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.
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.
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.
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 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.
This document discusses adult vaccination guidelines. It covers immunization types including active, live attenuated, inactivated, subunit/recombinant vaccines. It provides guidance on vaccination for hepatitis A, hepatitis B, HPV, Hib, and influenza. High-risk groups are identified for each vaccine. It emphasizes that immunocompromised individuals and pregnant women should receive inactivated/recombinant vaccines only. Screening tools are referenced to help assess vaccination needs for adults.
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.
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).
This document provides a table summarizing the contraindications and precautions for commonly used vaccines in adults in the United States in 2014. It lists the specific vaccines including influenza, tetanus/diphtheria/pertussis, varicella, HPV, shingles, measles/mumps/rubella, pneumococcal, meningococcal, hepatitis A & B, and Haemophilus influenzae type B. For each vaccine, it identifies the contraindications such as severe allergic reactions to previous doses or components as well as precautions like moderate or severe acute illness.
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.
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.
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 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.
This document discusses adult vaccination guidelines. It covers immunization types including active, live attenuated, inactivated, subunit/recombinant vaccines. It provides guidance on vaccination for hepatitis A, hepatitis B, HPV, Hib, and influenza. High-risk groups are identified for each vaccine. It emphasizes that immunocompromised individuals and pregnant women should receive inactivated/recombinant vaccines only. Screening tools are referenced to help assess vaccination needs for adults.
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.
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).
This document provides a table summarizing the contraindications and precautions for commonly used vaccines in adults in the United States in 2014. It lists the specific vaccines including influenza, tetanus/diphtheria/pertussis, varicella, HPV, shingles, measles/mumps/rubella, pneumococcal, meningococcal, hepatitis A & B, and Haemophilus influenzae type B. For each vaccine, it identifies the contraindications such as severe allergic reactions to previous doses or components as well as precautions like moderate or severe acute 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.
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.
2020 CDC ACIP Updates to the Child/Adolescent and Adult Immunization Recom...Wafa sheikh
The document summarizes updates to the 2020 Child/Adolescent and Adult Immunization Recommendations from the Advisory Committee on Immunization Practices (ACIP). Key updates include: recommending routine Hepatitis A vaccination for children and adolescents ages 2 to 18; use of Tdap for Td booster or tetanus prophylaxis if previously received; catch-up HPV vaccination through age 26; recommending PPSV23 for those 65+; and shared clinical decision-making for some vaccinations between ages 27 to 45 or 65+.
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.
This document summarizes different types of immunizing agents and adverse events following immunization (AEFI). It describes live and killed vaccines such as BCG, polio, measles, mumps, and rubella vaccines. Live vaccines provide long-lasting immunity but have greater safety risks than inactivated vaccines. Proper storage via cold chain equipment is essential to maintain vaccine efficacy. Potential AEFI include minor side effects as well as very rare but serious events like disseminated BCG infection. Investigating the cause of any AEFI is important for monitoring vaccine safety.
Pregnant women do not appear more likely to contract COVID-19 than the general population, but their immune systems are changed and they should take precautions. COVID-19 pneumonia in pregnancy is usually mild with good recovery. Pregnant women with heart disease have greater risk. The pandemic has increased perinatal anxiety and depression. Vertical transmission is probable but risk to neonates is still unknown. There is no evidence COVID-19 causes miscarriage or birth defects. Care should be tailored to essential visits while not delaying obstetric management.
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 case report describes a pregnant woman with severe COVID-19 who required mechanical ventilation and emergency cesarean section at 33 weeks gestation. Her newborn tested positive for SARS-CoV-2 via PCR testing just 16 hours after birth, representing the earliest reported case of a positive neonatal test. This raises concerns about possible vertical transmission. The mother did not have detectable antibodies at delivery but tested positive 4 days postpartum, further supporting in-utero transmission as a possibility. This case highlights the need to consider pregnant women a high-risk group for severe COVID-19 and the potential for vertical transmission.
Vaccination in immunocompromised adults - Slideset by Professor Filippo AnsaldiWAidid
The slideset by Professor Ansaldi explores the heterogeneous world of immunodeficiency with a focus on Primary (PID) and Secundary Immunodeficiencies (SID). The slideset shows the undervaccination in immunocompromised individual, while vaccination in PID and SID may improve quality of life and prognosis, reduce infectious complications and be life saving.
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.
Covid19 and pregnancy: There are case reports of preterm birth in women with COVID-19 but it is unclear whether the preterm birth was always iatrogenic, or whether some were spontaneous.
Claudia Llanten, MD, MPH of CMMB describes the importance of immunization in protecting the health of children and adults and how CMMB partners with other organizations to deliver vaccines at the CCIH 2018 conference.
