2012 Adult Immunization Schedule: The Key Changes In US

Human Papillomavirus

Human papillomavirus (HPV) vaccine, which is no longer just for girls. The new HPV recommendation: routine vaccination for males aged 11 through 21 years. (Routine vaccination for females is recommended for those aged 11 through 26 years). Female vaccination rates are now low, which makes male vaccination more cost-effective. Routine HPV vaccination in men who have sex with men is recommended through age 26 years; it is cost-effective, regardless of coverage rates in females.

Hepatitis B

Hepatitis B vaccination is now recommended routinely for adults with diabetes who are younger than age 60 years. Those with diabetes age 23 through 59 years have more than twice the risk for contracting hepatitis B compared with people without diabetes. Those with diabetes who are age 60 years or older may be vaccinated at physician discretion.

Tdap and Pertussis Protection

Recommendations for adult tetanus, diphtheria, and pertussis (Tdap) vaccination concern pertussis protection and, specifically, cocooning infants and young children by vaccinating family and household contacts, including those over age 65 years. The new change is when to vaccinate pregnant mothers, which should be during pregnancy, after 20 weeks' gestation. Timing the vaccination this way will allow the mother's antibodies to pass on to the fetus.

Influenza

In the latest recommendations, egg allergy is no longer a contraindication to the influenza vaccination, although egg-allergic patients must get the inactivated shot because that is what has been studied. In addition, the new intradermal influenza vaccine, with its microinjector apparatus and ultrafine needle, is an option for adults aged 18 through 64 years. Finally, everyone over 6 months old should be vaccinated for flu, and this includes healthcare workers.

References

1. Advisory Committee on Immunization Practices. Recommended Adult Immunization Schedule: United States, 2012. Ann Intern Med. 2012;156:211-217.
2. Fryhofer SA. Adult immunization 2012: politics, process, and progress. Ann Intern Med. 2012;156:243-245.