ACIP Releases Recommended Adult Immunization Schedule for 2015

Those who previously received 1 dose of MenACWY should receive a second dose at least 2 months after the first dose. These individuals may then develop varicella usually within 10-21 days after contact with a case. The first outbreak is usually the most severe and more outbreaks occur the first year than any subsequent year. Persons with impaired humoral immunity (e.g., hypogammaglobulinemia or dysgammaglobulinemia) can/should receive zoster vaccine. Vaccines for cholera are available as [i] injectable killed whole cell vaccine; and [ii] oral cholera vaccine.7-11 The injectable killed whole cell vaccine has been found to have a poor efficacy (45%) and the protection lasts for a duration of only 3 months (Level Ib). Therefore, Dr. Future studies should aim to further elucidate the potential benefits of vaccinating patients with RA specifically, including those younger than 60 years old and those currently receiving various forms of immunosuppressive therapy (figure 1).

The vesicles scab within 7 to 10 days. These 2 dose schedules are recommended in foreign countries for use with the bivalent and quadrivalent vaccines. Minor clarifications also were made to the footnotes for HPV vaccine, varicella vaccine, and pneumococcal polysaccharide vaccine (PPSV). MMWR Morb Mortal Wkly Rep. Men up to age 21 and women up to age 26 should receive three doses of the HPV vaccine. We recommend establishing the patient’s VZV immune status before initiating fingolimod therapy and immunization for patients susceptible to primary VZV infection. – Adults with HIV should receive two doses of a meningococcal vaccine.

A complete series consists of 3 doses. Due to effective antiretroviral therapy, human immunodeficiency virus (HIV) has become a chronic illness. ZOSTAVAX is contraindicated in persons with a history of anaphylactic/anaphylactoid reaction to gelatin, neomycin, or any other component of the vaccine; with a history of primary or acquired immunodeficiency states including leukemia; lymphomas of any type, or other malignant neoplasms affecting the bone marrow or lymphatic system; or with AIDS or other clinical manifestations of infection with human immunodeficiency viruses. However, unless the United States develops an infrastructure to cultivate and support adult vaccination, many of these may not proceed into very expensive Phase III clinical trials. Given the paucity of data on safety and efficacy of Zostavax® in patients with hematologic malignancy and HCT recipients, we elected to review our institution’s experience with this vaccine in this population. Although the patient remembered having varicella in childhood, the current presentation was the patient’s first episode of shingles, and he denied receiving a VZV vaccination prior to initiation of infliximab therapy. Two cases of VZV encephalitis have been reported in patients receiving TNFα inhibitors.

We describe VZV seroprevalence in adults in 5 U.S.-bound refugee groups using stored sera specimens. Each year, approximately 200,000 people are newly infected with genital herpes; continued HSV2 transmission is facilitated by the large number of undiagnosed cases, the frequency of atypical disease, and the occurrence of asymptomatic shedding. The live attenuated influenza vaccine (LAIV) is administered intranasally by spray and can cause mild to severe respiratory symptoms related to viral replication, therefore LAIV is contraindicated for immunosuppressed patients including SOT recipients. Td vaccination coverage among adults aged ≥19 years was 62.2%. • Women through age 26 years and men through age 21 years (and men aged 22 through 26 years who may receive HPV) who initiated HPV series before age 15 years and received 2 doses at least 5 months apart are considered adequately vaccinated and do not need an additional dose of HPV. Shingles can also develop in the eyes and cause vision loss. The live viruses in LAIV are temperature sensitive and do not replicate effectively at the human core body temperature; thus, they cannot produce disease.

Inactivated vaccines consist of viral or bacterial proteins and carbohydrates that are grown in culture and denatured using heat or chemical methods. At the October 2012 meeting, the ACIP recommended meningococcal vaccination for high-risk infants. Studies that also included patients with moderate or severe disease activity did not show more frequent side effects or disease flares, or decreased efficacy in patients with AIIRD compared with healthy controls.24,–,26 However, the numbers of patients in these studies were too small to conclude that vaccination during active disease is safe and efficacious. Burroughs M, Moscona A. Zoster vaccine should be stored in a freezer that maintains an average temperature of 215°C (5°F) or colder. People with diabetes are at increased risk for death from pneumonia (lung infection), bacteremia (blood infection) and meningitis (infection of the lining of the brain and spinal cord). Furthermore, it should generally be avoided in all patients with AIID because the inactivated vaccine is widely available and has comparable efficacy.

Used with permission from Gershon AA, Gardner P, Peter G, et al: Quality standards for immunization. There is a striking increase in the incidence of zoster for people 50 years of age and older.

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