New Adult Immunization Schedule
New Adult Immunization Schedule
Created by on 2/18/2013 8:42:52 AM

Quick Update on New Adult Immunization Schedule
By: Jansje Roberts, Pharm.D.


Quick Update on New Adult Immunization Schedule
By: Jansje Roberts, Pharm.D.

On an annual basis the Advisory Committee on Immunization Practices (ACIP) reviews the adult and pediatric immunization schedule. It can be found on the following website: http://www.cdc.gov/vaccines/schedules/hcp/adult.html and was also published in Annuals of Internal Medicine.1,3 The recommended changes for 2013 affect Tdap, pneumococcal vaccine, and influenza.

Tdap (Tetanus, diphtheria, acellular pertussis vaccine)
Due to the outbreaks of pertussis across the United States the new recommendation is to vaccinate pregnant women for each and every pregnancy preferably between 27 and 36 weeks pregnant even if they were previously vaccinated.1,2 The states of Kentucky, Tennessee, and Virginia experience greater than 3 fold increase in pertussis comparing 2011 data to 2012.2 Whereas Ohio only had less than a 2 fold increase in pertussis during that same time period.2 The Tdap booster is recommended for all adults including 65 years and older.3,4

Pneumococcal Vaccine (Prevnar 13 & Pneumovax or PPSV 23)
The change for these vaccines is in the adult immunocompromised adult population such as cochlear implants, functional or anatomic asplenia, HIV infection, cancer, cerebospinal fluid leaks, advanced kidney disease or other immunocompromised conditions. The recommendation is to give pneumococcal conjugate vaccine (PCV) 13, Prevnar 13 to all immunocompromised patients 19 years of age or older in addition to pneumococcal polysaccharide vaccine (PPSV 23), Pneumovax.1, 3, 4 If not previously vaccinated give Prevnar 13 first then wait 8 weeks before giving PPSV 23.4 If the patient has already been vaccinated with PPSV 23 give the Prevnar 13 one year or more after vaccination with PPSV 23.4

Influenza (TIV now IIV)
Influenza is still recommended for everyone over the age of 6 months on an annual basis.3,4 However, the formulation is changing for next year from a trivalent inactivated influenza vaccine to a quadrivalent inactivated influenza vaccine that increases the coverage to two influenza A and two influenza B strains.1

For further information and details on adult and childhood vaccination schedules go to: http://www.cdc.gov/vaccines/schedules/. Currently, ACIP and the CDC are working on mobile version of the 2013 vaccination schedule that should be available in February 2013 and March 2013 respectively. The current 2013 immunization schedule can be found at: http://www.cdc.gov/vaccines/schedules/hcp/adult.html#tool along with printable easy to read immunization schedules in English and Spanish and the Healthcare Personnel Vaccination Recommendations chart.

References:
1. New Adult Immunization Schedule: A Quick Overview accessed on 1/29/13 from www.medscape.com
2. Pertussis (Whooping Cough) Outbreaks. http://www.cdc.gov/pertussis/outbreaks.html accessed 2/14/13.
3. Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2013. Ann Intern Med. Feb 5 2013;158(3):191-199
4. Advisory Committee on Immunization Practices. Recommended immunization schedule for Persons 0 – 18 years old and Adults 19 years and older: United States, 2013.MMWR 2013;60