Immunization Update: 2018 Recommended Schedule for Adults Released by ACIP

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The recombinant zoster vaccine should be routinely used in adults with chronic conditions, including diabetes or chronic heart, lung, liver, or kidney disease.
The recombinant zoster vaccine should be routinely used in adults with chronic conditions, including diabetes or chronic heart, lung, liver, or kidney disease.

The Advisory Committee on Immunization Practices (ACIP) has released the 2018 Recommended Immunization Schedule for Adults Aged 19 Years or Older.

Major changes in the 2018 adult immunization schedule from the previous year's schedule include new recommendations on the use of recombinant zoster vaccine (RZV) for adults aged 50 or older, and the use of an additional dose of the measles, mumps, and rubella (MMR) vaccine in a mumps outbreak setting. 

With the October 2017 approval of Shingrix (GlaxoSmithKline), the ACIP recommends the use of:

  • RZV among immunocompetent adults aged 50 or older for the prevention of herpes zoster and related complications 
  • RZV among adults aged 50 or older who previously received the zoster vaccine live (ZVL; Zostavax)
  • RZV or ZVL for adults aged 60 or older (RZV preferred)

There is currently no ACIP recommendation on the use of RZV among pregnant women or immunocompromised adults (eg, HIV infection). In adults with chronic conditions (eg, diabetes, chronic heart, lung, liver, or kidney disease, asplenia, complement deficiencies), RZV should routinely be used. 

Recommendations on MMR vaccination have been updated to include the use of a third dose of a mumps virus-containing vaccine in certain individuals during a mumps outbreak. Adults identified by a public health authority as being at increased risk and who have received ≤2 doses of mumps virus-containing vaccine or whose mumps vaccination status is unknown should receive 1 dose of MMR. 

Adults with no immunity to mumps are recommended to receive 1 dose of MMR for mumps prevention. Students in post-secondary institutions, international travelers, or household contacts of immunocompromised persons should receive 2 doses of MMR at least 28 days apart. 

Reference

Kim DK, Riley LE, Hunter P. Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older — United States, 2018 [published online February 6, 2018]. MMWR Morb Mortal Wkly Rep. doi:10.15585/mmwr.mm6705e3

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