The document provides an update on the 2009/2010 influenza season and answers common questions about the seasonal and H1N1 vaccines. It outlines the vaccination campaign, including details on the adjuvanted and unadjuvanted H1N1 vaccines, their dosages for different populations, preparation instructions, potential adverse events, and a phased rollout plan prioritizing high-risk groups. Frequently asked questions about the safety of the adjuvanted vaccine for pregnant women are also addressed.
This document discusses adverse events following vaccination (AEFV), including definitions, classifications, common reactions, emergency management, controversies, and legal issues. It emphasizes that vaccines are largely safe, but serious adverse outcomes are usually due to programmatic or human errors. It concludes that vaccines should only be used as recommended and medical staff must be prepared to handle any adverse events.
This document discusses vaccinations in Egypt. It provides information on 20 diseases that vaccines protect against. It notes that Egypt annually spends 600 million pounds on its immunization program, which provides 10 compulsory vaccinations to children. Egypt has been free of polio since 2006 according to the WHO. The document then discusses the history of vaccinations, vaccination coverage rates, special vaccination needs for occupations and health conditions, maintaining the cold chain for vaccine storage and transport, and vaccination considerations and guidelines for specific populations including preterm babies, immunocompromised individuals, and those with asplenia or immunodeficiencies.
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.
Gout Summery Updated 2020 American College Of Rheumatology Guideline Wafa sheikh
- Gout is caused by urate crystal deposition and causes sudden painful inflammation, often in the big toe.
- Diagnosis is usually clinical based on symptoms and elevated uric acid levels. Treatment involves medications to reduce uric acid like allopurinol or febuxostat as well as anti-inflammatory drugs.
- The guidelines recommend a treat-to-target strategy, gradually increasing urate-lowering drugs to reach a target uric acid level of less than 6 mg/dl to prevent gout attacks.
This document provides information on a pentavalent vaccine for active immunization against diphtheria, tetanus, whooping cough, Haemophilus influenzae type b, and hepatitis B in infants. It describes the components of the vaccine, administration schedule, efficacy and safety profile based on clinical trials. The vaccine demonstrated high immunogenicity against all five diseases. Common adverse reactions were mild and included pain, redness, fever.
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.
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.
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.
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.
2020 CDC ACIP Updates to the Child/Adolescent and Adult Immunization Recom...Wafa sheikh
The document summarizes updates to the 2020 Child/Adolescent and Adult Immunization Recommendations from the Advisory Committee on Immunization Practices (ACIP). Key updates include: recommending routine Hepatitis A vaccination for children and adolescents ages 2 to 18; use of Tdap for Td booster or tetanus prophylaxis if previously received; catch-up HPV vaccination through age 26; recommending PPSV23 for those 65+; and shared clinical decision-making for some vaccinations between ages 27 to 45 or 65+.
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.
This document summarizes different types of immunizing agents and adverse events following immunization (AEFI). It describes live and killed vaccines such as BCG, polio, measles, mumps, and rubella vaccines. Live vaccines provide long-lasting immunity but have greater safety risks than inactivated vaccines. Proper storage via cold chain equipment is essential to maintain vaccine efficacy. Potential AEFI include minor side effects as well as very rare but serious events like disseminated BCG infection. Investigating the cause of any AEFI is important for monitoring vaccine safety.
Pregnant women do not appear more likely to contract COVID-19 than the general population, but their immune systems are changed and they should take precautions. COVID-19 pneumonia in pregnancy is usually mild with good recovery. Pregnant women with heart disease have greater risk. The pandemic has increased perinatal anxiety and depression. Vertical transmission is probable but risk to neonates is still unknown. There is no evidence COVID-19 causes miscarriage or birth defects. Care should be tailored to essential visits while not delaying obstetric management.
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 case report describes a pregnant woman with severe COVID-19 who required mechanical ventilation and emergency cesarean section at 33 weeks gestation. Her newborn tested positive for SARS-CoV-2 via PCR testing just 16 hours after birth, representing the earliest reported case of a positive neonatal test. This raises concerns about possible vertical transmission. The mother did not have detectable antibodies at delivery but tested positive 4 days postpartum, further supporting in-utero transmission as a possibility. This case highlights the need to consider pregnant women a high-risk group for severe COVID-19 and the potential for vertical transmission.
Vaccination in immunocompromised adults - Slideset by Professor Filippo AnsaldiWAidid
The slideset by Professor Ansaldi explores the heterogeneous world of immunodeficiency with a focus on Primary (PID) and Secundary Immunodeficiencies (SID). The slideset shows the undervaccination in immunocompromised individual, while vaccination in PID and SID may improve quality of life and prognosis, reduce infectious complications and be life saving.
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.
Covid19 and pregnancy: There are case reports of preterm birth in women with COVID-19 but it is unclear whether the preterm birth was always iatrogenic, or whether some were spontaneous.
Claudia Llanten, MD, MPH of CMMB describes the importance of immunization in protecting the health of children and adults and how CMMB partners with other organizations to deliver vaccines at the CCIH 2018 conference.
