RT Book, Section A1 Tovar, John A1 Farrell, Nicole A2 Attridge, Rebecca L. A2 Miller, Monica L. A2 Moote, Rebecca A2 Ryan, Laurajo SR Print(0) ID 57296099 T1 Immunizations T2 Internal Medicine: A Guide to Clinical Therapeutics YR 2013 FD 2013 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-174580-2 LK accesspharmacy.mhmedical.com/content.aspx?aid=57296099 RD 2024/03/28 AB Table Graphic Jump LocationTable B-1 Selected Recommended Adult ImmunizationsView Table||Download (.pdf)Table B-1 Selected Recommended Adult ImmunizationsVaccineType/Dose RouteIndicationScheduleContraindicationsCommentsTrivalentInactivatedInfluenzaVaccine (TIV)Live- attenuated Influenza Vaccine (LAIV)Inactivated 0.5mL IMAll adults1 dose every year in the fall or winterAnaphylaxis to vaccine components; egg allergy*Number of doses & target group may vary depending on flu seasonLive attenuated 0.1mL/nostril (0.2mL total)For 2–49yo healthy nonpregnant patients1 dose every year in the fall or winterAnaphylaxis to gentamicin, gelatin, arginine, or vaccine components; egg allergy*; pregnancyPneumococcal Polysaccharide Vaccine (PPSV)Inactivated 0.5mL IM/SQ≥65y; 2–64y at high risk†One-time dose if 1st dose given ≥65y2-dose lifetime maxAnaphylaxis to vaccine componentsRevaccinate younger patients (2–64y) in 5y if: chronic renal failure; functional or anatomic asplenia; immunocompromised; revaccinate≥65y if initial dose ≥5y ago AND if 65 if contact with infant anticipatedTdap should replace next Td booster if no prior Tdap1 lifetime dose; regardless of timing of last Td doseHistory of encephalopathy (e.g., coma or prolonged seizures) not attributable to an identifiable cause within 7d of administrationDefer vaccination if unstable neurologic condition; if decision made to continue vaccination with tetanus toxoid after Guillain-Barré syndrome (≤6wk after dose of tetanus toxoid), Tdap preferred to TdNo need to wait a minimum of 2y between Tdap & Td containing vaccines anymoreZosterLive attenuated 0.65mL SQ≥50yo to prevent shingles1 lifetime doseAnaphylaxis to gelatin or neomycin; immunodeficiency, immunosuppressive drugs, pregnancyDefer vaccination if TB &/or acute illness; unknown protection >4y; may be coadministered with TIV; do not give with PPSVMeningococcal Conjugate Vaccine (MCV4) Meningococcal Polysaccharide Vaccine (MPS4V)Inactivated 0.5mL IMAdolescents 11–12y; 2–55y at high risk‡Booster dose:Age 16 if primary dose at age 11 or 12yAge 16–18y if primary dose at age 13–15yNo booster if primary dose on or after age 16yMay revaccinate in 5y if still at risk for infection§Anaphylaxis to vaccine components (including diphtheria toxoid); history of Guillain-Barré syndrome (Menactra®)Menactra® (9mo–55yo); Menveo® (2–55yo)preferred drug ≤55yo; do not use Menactra® if latex hypersensitivity (vial stopper contains latex); no need to revaccinate if dorm living is risk factorA 2-dose primary series administered 2mo apart is recommended for persons 2–54yo with persistent complement component deficiency, functional or anatomic asplenia, & for adolescents with HIVInactivated 0.5mL SQPatients ≥2y at high risk‡Anaphylaxis to vaccine componentsPreferred drug ≥56yo; unknown protection >2yFootnotes for Table B-1IM, intramuscular; IN, intranasal; SQ, subcutaneous; HIV, human immunodeficiency virus*Patients who can eat lightly cooked eggs (e.g., scrambled eggs) without reaction are unlikely to be allergic. Conversely, egg-allergic persons might tolerate egg in baked products (e.g., bread or cake); tolerance to egg-containing foods does not exclude the possibility of egg allergy. Persons who have experienced only hives following exposure to egg may be given the vaccine by trained personnel.†High-risk groups pneumococcus: medical (chronic lung disease [including asthma]; chronic cardiovascular diseases; diabetes mellitus; chronic liver diseases, cirrhosis; chronic alcoholism; functional or anatomic asplenia [e.g., sickle cell disease or splenectomy]; immunocompromising conditions [including chronic renal failure ...