Chapter 66: Vaccines and Immunizations

Patricia H. Fabel; Catherine H. Kuhn

FOUNDATION OVERVIEW

Rates of vaccine-preventable diseases in the United States are at an all-time low due to the routine vaccination of infants, children, and adults. Unfortunately, gaps in coverage still exist. Providers are responsible for the appropriate administration of vaccines and for ensuring patients receive vaccinations as recommended by the Advisory Committee on Immunization Practices (ACIP). Routine childhood, adolescent, and adult vaccines are covered in this chapter. Readers are encouraged to visit the Centers for Disease and Prevention (CDC) vaccines website (http://www.cdc.gov/vaccines/) for information regarding travel and bioterrorism vaccines.

Indications

Indications and target populations for the vaccines available for use in the United States are listed in Table 66-1.

TABLE 66-1Vaccine Indications

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TABLE 66-1 Vaccine Indications

Vaccine

Indication

Target Population

DTaP

Prevention of diphtheria, tetanus, and pertussis

Children <7 y of age

Booster immunization against tetanus and diphtheria as well as tetanus prophylaxis in wound management

Adolescents and adults >7 y of age

Tdap

Booster immunization against tetanus, diphtheria, and pertussis

Adolescents and adults ≥11 y of age

Prevention of diphtheria and tetanus

Children <7 y of age who are allergic to the pertussis vaccine

Hep A

Prevention of hepatitis A infection^a

Children >12 mo of age

Adults at high risk for Hep A infection

Hep B

HepB-CpG

Prevention of hepatitis B infection

All infants beginning at birth

Unvaccinated children and adolescents

Adults at high risk for Hep B infection

Hib

Prevention of invasive bacterial disease caused by Haemophilus influenzae type b

Children <5 y of age

Adults with sickle cell disease, asplenia, leukemia, stem cell transplant or HIV infection

HPV-9

Prevention of cervical, vulvar, vaginal, and anal cancer, precancerous or dysplastic lesions and genital warts caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Females aged 9-26 y^b

Males 9-26 y^b

IPV

Prevention of poliomyelitis cause by poliovirus types 1,2,3

All children

MCV, MPSV

Prevention of invasive meningococcal disease caused by N. meningitidis serogroups A, C, Y, W135

Adolescents 11-12 y of age

Adults at high risk for meningococcal disease

MenB-FHbp, MenB-4C

Prevention of invasive disease caused by N. Meningitides serogroup B

High risk children and adults ≥10 y of age at high risk (persistent complement component deficiencies, asplenia, microbiologists, outbreaks)^c

MMR

Prevention of measles, mumps, rubella, and congenital rubella syndrome

Children >12 mo of age

PCV

Prevention of invasive pneumococcal disease caused by S. pneumoniae

Children <2 y of age

High risk adults (cochlear implant, asplenia, cerebrospinal fluid leaks, immunocompromising condition, or immunosuppressive therapy) ≥19 y of age^d

PPSV

Prevention of invasive pneumococcal disease caused by S. pneumoniae

Adults ≥65 y of age

Aged 2-64 y with chronic heart disease (excluding hypertension), chronic lung disease, diabetes mellitus, cerebrospinal fluid leaks, ...

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Chapter 66: Vaccines and Immunizations

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FOUNDATION OVERVIEW

Indications

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