The document provides an update on the 2009/2010 influenza season and answers common questions about the seasonal and H1N1 vaccines. It outlines the vaccination campaign, including details on the adjuvanted and unadjuvanted H1N1 vaccines, their dosages for different populations, preparation instructions, potential adverse events, and a phased rollout plan prioritizing high-risk groups. Frequently asked questions about the safety of the adjuvanted vaccine for pregnant women are also addressed.
This document discusses adverse events following vaccination (AEFV), including definitions, classifications, common reactions, emergency management, controversies, and legal issues. It emphasizes that vaccines are largely safe, but serious adverse outcomes are usually due to programmatic or human errors. It concludes that vaccines should only be used as recommended and medical staff must be prepared to handle any adverse events.
This document discusses vaccinations in Egypt. It provides information on 20 diseases that vaccines protect against. It notes that Egypt annually spends 600 million pounds on its immunization program, which provides 10 compulsory vaccinations to children. Egypt has been free of polio since 2006 according to the WHO. The document then discusses the history of vaccinations, vaccination coverage rates, special vaccination needs for occupations and health conditions, maintaining the cold chain for vaccine storage and transport, and vaccination considerations and guidelines for specific populations including preterm babies, immunocompromised individuals, and those with asplenia or immunodeficiencies.
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.
Gout Summery Updated 2020 American College Of Rheumatology Guideline Wafa sheikh
- Gout is caused by urate crystal deposition and causes sudden painful inflammation, often in the big toe.
- Diagnosis is usually clinical based on symptoms and elevated uric acid levels. Treatment involves medications to reduce uric acid like allopurinol or febuxostat as well as anti-inflammatory drugs.
- The guidelines recommend a treat-to-target strategy, gradually increasing urate-lowering drugs to reach a target uric acid level of less than 6 mg/dl to prevent gout attacks.
This document provides information on a pentavalent vaccine for active immunization against diphtheria, tetanus, whooping cough, Haemophilus influenzae type b, and hepatitis B in infants. It describes the components of the vaccine, administration schedule, efficacy and safety profile based on clinical trials. The vaccine demonstrated high immunogenicity against all five diseases. Common adverse reactions were mild and included pain, redness, fever.
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.
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 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.
This document discusses various preventive medicine topics including vaccines for MMR, influenza, meningococcal disease, pneumococcal disease, hepatitis A, hepatitis B, polio, and varicella. It provides information on indications, contraindications, dosing schedules, and evidence of immunity for each vaccine. Recommendations are given for vaccinating special populations including HIV patients, the elderly, those with chronic illnesses, international travelers, and health care workers.
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 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.
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 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.
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.
Influenza vaccines or flu shots protect against influenza. A new version of the vaccine is developed twice a year as the influenza virus rapidly changes. Their effectiveness varies from year to year, most provide modest to high protection against influenza.
Managing-common-infections-Guidance-for-Primary-Care-Mar-22-v1.0.pdfAllan F Kane
This document provides guidance on the management and treatment of common infections in primary care. It aims to promote the safe, effective and economic use of antibiotics while minimizing antibiotic resistance. It outlines 15 principles of treatment including initiating antibiotics promptly for severe infections, prescribing antibiotics only when there is a clear clinical benefit, and using narrow spectrum antibiotics when possible. It then provides treatment guidelines for various upper and lower respiratory tract infections, urinary tract infections, skin infections and other common infections.
As in the past, MPCA will again present an immunization update on influenza vaccines. Both Seasonal Flu vaccine and H1N1 flu vaccine will be included in this presentation.
Human vaccinations ppt by dr. hussein abassHosin Abass
Egypt spends 600 million pounds annually on its immunization program, which provides 10 compulsory vaccinations to the approximately 2.6 million children born each year. Egypt was declared polio-free by the WHO in 2006. The document then discusses the history of vaccinations from Jenner's smallpox vaccine in 1796 to modern vaccines, vaccination coverage rates, maintaining the cold chain of vaccine storage and transport, vaccinations for special occupations and populations like healthcare workers and preterm babies, and vaccinations for individuals with specific health conditions.
This document contains a screening checklist for contraindications to vaccines for children and teens. It includes 12 yes or no questions about the patient's health conditions and history that could preclude certain vaccinations. The questions cover topics like whether the patient is sick, has allergies, has had adverse reactions to previous vaccines, or has various health problems or risk factors. Answering yes to any question requires further discussion with a healthcare provider to determine vaccine eligibility and safety. The form is meant to help identify potential contraindications or precautions for vaccination.
This document presents the 2017 adult and pediatric immunization schedule as recommended by the Advisory Committee on Immunization Practices and approved by the Centers for Disease Control and Prevention. It consists of recommendations for routine vaccines for adults by age and medical condition/indication, including important footnotes on vaccine-specific considerations. The schedule aims to provide healthcare professionals with current evidence-based guidance on immunization for adults and children.
