Primary Care

Immunization of Adults

Updates to adult immunization standards were approved by the National Vaccine Advisory Committee in September 2013. Several of the changes are listed below:

  • Adults that have not previously received the Haemophilus influenzae type B (Hib) vaccine are advised to do so. Patients undergoing hematopoietic stem-cell transplant must be given three doses of the vaccine within 6-12 months of their procedure. Due to their low risk of Hib infection, patients with HIV are no longer recommended to receive the Hib vaccine.
  • Individuals aged 18-49 with egg allergies are permitted to take recombinant influenza vaccines as they now contain no egg proteins. Individuals with allergies to egg proteins can take either of the recombinant or inactivated influenza vaccines provided their sole allergic manifestation is hives.
  • For patients previously unvaccinated older than 10, one dose of the Tdap vaccine is initially, while booster vaccines should be received once every 10 years after the initial administration. Pregnant women, however, should receive a dose of the Tdap vaccine during gestation regardless of the time since last vaccination. The dose is best delivered between the 27-36th weeks of pregnancy.
  • To clarify the recommended order, the footnote for the 13-valent conjugated pneumococcal vaccine (PCV13) is listed before that of the PPSV23 as an additional reminder to vaccine providers that among persons that require both vaccines, the PCV13 vaccine must be administered first.
  • ┬áThe footnote for the meningococcal vaccine was altered to clarify the recommended dose for patients’ specific conditions as well as facilitate decisions on whether patients should take the meningococcal conjugate or the meningococcal polysaccharide quadrivalent vaccines.
  • Vaccination recommendations for hepatitis A and B as well as MMR were unchanged.

U.S. vaccination rates among adults are unfortunately much lower than would be hoped. The National Vaccine Advisory Committee strongly recommend that primary medical providers offer vaccinations at each and any visit patients make. Ideally, if providers do not keep a needed vaccine in stock, they should make the patient aware of providers that do offer the vaccination. It is also imperative that providers keep up-to-date information on their patients and updates their patients’ vaccination histories accordingly. Documentation is vital in ensuring that patients receive the appropriate vaccinations safely.