancy
virus [HIV])4,6,7,8,15
HIV infection CD4+ T
lymphocyte count 4,6,7,8,15
≥ 200
cells/μL
Tetanus, diphtheria, pertussis (Td/Tdap)
3,*
1 dose Tdap each
pregnancy
Asplenia (including
Men who Kidney failure, Heart disease,
elective splenectomy
have sex end-stage renal
chronic lung
and persistent
Chronic
with men disease, receipt disease, chronic complement component liver
(MSM)
of hemodialysi
alcoholism
deficiencies) 8,14
disease Diabetes
Healthcare
personnel
1 dose IIV or
LAIV annually
< 200
cells/μL
1 dose IIV annually
Influenza 2,*
1 dose IIV or LAIV
annually
1 dose IIV annually
Substitute 1-time dose of Tdap for Td booster; then boost with Td every 10 yrs
Contraindicated
Varicella 4,*
Human papillomavirus (HPV) Female 5,*
Human papillomavirus (HPV) Male
Zoster
1 dose
1 or more doses
11,*
5,*
2 doses
3 doses through age 26 yrs
3 doses through age 26 yrs
3 doses through age 26yrs
3 doses through age 21 yrs
Contraindicated
6
Measles, mumps, rubella (MMR) 7,*
1 dose
Contraindicated
1 or 2 doses
1 dose
Pneumococcal 13-valent conjugate (PCV13) 8,*
1 or 2 doses
Pneumococcal polysaccharide (PPSV23) 9,10
1 or more doses
Meningococcal 11,*
Hepatitis A
Hepatitis B
2 doses
12,*
13,*
Haemophilus influenzae type b (Hib) 14,*
3 doses
post-HSCT recipients only
1 or 3 doses
*Covered by the Vaccine Injury Compensation Program
For all persons in this category who meet the age requirements and who lack documentation of vaccination or
have no evidence of previous infection; zoster vaccine recommended regardless of prior episode of zoster
Recommended if some other risk factor is present (e.g., on the basis of medical, occupational, lifestyle, or other
indications)
No recommendation
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 February 1, 2014. For all vaccines being recommended
on the Adult Immunization Schedule: a vaccine series does not need to be restarted,
regardless of the time that has elapsed between doses. Licensed combination
vaccines may be used whenever any components of the 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 the year, consult the manufacturers’ package inserts and the
complete statements from the Advisory Committee on Immunization Practices
(www.cdc.gov/vaccines/hcp/acip-recs/index.html). Use of trade names and
commercial sources is for identification only and does not imply endorsement by
the U.S. Department of Health and Human Services.
2. Footnotes
Recommended Immunization Schedule for Adults Aged 19 Years or Older: United States, 2014
1.
2.
3.
4.
5.
6.
7.
Additional information
• Additional guidance for the use of the vaccines described in this supplement
is available at www.cdc.gov/vaccines/hcp/acip-recs/index.html.
• Information on vaccination recommendations when vaccination
status is unknown and other general immunization information
can be found in the General Recommendations on Immunization at
www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm.
• Information on travel vaccine requirements and recommendations (e.g.,
for hepatitis A and B, meningococcal, and other vaccines) is available at
http://wwwnc.cdc.gov/travel/destinations/list.
• Additional information and resources regarding vaccination of pregnant women
can be found at http://www.cdc.gov/vaccines/adults/rec-vac/pregnant.html.
Influenza vaccination
• Annual vaccination against influenza is recommended for all persons aged
6 months or older.
• Persons aged 6 months or older, including pregnant women and persons
with hives-only allergy to eggs, can receive the inactivated influenza
vaccine (IIV). An age-appropriate IIV formulation should be used.
• Adults aged 18 to 49 years can receive the recombinant influenza vaccine
(RIV) (FluBlok). RIV does not contain any egg protein.
• Healthy, nonpregnant persons aged 2 to 49 years without high-risk
medical conditions can receive either intranasally administered live,
attenuated influenza vaccine (LAIV) (FluMist), or IIV. Health care personnel
who care for severely immunocompromised persons (i.e., those who
require care in a protected environment) should receive IIV or RIV rather
than LAIV.
