This document provides recommendations for vaccine administration in specific groups. It discusses routine and catch-up vaccinations for adolescents including Tdap, meningococcal, HPV, and influenza vaccines. It recommends annual influenza and pneumococcal vaccines for the elderly to prevent complications. For international travelers, it advises assessing destination risk and updating routine vaccines plus typhoid, yellow fever, Japanese encephalitis, meningococcal, rabies, and COVID vaccines if needed. Occupational workers may require hepatitis B, influenza, varicella, tuberculosis screening and vaccines depending on their exposure risks. Common refugee vaccines include routine, hepatitis A & B, meningococcal, tuberculosis screening, influenza, pneumococcal and HPV vaccines.

1. LECTURE 10:
VACCINE RECOMMENDATIONS
IN
SPECIFIC GROUPS (Part 2)
Professor Dr. Aida Mohey
Community Medicine & Public Health
Head of Community Medicine department
aida_mohey@yahoo.com

2. Learning Objectives
Determine the recommendations of immunization for
specific groups namely:
1. Adolescents
2. Elderly
3. International travelers
4. Occupational workers
5. Refugees

3. Vaccination of adolescents is an important aspect of public health:
▪ Helping to protect individuals from preventable diseases
▪ Contributing to community (herd) immunity
1. Adolescents

4. 1. Routine vaccination
2. Catch-up vaccination

6. ▪Tetanus, Diphtheria, Pertussis (Tdap): This vaccine is
typically given to adolescents around the age of 11 or 12
years. It provides protection against tetanus, diphtheria,
and pertussis (whooping cough).
▪Meningococcal Vaccines: Adolescents should receive
the meningococcal conjugate vaccine, which helps
protect against meningococcal diseases, including
meningitis. A booster dose is often recommended
around age 16 years.
1. Routine Vaccinations

7. • Human Papillomavirus (HPV) Vaccine: The HPV
vaccine is recommended for both males and
females around the age of 11 or 12 years. It
protects against certain strains of the human
papillomavirus, which can lead to various
cancers.
• Influenza (Flu) Vaccine: Adolescents should
receive the annual influenza vaccine to protect
against seasonal flu viruses.

8. Adolescents who may have missed earlier
vaccinations should consult healthcare
provider to catch up on any recommended
doses.
2. Catch-up vaccinations
Why is it important for adolescents to catch up on missed vaccinations?
To prevent the spread of infectious diseases

9. 2. Elderly

10. Benefits of Vaccination for the Elderly
• Reduced risk of
contracting infectious
diseases
• Reduced severity of
illnesses
• Protection against
complications of
vaccine-preventable
illnesses
• Enhanced quality of
life and independence

11. 1.Influenza vaccine
2.Pneumococcal vaccine
3.Shingles (Herpes Zoster)
vaccine
4.Tetanus and Diphtheria (Td)
vaccine
5.Hepatitis B vaccine
6. COVID-19 vaccine
Common Vaccines for the Elderly

12. • Influenza (Flu) Vaccine:
The flu vaccine is recommended annually for the elderly
• Pneumococcal Vaccines:
• There are two types of pneumococcal vaccines
recommended for older adults:
• Pneumococcal conjugate vaccine (PCV13)
• Pneumococcal polysaccharide vaccine (PPSV23)
• These vaccines protect against pneumonia, which can be
a serious concern for the elderly.
• Shingles (Herpes Zoster) Vaccine:
The shingles vaccine is recommended for adults aged
50 and older. It helps protect against shingles
(a painful rash) caused by the reactivation
of the varicella-zoster virus.

13. • Tetanus, Diphtheria, Pertussis (Tdap) and Tetanus,
Diphtheria (Td) Vaccines:
Boosters of these vaccines may be recommended to ensure
ongoing protection against tetanus, diphtheria, and pertussis.
• Hepatitis B Vaccine:
The hepatitis B vaccine may be recommended for older adults who are
at increased risk of hepatitis B infection due to certain medical
conditions: individuals with diabetes, chronic liver disease,
hemodialysis patients, or international travelers to endemic areas and
those in close contact with hepatitis B-infected individuals
• COVID-19 Vaccine:
COVID-19 vaccination is crucial for the elderly, given the
increased risk of severe outcomes from the virus. Booster shots
may also be recommended based on evolving guidelines and the
emergence of new variants.

14. The annual flu vaccine is recommended
for the elderly for several reasons:
1. Increased Vulnerability: to severe complications and hospitalization
due to influenza.
2. Weakened Immune Response by age
3. Prevention of Complications: such as pneumonia, exacerbation of
pre-existing chronic conditions (like heart disease or diabetes), and
an increased risk of falls.
4. Boosting herd Immunity: By vaccinating a significant portion of the
population, including the elderly, a high level of herd immunity can
be achieved.
5. Annual Strain Variability: The flu vaccine is updated annually to
provide protection against the specific strains that are expected to
be prevalent in a given flu season.

15. 3. International Travelers
Vaccination recommendations for travelers
depend on various factors, including:
▪ The destination
▪ The traveler's health status
▪ The duration of the trip
▪ The activities planned during travel
Case Scenario:
Sarah, a 30-year-old woman, is planning a two-week trip to
Southeast Asia. She is generally healthy, but she has a history of
asthma. Her travel itinerary includes visiting urban areas, hiking in
rural regions, and spending a few days on a remote island.