The document provides guidance on vaccinating pregnant women against COVID-19 in India. It recommends that pregnant women may choose to get vaccinated after being informed of the risks of COVID-19 infection and the benefits and potential side effects of vaccination. Pregnant women who develop COVID-19 have worse outcomes, so the benefits of the vaccine for pregnant women outweigh the risks. It also provides guidance on obtaining informed consent and monitoring for any adverse effects.
- Some adults were never vaccinated as children and immunity can fade over time, making adults more susceptible to vaccine-preventable diseases. Newer vaccines have also become available.
- Adult immunization recommendations include vaccines for influenza, pneumococcus, human papillomavirus, hepatitis A/B, herpes zoster, and tetanus, diphtheria, pertussis based on age, risk factors and other criteria.
- Vaccinating adults can contribute to herd immunity and help reduce the burden of adult vaccine-preventable diseases.
1. The document discusses an update on COVID-19 vaccinations in Singapore, including an overview of the COVID-19 outbreak, the vaccination program, types of vaccines like Pfizer and Moderna, and guidance on vaccination for different groups.
2. It provides details on the Pfizer vaccine including its 95% efficacy, two dose administration three weeks apart, and authorization for use in Singapore for those 16 and older.
3. Recommendations are given for vaccination of different groups like pregnant women, those trying to conceive, and immunocompromised individuals, with some groups recommended to defer vaccination for now due to lack of data.
Vaccines are not without risk but the risks of vaccine-preventable diseases far outweigh the risks of vaccination. Clinical trials are required to evaluate vaccine safety and efficacy prior to licensure. Rare adverse events may require very large clinical trials to detect. After licensure, ongoing monitoring through observational studies is important to further evaluate safety. Immunization providers play an important role in ensuring vaccine safety through proper vaccine handling, administration, reporting of side effects, and patient education.
This document provides recommendations for adult vaccination in India. It discusses the need for adult vaccination as immunity from childhood vaccines can fade over time. It then provides vaccination schedules and recommendations for various diseases in different adult age groups, including tetanus, diphtheria, pertussis, influenza, pneumococcus, human papillomavirus, hepatitis A, hepatitis B, meningococcus, herpes zoster, and others. Contraindications and special considerations are also outlined for each vaccine. The document emphasizes the importance of vaccination for healthcare workers, travelers, and those at high-risk of certain diseases.
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.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
1. Summary of Recommendations for Adult Immunization (Age 19 years & older)
Vaccine name
and route
Influenza
Inactivated
Influenza
vaccine
(IIV)
Give IM or
intradermally
Live attenuated
influenza
vaccine
(LAIV)
Give
intranasally
Pneumococcal
polysaccharide
(PPSV)
Give IM or SC
Pneumococcal
conjugate
(PCV13)
Give IM
Note: Healthcare personnel who care for severely immunocompromised people (i.e., those who require care in a protected environment) should receive IIV rather than LAIV. For information on other
contraindications and precautions to LAIV, see far right column.
Contraindications and precautions
(mild illness is not a contraindication)
• Give 1 dose every year in the fall or winter.
• Begin vaccination services as soon as
vaccine is available and continue until the
supply is depleted.
• Continue to give vaccine to unvaccinated
adults throughout the influenza season
(including when influenza activity is present in the community) and at other times
when the risk of influenza exists.
• If 2 or more of the following live virus vaccines are to be given—LAIV, MMR, Var,
HZV, and/or yellow fever—they should
be given on the same day. If they are not,
space them by at least 28d.
Contraindications
• Previous anaphylactic reaction to this vaccine, to any of its
components, including egg protein.
• For LAIV only: pregnancy; chronic pulmonary (including
asthma), cardiovascular (except hypertension), renal, hepatic,
neurological/neuromuscular, hematologic, or metabolic
(including diabetes) disorders; immunosuppression (including
that caused by medications or HIV). For adults who experience only hives with exposure to eggs, give IIV with additional safety precautions as found in the 2012 ACIP influenza
recommendations, pages 613–618.*
Precautions
• Moderate or severe acute illness.
• History of Guillain-Barré syndrome (GBS) within 6wks following previous influenza vaccination.
• For LAIV only: receipt of specific antivirals (i.e., amantadine,
rimantadine, zanamivir, or oseltamivir) 48hrs before vaccination. Avoid use of these antiviral drugs for 14d after vaccination.
For people through age 18 years, consult “Summary of Recommen- • Give 1 dose if unvaccinated or if previous
dations for Child/Teen Immunization” at www.immunize.org/catg.d/ vaccination history is unknown.
p2010.pdf.
• Give a 1-time revaccination to people
• People age 65yrs and older.