• The intramuscularly or intradermally administered IIV are options for
adults aged 18 to 64 years.
• Adults aged 65 years or older can receive the standard-dose IIV or the
high-dose IIV (Fluzone High-Dose).
Tetanus, diphtheria, and acellular pertussis (Td/Tdap) vaccination
• Administer 1 dose of Tdap vaccine to pregnant women during each
pregnancy (preferred during 27 to 36 weeks’ gestation) regardless of
interval since prior Td or Tdap vaccination.
• Persons aged 11 years or older who have not received Tdap vaccine or for
whom vaccine status is unknown should receive a dose of Tdap followed
by tetanus and diphtheria toxoids (Td) booster doses every 10 years
thereafter. Tdap can be administered regardless of interval since the most
recent tetanus or diphtheria-toxoid containing vaccine.
• Adults with an unknown or incomplete history of completing a 3-dose
primary vaccination series with Td-containing vaccines should begin or
complete a primary vaccination series including a Tdap dose.
• For unvaccinated adults, administer the first 2 doses at least 4 weeks apart
and the third dose 6 to 12 months after the second.
• For incompletely vaccinated (i.e., less than 3 doses) adults, administer
remaining doses.
• Refer to the ACIP statement for recommendations for administering Td/
Tdap as prophylaxis in wound management (see footnote 1).
Varicella vaccination
• All adults without evidence of immunity to varicella (as defined below)
should receive 2 doses of single-antigen varicella vaccine or a second
dose if they have received only 1 dose.
• Vaccination should be emphasized for those who have close contact
with persons at high risk for severe disease (e.g., health care personnel
and family contacts of persons with immunocompromising conditions)
or are at high risk for exposure or transmission (e.g., teachers; child care
employees; residents and staff members of institutional settings, including
correctional institutions; college students; military personnel; adolescents
and adults living in households with children; nonpregnant women of
childbearing age; and international travelers).
• Pregnant women should be assessed for evidence of varicella immunity.
Women who do not have evidence of immunity should receive the first
dose of varicella vaccine upon completion or termination of pregnancy
and before discharge from the health care facility. The second dose should
be administered 4 to 8 weeks after the first dose.
• Evidence of immunity to varicella in adults includes any of the following:
—— documentation of 2 doses of varicella vaccine at least 4 weeks apart;
—— U.S.-born before 1980, except health care personnel and pregnant
women;
—— history of varicella based on diagnosis or verification of varicella disease
by a health care provider;
—— history of herpes zoster based on diagnosis or verification of herpes
zoster disease by a health care provider; or
—— laboratory evidence of immunity or laboratory confirmation of disease.
Human papillomavirus (HPV) vaccination
• Two vaccines are licensed for use in females, bivalent HPV vaccine (HPV2) and
quadrivalent HPV vaccine (HPV4), and one HPV vaccine for use in males (HPV4).
• For females, either HPV4 or HPV2 is recommended in a 3-dose series for
routine vaccination at age 11 or 12 years and for those aged 13 through
26 years, if not previously vaccinated.
• For males, HPV4 is recommended in a 3-dose series for routine vaccination
at age 11 or 12 years and for those aged 13 through 21 years, if not
previously vaccinated. Males aged 22 through 26 years may be vaccinated.
• HPV4 is recommended for men who have sex with men through age 26
years for those who did not get any or all doses when they were younger.
• Vaccination is recommended for immunocompromised persons (including
those with HIV infection) through age 26 years for those who did not get
any or all doses when they were younger.
• A complete series for either HPV4 or HPV2 consists of 3 doses. The second
dose should be administered 4 to 8 weeks (minimum interval of 4 weeks)
after the first dose; the third dose should be administered 24 weeks after
the first dose and 16 weeks after the second dose (minimum interval of
at least 12 weeks).
• HPV vaccines are not recommended for use in pregnant women. However,
pregnancy testing is not needed before vaccination. If a woman is found
to be pregnant after initiating the vaccination series, no intervention
is needed; the remainder of the 3-dose series should be delayed until
completion of pregnancy.
