Immunizations¶
Whitney George
Vaccines¶
| Vaccine | Indications |
|---|---|
| COVID-19 | Recommended for all adults Unvaccinated ➔ 1 dose of Moderna or Pfizer-BioNTech vaccine OR 2 dose series of updated Novavax at 0 then 3-8 weeks |
| Influenza | Recommended for all Adults: 1 dose annually |
| Respiratory Syncytial Virus (RSV) | Recommended for: ➔ 60+ years: consider based on shared clinical decision making giving 1 dose to those most at risk for severe RSV disease (heart failure, over age 80, cardiopulmonary disease) ➔ Pregnant at 32-36 weeks gestation from Sept-January (most states) *** NOT covered by Medicare in clinic*** |
| Tetanus, diphtheria, pertussis (Tdap or Td) | Recommended for all adults: 1 dose Tdap, then Td or Tdap booster q10 years ➔ For patients with clean/minor wounds, administer only if >10 years since last tetanus containing vaccine ➔ For all other wounds, administer if >5 years since last tetanus containing vaccine ***NOT covered by Medicare in clinic*** |
| Measles, mumps, rubella (MMR) | Usually given in childhood, recommended for all adults without evidence of immunity to measles, mumps or rubella (2 doses separated by at least 28 days) |
| Varicella (VAR) | Usually given in childhood, recommended for all adults without evidence of immunity to varicella - 2 dose series 4-8 weeks apart |
| Zoster recombinant (RZV) | Recommended for all adults 50+ years old: 2 dose series 2-6 months apart ***NOT covered by Medicare in clinic*** |
| Human Papillomavirus (HPV) | Recommended for all adults 18-26 years old: 2 or three dose series depending on age at initial vaccine ➔ Age 9-14 yrs at initial vaccination and received 1 dose or 2 doses less than 5 months apart, give additional dose. If given between 9-14 and received two doses, at least 5 months apart – no additional dose ➔ Age 15 or older, three dose series at 0, 1-2 m, 6m ➔ Age 27–45 : shared clinical decision making on vaccination (3 dose series) |
| Pneumococcal (PCV15, PCV20, PPSV23) | Recommended for all adults 65+ years: depends on previously administered type of Pneumo vaccine, recommend CDC app (cdc.gov/vaccines/vpd/pneumo/hcp/pneumoapp.html) ➔ If no prior pneumococcal vaccines, can give one dose of PCV15 OR PCV20 ➔ Immunization also recommended for adults 19-64 with immunocompromising conditions (renal failure, nephrotic syndrome, immunodeficiencies, iatrogenic immunosuppression, malignancy, HIV, Hodgkin disease, solid organ transplant, asplenia, SSD, alcoholism, chronic heart/liver/lung disease, tobacco use, diabetes) |
| Hepatitis A | Recommended for all adults who request vaccination OR is at risk ➔ At risk populations include patients with chronic liver disease, HIV infection, MSM, IVDU, persons experiencing homelessness, travel in countries with high/intermediate endemic risk, healthcare settings with high potential for exposure ➔2 dose (havrix 6-12 m apart) or 3 dose series (Twinrix Hep-A-HepB, 0,1, 6 m apart) |
| Hepatitis B | Recommended for: ➔ All adults aged 19-56 years: 2 (heplisav 4 wk apart), 3 (Engerix-B, PreHevbrio, or Recombinvax at 0,1, 6 m) or 4 dose series (hepA-HepB Twinrix accelerated schedule) ➔ 60+ years: may receive without risk factors, should receive with known risk factors or requests. Risk factors include: Chronic liver disease, HIV, sexual exposure risk, IVDU, Incarceration, travel to countries with high/intermediate endemic hep B Risk) |
| Meningococcal A, C, W, Y (MenACWY) | Recommended for: ➔ Patients with asplenia (anatomical or functional), including HIV, complement deficiencies, compliment inhibitor medication – 2 dose series (MenACWY) at least 8 weeks apart, revaccinated q5 yr if risk remains ➔ Patients traveling to countries with hyperendemic or epidemic meningococcal disease – 1 dose MenACWY and revaccinate q5yr if risk remains ➔ First-year college studies who live in residential housing or military recruits- 1 dose MenACWY |
| Meningococcal B (MenB) | Recommended for adults 16-23 years: based on shared clinical decision making, 2 dose series |
| Haemophilus influenzae type b (Hib) | Recommended for: ➔ Adults with anatomic or functional asplenia including sickle cell, and stem cell transplant recipients |