- Age 65yrs and older if 1st dose was given
prior to age 65yrs and 5yrs have elapsed
• People younger than age 65yrs who have chronic illness or
since dose #1.
other risk factors, including chronic cardiac or pulmonary disease
(including asthma), chronic liver disease, alcoholism, diabetes,
Age 19 through 64yrs who are at highCSF leaks, cigarette smoking, as well as candidates for or recipiest risk of fatal pneumococcal infection
ents of cochlear implants and people living in special environments
or rapid antibody loss (see the 3rd bullet
or social settings (including American Indian/Alaska Natives age
in the box to left for listings of people at
50 through 64yrs if recommended by local public health authorihighest risk) and 5yrs have elapsed since
ties).
dose #1.
• Those at highest risk of serious pneumococcal infection, including • Give 1 dose of PCV13 to people age 19yrs
people who
and older at highest risk of serious pneumo- Have anatomic or functional asplenia, including sickle cell discoccal infection (see column to left), and
ease.
to those who have CSF leaks, or are candidates for or recipient of cochlear implants.
Have an immunocompromising condition, including HIV infecIf previously vaccinated with PPSV, give
tion, leukemia, lymphoma, Hodgkin’s disease, multiple myeloPCV13 at least 12m following PPSV; if
ma, generalized malignancy, chronic renal failure, or nephrotic
not previously vaccinated with PPSV, give
syndrome.
PCV13 first, followed by PPSV in 8wks.
Are receiving immunosuppressive chemotherapy (including
corticosteroids).
Have received an organ or bone marrow transplant.
-
* This document was adapted from the recommendations of the Advisory Committee on Immunization Practices (ACIP). To obtain copies of these recommendations, visit CDC’s website at www.cdc.gov/vaccines/
pubs/ACIP-list.htm or visit the Immunization Action Coalition (IAC) website at www.immunize.org/acip.
Contraindication
Previous anaphylactic reaction to this vaccine, including (for
PCV13) to any diphtheria toxoid-containing vaccine, or to any
of its components.
Precaution
Moderate or severe acute illness.
This table is revised periodically. Visit IAC’s website at www.immunize.org/adultrules to make sure you
have the most current version.
www.immunize.org/catg.d/p2011.pdf • Item #P2011 (5/13)
Technical content reviewed by the Centers for Disease Control and Prevention
Immunization Action Coalition
•
1573 Selby Avenue
(Page 1 of 4)
Schedule for vaccine administration
(any vaccine can be given with another)
People for whom vaccination is recommended
For people through age 18 years, consult “Summary of Recommendations for Child/Teen Immunization” at www.immunize.org/catg.d/
p2010.pdf.
• Vaccination is recommended for all adults. (This includes healthy
adults age 19–49yrs without risk factors.)
• LAIV is approved only for healthy nonpregnant people age 2–49yrs.
• Adults age 18 through 64yrs may be given any intramuscular IIV
product or, alternatively, the intradermal IIV product (Fluzone
Intradermal).
• Adults age 65yrs and older may be given standard-dose IIV or,
alternatively, high-dose IIV (Fluzone High-Dose).
•
Saint Paul, MN 55104
•
(651) 647-9009
•
www.immunize.org
•
www.vaccineinformation.org
•
admin@immunize.org
2. Summary of Recommendations for Adult Immunization (Age 19 years & older)
Vaccine name
and route
People for whom vaccination is recommended
(Page 2 of 4)
Schedule for vaccine administration
(any vaccine can be given with another)
Contraindications and precautions
(mild illness is not a contraindication)
MMR
(Measles,
mumps,
rubella)
Give SC
For people through age 18 years, consult “Summary of Recommendations for Child/Teen Immunization” at www.immunize.org/catg.d/
p2010.pdf.
• People born in 1957 or later (especially those born outside the U.S.)
should receive at least 1 dose of MMR if they have no laboratory
evidence of immunity to each of the 3 diseases or documentation of a
dose given on or after the first birthday.
• People in high-risk groups, such as healthcare personnel (paid, unpaid, or volunteer), students entering college and other post–high
school educational institutions, and international travelers, should
receive a total of 2 doses.
• People born before 1957 are usually considered immune, but
evidence of immunity (serology or documented history of 2 doses of
MMR) should be considered for healthcare personnel.
• Women of childbearing age who do not have acceptable evidence of
rubella immunity or vaccination.
• Give 1 or 2 doses (see criteria in 1st
and 2nd bullets in box to left).
• If dose #2 is recommended, give it no
sooner than 4wks after dose #1.
• If a pregnant woman is found to be
rubella susceptible, give 1 dose of
MMR postpartum.
• If 2 or more of the following live
virus vaccines are to be given—
LAIV, MMR, Var, HZV, and/or yellow fever—they should be given on
the same day. If they are not, space
them by at least 28d.
• Within 72hrs of measles exposure,
give 1 dose as postexposure prophylaxis to susceptible adults.
Note: Routine post-vaccination serologic testing is not recommended.
Contraindications
• Previous anaphylactic reaction to this vaccine or to any of its
components.
• Pregnancy or possibility of pregnancy within 4wks.