Zoster vaccination
• A single dose of zoster vaccine is recommended for adults aged 60 years
or older regardless of whether they report a prior episode of herpes zoster.
Although the vaccine is licensed by the U.S. Food and Drug Administration
for use among and can be administered to persons aged 50 years or older,
ACIP recommends that vaccination begin at age 60 years.
• Persons aged 60 years or older with chronic medical conditions may be
vaccinated unless their condition constitutes a contraindication, such as
pregnancy or severe immunodeficiency.
Measles, mumps, rubella (MMR) vaccination
• Adults born before 1957 are generally considered immune to measles and
mumps. All adults born in 1957 or later should have documentation of 1 or
more doses of MMR vaccine unless they have a medical contraindication
to the vaccine or laboratory evidence of immunity to each of the three
diseases. Documentation of provider-diagnosed disease is not considered
acceptable evidence of immunity for measles, mumps, or rubella.
Measles component:
• A routine second dose of MMR vaccine, administered a minimum of 28
days after the first dose, is recommended for adults who:
—— are students in postsecondary educational institutions;
—— work in a health care facility; or
—— plan to travel internationally.
• Persons who received inactivated (killed) measles vaccine or measles
vaccine of unknown type during 1963–1967 should be revaccinated with
2 doses of MMR vaccine.
Mumps component:
• A routine second dose of MMR vaccine, administered a minimum of 28
days after the first dose, is recommended for adults who:
—— are students in a postsecondary educational institution;
—— work in a health care facility; or
—— plan to travel internationally.
• Persons vaccinated before 1979 with either killed mumps vaccine
or mumps vaccine of unknown type who are at high risk for mumps
infection (e.g., persons who are working in a health care facility) should
be considered for revaccination with 2 doses of MMR vaccine.
Rubella component:
• For women of childbearing age, regardless of birth year, rubella immunity
should be determined. If there is no evidence of immunity, women who
are not pregnant should be vaccinated. Pregnant women who do not
have evidence of immunity should receive MMR vaccine upon completion
or termination of pregnancy and before discharge from the health care
facility.
Health care personnel born before 1957:
• For unvaccinated health care personnel born before 1957 who lack
laboratory evidence of measles, mumps, and/or rubella immunity or
laboratory confirmation of disease, health care facilities should consider
vaccinating personnel with 2 doses of MMR vaccine at the appropriate
interval for measles and mumps or 1 dose of MMR vaccine for rubella.
Pneumococcal conjugate (PCV13) vaccination
• Adults aged 19 years or older with immunocompromising conditions
(including chronic renal failure and nephrotic syndrome), functional or
anatomic asplenia, cerebrospinal fluid leaks, or cochlear implants who
have not previously received PCV13 or PPSV23 should receive a single
dose of PCV13 followed by a dose of PPSV23 at least 8 weeks later.
• Adults aged 19 years or older with the aforementioned conditions who
have previously received 1 or more doses of PPSV23 should receive a dose
of PCV13 one or more years after the last PPSV23 dose was received. For
adults who require additional doses of PPSV23, the first such dose should
be given no sooner than 8 weeks after PCV13 and at least 5 years after the
most recent dose of PPSV23.
• When indicated, PCV13 should be administered to patients who are
uncertain of their vaccination status history and have no record of previous
vaccination.
11. Meningococcal vaccination
• Administer 2 doses of quadrivalent meningococcal conjugate vaccine
(MenACWY-D [Menactra]) at least 2 months apart to adults of all ages with
functional asplenia or persistent complement component deficiencies. HIV
infection is not an indication for routine vaccination with MenACWY-D. If
an HIV-infected person of any age is vaccinated, 2 doses of MenACWY-D
should be administered at least 2 months apart.
• Administer a single dose of meningococcal vaccine to microbiologists
routinely exposed to isolates of Neisseria meningitidis, military recruits,
persons at risk during an outbreak attributable to a vaccine serogroup,
and persons who travel to or live in countries in which meningococcal
disease is hyperendemic or epidemic.
• First-year college students up through age 21 years who are living in
residence halls should be vaccinated if they have not received a dose on
or after their 16th birthday.
