ACIP Updates Recommendations for US Adult Immunization Schedule
The ACIP and CDC have approved and released 2019 recommendations for the adult immunization schedule in the US.
The tetanus, diphtheria, pertussis (Tdap) vaccine should be administered as 1 dose followed by a booster every 10 years for all ages. In individuals born in 1957 or later and individuals with HIV and a CD4 count >200 cell/μL for more than 6 months, the measles, mumps, rubella vaccine should be administered in 2 doses at least 4 weeks apart. In addition, the varicella vaccine should be given in 2 doses in people born in 1980 or later. A total of 2 doses of the zoster recombinant vaccine is recommended in individuals aged ≥50 years, whereas the live zoster vaccine should be administered as 1 dose in individuals aged ≥65 years. The 2019 update also included recommendations on human papillomavirus vaccination in males (2 or 3 doses depending on age at initial vaccination and identified risk factors), pneumococcal conjugate and pneumococcal polysaccharide, and vaccines for meningococcal bacteria.
New Recommendation Displays
In Table 2 of the recommendations, the ACIP provides 2 new recommendations, categorized by colors: pink (Delay vaccination until after pregnancy if vaccine indicated) and orange (Precaution—vaccine might be indicated if benefit of protection outweighs risk of adverse reaction).
The ACIP recommendations also offered an overview of adult vaccination coverage rates, which, overall, have remained low in the US despite modest increases in 2016. According to the ACIP, influenza coverage rates for the 2015 to 2016 influenza season remained similar to those in the 2014 to 2015 season in individuals aged ≥19 years (43.5%). Conversely, coverage rates decreased to 70.4% during the same period in individuals aged ≥65 years. However, a 3.3% increase in the 2016 pneumococcal vaccination coverage rate in adults aged ≥65 years was observed from 2015.
ACIP Take Home Message
“By consistently using the Recommended Adult Immunization Schedule, United States, 2019, and implementing the standards for adult immunization practice,” the ACIP task force wrote, “health care providers can reduce the burden of illnesses, hospitalizations, and mortality associated with vaccine-preventable diseases among their adult patients.”
Hunter P, Kim D for the Adult Immunization Work Group, Advisory Committee on Immunization Practices. Centers for Disease Control and Prevention (CDC). Recommended Adult Immunization Schedule, United States, 2019. www.cdc.gov/vaccines/acip/meetings/downloads/slides-2018-10/Adult-Imz-Hunter-Kim-508.pdf. October 24, 2018. Accessed February 1, 2019.