• Severe immunodeficiency (e.g., hematologic and solid tumors;
receiving chemotherapy; congenital immunodeficiency; longterm immunosuppressive therapy; or severely symptomatic HIV).
Note: HIV infection is NOT a contraindication to MMR for those
who are not severely immunocompromised (i.e., CD4+ T-lymphocyte counts are greater than or equal to 200 cells/µL) for 6 months.*
Precautions
• Moderate or severe acute illness.
• If blood, plasma, and/or immune globulin were given in past
11m, see ACIP’s General Recommendations on Immunization*
regarding time to wait before vaccinating.
• History of thrombocytopenia or thrombocytopenic purpura.
Note: If TST (tuberculosis skin test) and MMR are both needed
but not given on same day, delay TST for 4–6wks after MMR.
Varicella
(chickenpox)
(Var)
Give SC
For people through age 18 years, consult “Summary of Recommendations for Child/Teen Immunization” at www.immunize.org/catg.d/
p2010.pdf.
• All adults without evidence of immunity.
Note: Evidence of immunity is defined as written documentation of
2 doses of varicella vaccine; a history of varicella disease or herpes
zoster (shingles) based on healthcare-provider diagnosis; laboratory
evidence of immunity or confirmation of disease; and/or birth in the
U.S. before 1980, with the exceptions that follow.
Healthcare personnel born in the U.S. before 1980 who do not meet
any of the criteria above should be tested or given the 2-dose vaccine
series. If testing indicates they are not immune, give the 1st dose of
varicella vaccine immediately. Give the 2nd dose 4–8 wks later.
Pregnant women born in the U.S. before 1980 who do not meet any
of the criteria above should either 1) be tested for susceptibility during pregnancy and if found susceptible, given the 1st dose of varicella vaccine postpartum before hospital discharge, or 2) not be tested
for susceptibility and given the 1st dose of varicella vaccine postpartum before hospital discharge. Give the 2nd dose 4–8wks later.
• Give 2 doses.
• Dose #2 is given 4–8wks after dose
#1.
• If dose #2 is delayed, do not repeat
dose #1. Just give dose #2.
• If 2 or more of the following live
virus vaccines are to be given—
LAIV, MMR, Var, HZV, and/or yellow fever—they should be given on
the same day. If they are not, space
them by at least 28d.
• May use as postexposure prophylaxis
if given within 5d.
Note: Routine post-vaccination serologic testing is not recommended.
Contraindications
• Previous anaphylactic reaction to this vaccine or to any of its
components.
• Pregnancy or possibility of pregnancy within 4wks.
• People on long-term immunosuppressive therapy or who are
immunocompromised because of malignancy and primary or
acquired immunodeficiency, including HIV/AIDS (although vaccination may be considered if CD4+ T-lymphocyte counts are
greater than or equal to 200 cells/µL. See MMWR 2007;56,RR-4).
Precautions
• Moderate or severe acute illness.
• If blood, plasma, and/or immune globulin (IG or VZIG) were
given in past 11m, see ACIP’s General Recommendations on Immunization* regarding time to wait before vaccinating.
• Receipt of specific antivirals (i.e., acyclovir, famciclovir, or
valacyclovir) 24hrs before vaccination, if possible; delay resump-
tion of these antiviral drugs for 14d after vaccination.
• People age 60yrs and older.
• Give 1-time dose if unvaccinated,
regardless of previous history of herpes zoster (shingles) or chickenpox.
• If 2 or more of the following live virus vaccines are to be given—MMR,
Var, HZV and/or yellow fever—they
should be given on the same day. If
they are not, space them by at least
28d.
Contraindications
• Previous anaphylactic reaction to any component of zoster vaccine.
• Primary cellular or acquired immunodeficiency.
• Pregnancy.
Precautions
• Moderate or severe acute illness.
• Receipt of specific antivirals (i.e., acyclovir, famciclovir, or
valacyclovir) 24hrs before vaccination, if possible; delay
resumption of these antiviral drugs for 14d after vaccination.
Zoster
(shingles)
(HZV)
Give SC
May 2013
3. Summary of Recommendations for Adult Immunization (Age 19 years & older)
Vaccine name
and route
Hepatitis A
(HepA)
Give IM
Brands may
be used
interchangeably.
Hepatitis B
(HepB)
Give IM
Brands may
be used
interchangeably.
Inactivated
Polio
(IPV)
Give IM or SC
People for whom vaccination is recommended
Schedule for vaccine administration
(any vaccine can be given with another)
(Page 3 of 4)
Contraindications and precautions
(mild illness is not a contraindication)
For people through age 18 years, consult “Summary of Recommendations for Child/ • Give 2 doses, spaced 6–12m apart.
Teen Immunization” at www.immunize.org/catg.d/p2010.pdf.
• If dose #2 is delayed, do not repeat dose #1. Just give
• All people who want to be protected from hepatitis A virus (HAV) infection and
dose #2.
lack a specific risk factor.