• MenACWY-D is preferred for adults with any of the preceding indications
who are aged 55 years or younger as well as for adults aged 56 years
or older who a) were vaccinated previously with MenACWY-D and are
recommended for revaccination, or b) for whom multiple doses are
anticipated. Meningococcal polysaccharide vaccine (MenACWY-CRM
[Menveo]) is preferred for adults aged 56 years or older who have not
received MenACWY-D previously and who require a single dose only (e.g.,
travelers).
• Revaccination with MenACWY-D every 5 years is recommended for
adults previously vaccinated with MenACWY-D or MenACWY-CRM
who remain at increased risk for infection (e.g., adults with anatomic or
functional asplenia, persistent complement component deficiencies, or
microbiologists).
12. Hepatitis A vaccination
• Vaccinate any person seeking protection from hepatitis A virus (HAV)
infection and persons with any of the following indications:
—— men who have sex with men and persons who use injection or noninjection illicit drugs;
—— persons working with HAV-infected primates or with HAV in a research
laboratory setting;
—— persons with chronic liver disease and persons who receive clotting
factor concentrates;
—— persons traveling to or working in countries that have high or intermediate endemicity of hepatitis A; and
—— unvaccinated persons who anticipate close personal contact (e.g.,
household or regular babysitting) with an international adoptee during
the first 60 days after arrival in the United States from a country with
high or intermediate endemicity. (See footnote 1 for more information
on travel recommendations.) The first dose of the 2-dose hepatitis A
vaccine series should be administered as soon as adoption is planned,
ideally 2 or more weeks before the arrival of the adoptee.
• Single-antigen vaccine formulations should be administered in a 2-dose
schedule at either 0 and 6 to 12 months (Havrix), or 0 and 6 to 18 months
(Vaqta). If the combined hepatitis A and hepatitis B vaccine (Twinrix) is
used, administer 3 doses at 0, 1, and 6 months; alternatively, a 4-dose
schedule may be used, administered on days 0, 7, and 21 to 30 followed
by a booster dose at month 12.
13. Hepatitis B vaccination
• Vaccinate persons with any of the following indications and any person
seeking protection from hepatitis B virus (HBV) infection:
• Although PCV13 is licensed by the U.S. Food and Drug Administration for
use among and can be administered to persons aged 50 years or older,
ACIP recommends PCV13 for adults aged 19 years or older with the specific
medical conditions noted above.
9. Pneumococcal polysaccharide (PPSV23) vaccination
• When PCV13 is also indicated, PCV13 should be given first (see footnote 8).
• Vaccinate all persons with the following indications:
—— all adults aged 65 years or older;
—— adults younger than 65 years with chronic lung disease (including
chronic obstructive pulmonary disease, emphysema, and asthma),
chronic cardiovascular diseases, diabetes mellitus, chronic renal
failure, nephrotic syndrome, chronic liver disease (including cirrhosis),
alcoholism, cochlear implants, cerebrospinal fluid leaks, immunocompromising conditions, and functional or anatomic asplenia (e.g., sickle
cell disease and other hemoglobinopathies, congenital or acquired
asplenia, splenic dysfunction, or splenectomy [if elective splenectomy
is planned, vaccinate at least 2 weeks before surgery]);
—— residents of nursing homes or long-term care facilities; and
—— adults who smoke cigarettes.
• Persons with immunocompromising conditions and other selected
conditions are recommended to receive PCV13 and PPSV23 vaccines. See
footnote 8 for information on timing of PCV13 and PPSV23 vaccinations.
• Persons with asymptomatic or symptomatic HIV infection should be
vaccinated as soon as possible after their diagnosis.
• When cancer chemotherapy or other immunosuppressive therapy is
being considered, the interval between vaccination and initiation of
immunosuppressive therapy should be at least 2 weeks. Vaccination
during chemotherapy or radiation therapy should be avoided.
• Routine use of PPSV23 vaccine is not recommended for American Indians/
Alaska Natives or other persons younger than 65 years unless they have
underlying medical conditions that are PPSV23 indications. However,
public health authorities may consider recommending PPSV23 for
American Indians/Alaska Natives who are living in areas where the risk
for invasive pneumococcal disease is increased.
