The Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule to ensure that the schedule reflects current recommendations for the licensed vaccines. In June 2007, ACIP approved the Adult Immunization Schedule for October 2007–September 2008.
Additional information is available as follows: schedule (in English and Spanish)
at http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm; adult vaccinations at http://www.cdc.gov/vaccines/default.htm; ACIP statements for specific
vaccines at http://www.cdc.gov/vaccines/pubs/acip-list.htm; and reporting adverse events at http://www.vaers.hhs.gov or by telephone, 800-822-7967.
Age-Based Schedule (Figure 1)
• The yellow bar for varicella vaccine has been extended through all age groups, indicating that the vaccine is recommended for all adults without evidence of immunity to varicella.
• Zoster vaccine has been added, with a yellow bar indicating that the vaccine is recommended for persons aged ≥60 years.
Medical/Other Indications Schedule (Figure 2)
• The title has been changed to “Vaccines that might be indicated for adults based on medical and other indications,” indicating that not all of the vaccines are recommended based on medical indications.
• The word “contraindicated” has been added to the red bars and removed from the legend.
• The “immunocompromising conditions” column heading has been shortened by removing the list of conditions.
• The “human immunodeficiency virus (HIV) infection” column has been moved next to the “immunocompromising conditions” column.
• The HIV column has been split into CD4+ T lymphocyte counts of <200 cells/μL and ≥200 cells/μL.
• The indication “recipients of clotting factor concentrates” has been removed from the column heading “chronic liver disease” because only one vaccine has this recommendation. The indication remains in the hepatitis A vaccine footnote.
• The varicella vaccine yellow bar has been extended to include persons infected with HIV who have CD4+ T lymphocyte counts of ≥200 cells/μL.1
• The influenza vaccine yellow bar for “health-care personnel” indicates that health-care personnel can receive either trivalent inactivated influenza vaccine (TIV) or live, attenuated influenza vaccine (LAIV).
• The yellow bar for influenza vaccine has been extended to include persons in the “asplenia” risk group.
• The bar for meningococcal vaccine has been revised to indicate that 1 or more doses might be indicated.
• Zoster vaccine has been added to the schedule with a yellow bar to indicate that the vaccine is recommended for all indications except pregnancy, immunocompromising conditions, and HIV. A red bar, indicating a contraindication, has been inserted for pregnancy, immunocompromising conditions, and HIV infection with a CD4+ T lymphocyte count of <200 cells/μL.
Footnotes (Figure 1 and Figure 2)
• Text for vaccine contraindications in pregnancy has been removed from the footnotes of human papillomavirus (HPV) (#2); measles, mumps, rubella (MMR) (#3); and varicella (#4) to be consistent with the intent of the footnotes to summarize the indications for vaccine use. Pregnancy contraindications are indicated with a red bar.
• The HPV footnote (#2) has been revised to clarify evidence of prior infection, clarify that HPV vaccine is not specifically indicated based on medical conditions, and indicate that efficacy and immunogenicity might be lower in persons with certain medical conditions.
• The varicella footnote (#4) has been revised to clarify that birth before 1980 for immunocompromised persons is not evidence of immunity and to add a requirement for evidence of immunity.
• The pneumococcal polysaccharide vaccine (PPV) footnote (#6) has been revised by adding chronic alcoholism and cerebrospinal fluid leaks and deleting the immunocompromising conditions.
• The hepatitis B footnote (#9) has been revised by removing persons who receive clotting factor concentrates as a risk group and by clarifying the special formulations dose.
• The meningococcal vaccine footnote (#10) has been revised to clarify that persons who remain at increased risk for infection might be indicated for revaccination.
• A footnote (#11) has been added to reflect ACIP recommendations for herpes zoster vaccination for persons aged ≥60 years.
• A footnote (#13) has been added to provide a reference for vaccines in persons with immunocompromising conditions.
The Recommended Adult Immunization Schedule has been approved by the Advisory Committee on Immunization Practices, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Physicians. The standard MMWR footnote format has beenmodified for publication of this schedule.
SOURCE: Centers for Disease Control and Prevention. Recommended Adult Immunization Schedule—United States, October 2007–September 2008. MMWR2007;56:Q1–Q4.
Recommended Adult Immunization Schedule—United States, October 2007–September 2008. JAMA. 2007;298(21):2477-2480. doi:10.1001/jama.298.21.2477