• People who travel or work anywhere EXCEPT the U.S., Western Europe, New
Zealand, Australia, Canada, and Japan.
• People with chronic liver disease; injecting and non-injecting drug users; men who
have sex with men; people who receive clotting-factor concentrates; people who
For Twinrix (hepatitis A and B comwork with HAV in experimental lab settings; food handlers when health authorities
bination vaccine [GSK]) for patients
or private employers determine vaccination to be appropriate.
age 18yrs and older only: give
3 doses on a 0, 1, 6m schedule. There
• People who anticipate close personal contact with an international adoptee from a
must be at least 4wks between doses
country of high or intermediate endemicity during the first 60 days following the
#1 and #2, and at least 5m between
adoptee’s arrival in the U.S.
doses #2 and #3.
• Adults age 40yrs or younger with recent (within 2 wks) exposure to HAV. For
An alternative schedule can also be
people older than age 40yrs with recent (within 2 wks) exposure to HAV, immune
used at 0, 7d, 21–30d, and a booster
globulin is preferred over HepA vaccine.
at 12m.
For people through age 18 years, consult “Summary of Recommendations for Child/
Teen Immunization” at www.immunize.org/catg.d/p2010.pdf.
Give 3 doses on a 0, 1, 6m schedule.
• All adults who want to be protected from hepatitis B virus infection and lack a spe• Alternative timing options for vaccination include
cific risk factor.
0, 2, 4m; 0, 1, 4m; and 0, 1, 2, 12m (Engerix brand
• Household contacts and sex partners of HBsAg-positive people; injecting drug usonly).
ers; sexually active people not in a long-term, mutually monogamous relationship;
• There must be at least 4wks between doses #1 and
men who have sex with men; people with HIV; people seeking STD evaluation
#2, and at least 8wks between doses #2 and #3. Overor treatment; hemodialysis patients and those with renal disease that may result in
all, there must be at least 16wks between doses #1
dialysis; diabetics younger than age 60yrs (diabetics age 60yrs and older may be
and #3.
vaccinated at the clinician’s discretion [see ACIP recommendations*]); healthcare
• Give adults on hemodialysis or with other immunopersonnel and public safety workers who are exposed to blood; clients and staff
compromising conditions 1 dose of 40μg/mL (Reof institutions for the developmentally disabled; inmates of long-term correctional
combivax HB) at 0, 1, 6m or 2 doses of 20 μg/mL
facilities; certain international travelers; and people with chronic liver disease.
(Engerix-B) given simultaneously at 0, 1, 2, 6m.
Note: Provide serologic screening for immigrants from endemic areas. If patient is
Schedule for those who have fallen behind: If the
chronically infected, assure appropriate disease management. For sex partners and
series is delayed between doses, DO NOT start the sehousehold contacts of HBsAg-positive people, provide serologic screening and adries over. Continue from where you left off.
minister initial dose of HepB vaccine at same visit.
Contraindication
Previous anaphylactic reaction to this
vaccine or to any of its components.
Precaution
Moderate or severe acute illness.
For people through age 18 years, consult “Summary of Recommendations for Child/
Teen Immunization” at www.immunize.org/catg.d/p2010.pdf.
• Not routinely recommended for U.S. residents age 18yrs and older.
Note: Adults living in the U.S. who never received or completed a primary series
of polio vaccine need not be vaccinated unless they intend to travel to areas where
exposure to wild-type virus is likely. Previously vaccinated adults can receive 1
booster dose if traveling to polio endemic areas or to areas where the risk of exposure is high.
• Refer to ACIP recommendations* regarding unique
situations, schedules, and dosing information.
Contraindication
Previous anaphylactic reaction to this
vaccine or to any of its components.
Precautions
• Moderate or severe acute illness.
• Pregnancy.
• Give 1 dose of any Hib conjugate vaccine to adults
in categories 1 or 2 (see 2nd bullet in column to left) if
no history of previous Hib vaccine.
• For HSCT patients, regardless of Hib vaccination
history, give 3 doses, at least 4wks apart, beginning
6–12m after transplant.
Contraindication
Previous anaphylactic reaction to this
vaccine or to any of its components.
Precaution
Moderate or severe acute illness.
Hib
For people through age 18 years, consult “Summary of Recommendations for Child/
(Haemophilus
Teen Immunization” at www.immunize.org/catg.d/p2010.pdf.
influenzae type b) • Not routinely recommended for healthy adults.
• Those adults at highest risk of serious Hib disease include people who 1) have anaGive IM
tomic or functional asplenia, 2) are undergoing an elective splenectomy, or 3) are
recipients of hematopoietic stem cell transplant (HSCT).
Contraindication
Previous anaphylactic reaction to this
vaccine or to any of its components.
Precaution
Moderate or severe acute illness.