16. Travelers should ensure that routine
vaccinations are up-to-date.
These may include vaccines for
measles, mumps, rubella, diphtheria,
tetanus, pertussis, polio, and
influenza.
1. Routine Vaccinations

17. 2. Travel-Specific Vaccines
Hepatitis A and B Vaccines: Depending on the destination, vaccination
against hepatitis A and B may be recommended. Hepatitis A is a concern in
areas with poor sanitation, while hepatitis B can be transmitted through
contaminated blood and body fluids.
Typhoid Vaccine: Travelers to areas with poor sanitation and hygiene may
be advised to get vaccinated against typhoid.
Yellow Fever Vaccine: YF is endemic in tropical and subtropical regions of
Africa and South America. Because it can be a serious and potentially fatal
disease, some countries have implemented entry requirements to prevent
the introduction and spread of the virus. These requirements often include
proof of yellow fever vaccination (yellow card).

18. Travel-Specific Vaccines
Japanese Encephalitis Vaccine: Recommended for travelers to areas with a
risk of Japanese encephalitis, especially if the visit includes rural areas or
outdoor activities.
Meningococcal Vaccine: Recommended for travelers to regions with a
higher risk of meningococcal disease, such as the meningitis belt in sub-
Saharan Africa.
Rabies Vaccine: Travelers to areas where rabies is prevalent, particularly if
planning activities that may increase the risk of exposure (e.g., working with
animals), may consider rabies

20. Meningitis belt- risk areas Japanese encephalitis risk areas

21. • COVID-19 Vaccine:
• Depending on the current global situation and destination-specific
requirements, COVID-19 vaccination may be recommended or required for
travel.
• Pre-Travel Consultation:
• It's crucial for travelers to schedule a pre-travel consultation with a
healthcare provider or travel medicine specialist. During this consultation,
the healthcare professional can assess the individual's health, travel itinerary
‫لةا‬ ‫الر‬ ‫مسار‬, and provide personalized recommendations for vaccinations and
other preventive measures.
• Malaria Prophylaxis:
• In malaria-endemic regions, travelers may need to take antimalarial
medications. This is not a vaccine but an important preventive measure for
certain destinations.
• Post-Travel Follow-Up:
• Some vaccinations may require multiple doses or boosters. Travelers should
follow up with their healthcare provider post-travel to ensure completion of
any vaccine series and discuss any health concerns that may have arisen
during the trip.

22. 4. Occupational workers

23. 1. Healthcare Workers
• Hepatitis B Vaccine: Healthcare workers are often recommended to
receive the hepatitis B vaccine due to the risk of exposure to blood and
body fluids.
• Influenza Vaccine: Annual influenza vaccination is typically
recommended for healthcare workers to prevent the spread of influenza
in healthcare settings.
• Varicella (Chickenpox) Vaccine: Varicella vaccination may be
recommended for healthcare workers who are not immune to
chickenpox.
• Tuberculosis (TB) Screening: While not a vaccine, healthcare workers
may undergo screening for tuberculosis, and those at risk may receive
preventive treatment.

24. 2. Laboratory Workers
• Hepatitis B Vaccine: Similar to healthcare workers,
laboratory workers who may be exposed to blood or
bodily fluids should receive the hepatitis B vaccine.
• Other Vaccines Based on Specific Hazards:
Depending on the type of work and potential hazards,
other vaccines such as tetanus, diphtheria, pertussis
(Tdap), and others may be recommended.

25. 3. Occupations with Animal Exposure:
• Rabies Vaccine: Workers in occupations
with a risk of exposure to rabies, such as
veterinarians and animal control officers,
may be recommended to receive the rabies
vaccine.
4. Occupations Involving Travel:
• Travel-Related Vaccines: Workers who
frequently travel to regions with specific
health risks may need vaccinations such as
those for yellow fever, typhoid, Japanese
encephalitis, and others.

26. 5. Occupations Involving Hazardous
Materials or Biological Agents:
• Specific Vaccines Based on Exposures: Workers
handling hazardous materials or biological agents
may need vaccines specific to the potential exposures
they face.
6. General Workplace Health Programs:
• Wellness Programs: Some employers may offer
wellness programs that include vaccinations, such as
flu shots and other routine vaccinations, to promote
the overall health of their workforce.

27. Who is a refugee?
5. Refugees
‘Refugees’ have to leave their home because
they are escaping conflict or persecution
‫لضطهردا‬, and cannot return home safely.

28. Common vaccines administered to refugees often include:
1.Routine Vaccines:
•Measles, Mumps, and Rubella (MMR)
•Diphtheria, Tetanus, and Pertussis (DTaP)
•Polio
2.Hepatitis B Vaccine:
•Given to prevent hepatitis B, a viral infection that can affect the liver.
3.Hepatitis A Vaccine:
•Protection against hepatitis A, a viral infection that affects the liver
and is often transmitted through contaminated food and water.
4.Meningococcal Vaccine:
•Protects against meningococcal disease, which can cause meningitis
and sepsis.

29. 5. Tuberculosis (TB) Screening:
Refugees may undergo TB screening, and if necessary, receive the
BCG vaccine or treatment for latent TB infection.
6. Influenza (Flu) Vaccine:
Seasonal influenza vaccines may be administered, especially
during flu seasons.
7. Pneumococcal Vaccine:
Guards against pneumonia and other diseases caused by the
bacterium Streptococcus pneumoniae.
8. Human Papillomavirus (HPV) Vaccine:
Depending on the age and gender, refugees, particularly
adolescents, may receive the HPV vaccine to prevent HPV-related
cancers.
9. Malaria Prevention: While not a vaccine, refugees in malaria-
endemic regions may receive antimalarial drugs or bed nets to
prevent malaria.