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Notice to Readers: Recommended Adult Immunization Schedule ---
United States, 2002--2003
Please note:
A
clarification has been published for this article. To view the clarification,
please click here.
Although the childhood immunization program in the United States has reduced the burden of vaccine-preventable
disease substantially among children, substantial vaccine-preventable morbidity and mortality from diseases such as hepatitis
A, hepatitis B, influenza, and pneumococcal infections continue to occur among adults. In February 2002, the
Advisory Committee on Immunization Practices (ACIP) approved for the first time a schedule for the routine vaccination of persons aged >19 years. The Adult Immunization Schedule has been accepted by the American Academy of Family Physicians (AAFP) and the American College of Obstetricians and Gynecologists (ACOG). ACIP will review and approve annually both
the recommended adult and childhood immunization schedules. Together, these schedules provide a comprehensive summary
of recommendations for prevention of vaccine-preventable diseases during the life span of persons in the United States.
The Adult Immunization Schedule is based on published recommendations of ACIP
(1), AAFP (2), ACOG (3), and
the American College of Physicians--American Society of Internal Medicine (ACP-ASIM) with the Infectious Diseases Society of America (4) and was developed by members of these organizations and CDC. The schedule presents a tabular,
color-coded summary of vaccine indications by age group (Figure 1) and medical condition (Figure 2). Footnotes included in Figure 1 are summaries of the ACIP recommendations for specific vaccines since 1991. Figure 2 includes special considerations
or contraindications for vaccinating persons with specific medical conditions. Licensed combination vaccines can be
used whenever any components of the combination are indicated and the vaccine's other components are not
contraindicated. Providers should consult manufacturers' package inserts for detailed recommendations. CDC and ACIP will update the schedule annually through collaboration with members of AAFP, ACOG, and ACP-ASIM.
Providers should report all postvaccination reactions to the Vaccine Adverse Event Reporting System (VAERS),
telephone 800-822-7967. Reporting forms and instructions on filing a VAERS report are available at
http://www.vaers.org. Tetanus-diphtheria (Td); hepatitis B; measles, mumps, and rubella (MMR); and varicella vaccines are covered by the Vaccine Injury Compensation Program (VICP). Health-care providers are required to give adult patients copies of the Vaccine
Information Statements developed by CDC before administering each dose of the vaccines covered by VICP. Information on how to file a claim with VICP is available at 800-338-2382.
The schedule provides an up-to-date tool for family physicians, gynecologists, internists, and other health-care providers
to assess the vaccine needs of patients during office visits and to administer the appropriate vaccines. Providers can use
the schedule to promote the use of standing orders, patient- reminder/recall systems, provider-reminder systems, and
other strategies that reduce missed opportunities to vaccinate their patients. The notes accompanying the age-based table and
the footnotes for highlighting issues unique to chronic disease groups provide information for providers who might be
unfamiliar with the dosage or contraindications of a particular vaccine.
Because adult vaccination requires the participation of health-care providers in three medical specialties (internal
medicine, family practice, and obstetrics and gynecology) that do not include vaccinations in clinical training, tools such as the
adult immunization schedule could play an important role in educating health-care providers who want to vaccinate their
adult patients.
A printable, annotated, color version of the schedule will be available at
http://www.cdc.gov/nip. Additional
information on adult immunization and ordering instructions
for Increasing Adult Vaccination Rates: What
Works, a CD-ROM--based continuing education program offering primary-care providers strategies for increasing vaccination rates among their
adult patients, also will be available at this website.
American College of Obstetricians and Gynecologists. Immunization during pregnancy. ACOG Technical bulletin 160, October 1991.
Washington, DC: American College of Obstetricians and Gynecologists, 1991.
American College of Physicians. Guide for adult immunization. 3rd ed. Philadelphia, Pennsylvania: American College of Physicians, 1994.
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Health and Human Services.References to non-CDC sites on the Internet are
provided as a service to MMWR readers and do not constitute or imply
endorsement of these organizations or their programs by CDC or the U.S.
Department of Health and Human Services. CDC is not responsible for the content
of pages found at these sites. URL addresses listed in MMWR were current as of
the date of publication.
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