• When indicated, PPSV23 vaccine should be administered to patients who
are uncertain of their vaccination status and have no record of vaccination.
10. Revaccination with PPSV23
• One-time revaccination 5 years after the first dose of PPSV23 is
recommended for persons aged 19 through 64 years with chronic renal
failure or nephrotic syndrome, functional or anatomic asplenia (e.g., sickle
cell disease or splenectomy), or immunocompromising conditions.
• Persons who received 1 or 2 doses of PPSV23 before age 65 years for any
indication should receive another dose of the vaccine at age 65 years or
later if at least 5 years have passed since their previous dose.
• No further doses of PPSV23 are needed for persons vaccinated with
PPSV23 at or after age 65 years.
—— sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., persons with more than 1 sex partner during
the previous 6 months); persons seeking evaluation or treatment for
a sexually transmitted disease (STD); current or recent injection drug
users; and men who have sex with men;
—— health care personnel and public safety workers who are potentially
exposed to blood or other infectious body fluids;
—— persons with diabetes who are younger than age 60 years as soon as
feasible after diagnosis; persons with diabetes who are age 60 years or
older at the discretion of the treating clinician based on the likelihood
of acquiring HBV infection, including the risk posed by an increased
need for assisted blood glucose monitoring in long-term care facilities,
the likelihood of experiencing chronic sequelae if infected with HBV,
and the likelihood of immune response to vaccination;
—— persons with end-stage renal disease, including patients receiving hemodialysis, persons with HIV infection, and persons with chronic liver disease;
—— household contacts and sex partners of hepatitis B surface antigen–
positive persons, clients and staff members of institutions for persons
with developmental disabilities, and international travelers to countries
with high or intermediate prevalence of chronic HBV infection; and
—— all adults in the following settings: STD treatment facilities, HIV testing
and treatment facilities, facilities providing drug abuse treatment and
prevention services, health care settings targeting services to injection
drug users or men who have sex with men, correctional facilities, endstage renal disease programs and facilities for chronic hemodialysis
patients, and institutions and nonresidential day care facilities for
persons with developmental disabilities.
• Administer missing doses to complete a 3-dose series of hepatitis B vaccine
to those persons not vaccinated or not completely vaccinated. The second
dose should be administered 1 month after the first dose; the third dose
should be given at least 2 months after the second dose (and at least 4
months after the first dose). If the combined hepatitis A and hepatitis B
vaccine (Twinrix) is used, give 3 doses at 0, 1, and 6 months; alternatively, a
4-dose Twinrix schedule, administered on days 0, 7, and 21 to 30 followed
by a booster dose at month 12 may be used.
• Adult patients receiving hemodialysis or with other immunocompromising
conditions should receive 1 dose of 40 mcg/mL (Recombivax HB)
administered on a 3-dose schedule at 0, 1, and 6 months or 2 doses of 20
mcg/mL (Engerix-B) administered simultaneously on a 4-dose schedule
at 0, 1, 2, and 6 months.
14. Haemophilus influenzae type b (Hib) vaccination
• One dose of Hib vaccine should be administered to persons who have
functional or anatomic asplenia or sickle cell disease or are undergoing
elective splenectomy if they have not previously received Hib vaccine.
Hib vaccination 14 or more days before splenectomy is suggested.
• Recipients of a hematopoietic stem cell transplant should be vaccinated
with a 3-dose regimen 6 to 12 months after a successful transplant,
regardless of vaccination history; at least 4 weeks should separate doses.
• Hib vaccine is not recommended for adults with HIV infection since their
risk for Hib infection is low.
15. Immunocompromising conditions
• Inactivated vaccines generally are acceptable (e.g., pneumococcal,
meningococcal, and inactivated influenza vaccine) and live vaccines
generally are avoided in persons with immune deficiencies or
immunocompromising conditions. Information on specific conditions is
available at http://www.cdc.gov/vaccines/hcp/acip-recs/index.html.
8.