May 2013
4. Summary of Recommendations for Adult Immunization (Age 19 years & older)
Vaccine name
and route
Human
papillomavirus
(HPV)
(HPV2, Cervarix)
(HPV4, Gardasil)
Give IM
Meningococcal
conjugate vaccine,
quadrivalent
(MCV4)
Menactra,
Menveo
Give IM
Meningococcal
polysaccharide
vaccine
(MPSV4)
Menomune
Give SC
Tdap, Td
(Tetanus,
diphtheria,
acellular
pertussis)
Give IM
Using
tetanus
toxoid (TT)
instead of
Tdap or Td
is not recommended.
People for whom vaccination is recommended
Schedule for vaccine administration
(any vaccine can be given with another)
(Page 4 of 4)
Contraindications and precautions
(mild illness is not a contraindication)
For people through age 18 years, consult “Summary of Recommen- • Give 3 doses on a 0, 2, 6m schedule. Use either HPV2 or
dations for Child/Teen Immunization” at www.immunize.org/
HPV4 for women, and only HPV4 for men.
catg.d/p2010.pdf.
• There must be at least 4wks between doses #1 and #2 and at
• All previously unvaccinated women through age 26yrs and men
least 12wks between doses #2 and #3. Overall, there must
through age 21yrs.
be at least 24wks between doses #1 and #3. If possible, use
• All previously unvaccinated men through age 26yrs who 1) have
the same vaccine product for all three doses.
sex with men or 2) are immunocompromised as a result of infection (including HIV), disease, or medications or who lack either
of the preceding risk factors but want to be vaccinated.
Contraindication
Previous anaphylactic reaction to this vaccine or
to any of its components.
Precautions
• Moderate or severe acute illness.
• Pregnancy.
• Give 2 initial doses of MCV4 separated by 2m to adults
55yrs and younger with risk factors listed in 1st bullet in
column to left or if vaccinating adults with HIV infection
in this age group. Give 1 dose of MPSV4 to adults 56yrs
and older with risk factors.
• Give 1 initial dose to all other adults with risk factors (see
2nd–4th bullets in column to left).
• Give booster doses every 5yrs to adults with continuing risk
(see the 1st–3rd bullets in column to left).
• MCV4 is preferred over MPSV4 for people age 55yrs and
younger. For people age 56yrs and older who anticipate
multiple doses (see the 1st–3rd bullets in column to left) or
who have received MCV4 previously, use MCV4. For all
others, use MPSV4.
• For first year college students age 19–21yrs living in residence halls, give 1 initial dose if unvaccinated and give
booster dose if most recent dose was given when younger
than age 16yrs.
Contraindication
Previous anaphylactic reaction to this vaccine or
to any of its components.
Precaution
• Moderate or severe acute illness.
For people through age 18 years, consult “Summary of Recommendations for Child/Teen Immunization” at www.immunize.org/
catg.d/p2010.pdf.
• People with anatomic or functional asplenia or persistent complement component deficiency.
• People who travel to or reside in countries in which meningococcal disease is hyperendemic or epidemic (e.g., the “meningitis
belt” of Sub-Saharan Africa).
• Microbiologists routinely exposed to isolates of N. meningitidis.
• First year college students through age 21yrs who live in residence halls; see 5th bullet in the box to the right for details.
For people through age 18 years, consult “Summary of Recommen- • For people who are unvaccinated or behind, complete the
primary Td series (spaced at 0, 1–2m, 6–12m intervals);
dations for Child/Teen Immunization” at www.immunize.org/
substitute a one-time dose of Tdap for one of the doses in
catg.d/p2010.pdf.
the series, preferably the first.
• All people who lack written documentation of a primary series
• Give Td booster every 10yrs after the primary series has
consisting of at least 3 doses of tetanus- and diphtheria-toxoidbeen completed.
containing vaccine.
• A booster dose of Td or Tdap may be needed for wound manage- • Tdap should be given regardless of interval since previous
Td.
ment, so consult ACIP recommendations.*
For Tdap only:
• Adults who have not already received Tdap.
• Healthcare personnel of all ages.
• Give Tdap to pregnant women during each pregnancy (preferred
during 27–36 weeks’ gestation), regardless of number of years
since prior Td or Tdap.
Contraindications
• Previous anaphylactic reaction to this vaccine
or to any of its components.
• For Tdap only, history of encephalopathy not
attributable to an identifiable cause, within 7d
following DTP/DTaP, or Tdap.
Precautions
• Moderate or severe acute illness.
• Guillain-Barré syndrome within 6wks following previous dose of tetanus toxoid-containing
vaccine.
• History of arthus reaction following a prior
dose of tetanus- or diphtheria toxoid-containing vaccine (including MCV4); defer vaccination until at least 10yrs have elapsed since the
last tetanus toxoid-containing vaccine.
• For Tdap only, progressive or unstable neurologic disorder, uncontrolled seizures, or
progressive encephalopathy until a treatment
regimen has been established and the condition
May 2013
has stabilized.