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Whitney George


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 (
➔ 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