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Clinical Preventive Services -
Immunizations and Chemoprophylaxis -
Adult Immunizations,
Including
Chemoprophylaxis
Against Influenza A
ACPM Recommendations:
Adults aged 18 years of age and older
without contraindications should receive
immunizations for influenza,
pneumococcal disease, hepatitis B,
tetanus-diphtheria, and
measles-mumps-rubella as outlined in the
ACIP's Update on Adult Immunization
(Table 1). Priorities should include
efforts to improve provider and public
awareness of the safety and efficacy of
adult vaccination; to avoid missed
opportunities for vaccination, such as
visits to health care providers for
other problems, entry into school or
employment situations, or travel; to use
reminder systems for patients and
providers; to have adequate supplies of
vaccine; to improve mechanisms for
financing and delivery of vaccine; and
to assure support for research on better
vaccines. Individuals with special risk
factors might require additional
immunizations.
- See the entire ACPM recommendation
in:
Adult Immunizations.
Ann R. Fingar, MD, MPH and Byron J.
Francis, MD, FACPM, Illinois Department
of Public Health. Am J Prev Med.
February 1998.
U.S. Preventive Services Task Force
Recommendations:
Annual influenza vaccine is
recommended for all persons aged 65 and
older and persons in selected high-risk
groups (see Clinical Intervention).
Pneumococcal vaccine is recommended for
all immunocompetent individuals who are
age 65 years and older or otherwise at
increased risk for pneumococcal disease
(see Clinical Intervention).
There is insufficient evidence to
recommend for or against pneumococcal
vaccine for high-risk immunocompromised
individuals, but recommendations for
vaccinating these persons may be made on
other grounds. The series of combined
tetanus-diphtheria toxoids (Td) should
be completed for adults who have not
received the primary series, and all
adults should receive periodic Td
boosters. Vaccination against measles
and mumps should be provided to all
adults born after 1956 who lack evidence
of immunity. A second measles
vaccination is recommended for
adolescents and young adults in settings
where such individuals congregate (e.g.,
high schools and colleges). See Screening
for Rubella
for recommendations for rubella vaccine.
Hepatitis B vaccine is recommended for
all young adults not previously
immunized and for all persons at high
risk for infection (see Clinical
Intervention). Hepatitis A vaccine
is recommended for persons at high risk
for hepatitis A virus (HAV) infection
(see Clinical Intervention).
Varicella vaccine is recommended for
susceptible adults (see also Chapter
65). See Screening
for Tuberculosis Infection for
recommendations regarding the Bacille
Calmette-Guérin (BCG) vaccine.
Recommendations for postexposure
prophylaxis against selected infectious
diseases are in Chapter 67; see also
Chapter 24, Screening for Hepatitis B
Virus Infection.
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