ACIP Issues 2014 Immunization Schedule for Adults

Fran Lowry

February 03, 2014

Updated vaccination recommendations for adults aged 19 years and older for 2014 have been released by the Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization.

The committee approved the Adult Immunization Schedule for 2014 in October 2013; the schedule was also reviewed and approved by the American Academy of Family Physicians, American College of Physicians, American College of Obstetricians and Gynecologists, and American College of Nurse-Midwives.

The immunization schedule is being simultaneously published in the February 4 issue of the Annals of Internal Medicine and on the CDC's Web site.

Additional guidance for the use of the vaccines and updates is also provided on the CDC's Web site.

Immunization Highlights

A press release from the journal highlights key changes in the recommendations, including:

  • Haemophilus influenza type b (Hib): The Hib "vaccine recommendations were updated. The vaccine is recommended for certain adults at increased risk for Hib who have not received the vaccine before, except for those with HIV because their risk for Hib infection is low. Adults who have had a successful hematopoietic stem cell transplant are recommended to receive a 3-dose series of Hib vaccine 6 to 12 months after the transplant regardless of Hib vaccination status."

  • Influenza vaccine: The update adds "[i]nformation on the use of the recombinant influenza (RIV) and inactivated influenza (IIV) vaccines among egg-allergic patients was added to the footnote and indicates that RIV or IIV can be used among persons with hives-only allergy to eggs, as it contains no egg protein."

  • "Td/Tdap: The tetanus, diphtheria, acellular pertussis (Tdap) and tetanus, diphtheria (Td) vaccines footnote was edited to harmonize with the language used in the pediatric immunization schedule. A single dose of Tdap vaccine is recommended for previously unvaccinated persons aged 11 years or older, and Td booster should be administered every 10 years thereafter."

  • Human papillomavirus: "Information was added to the humanpapillomavirus...vaccine footnote to clarify the timing between the second and third doses and to harmonize language between the pediatric and adult immunization schedules. No changes in recommendations were made."

  • Zoster: "Being a healthcare worker is no longer an indication for vaccination."

  • Pneumococcal vaccines: "PCV13 [the 13-valent pneumococcal vaccine] is recommended to be administered before PPSV23 [the 23-valent pneumococcal vaccine] among persons for whom both vaccines are recommended. The PCV13 footnote now precedes the PPSV23 footnote and includes wording to remind providers of the appropriate order of these vaccines when both are indicated."

  • Meningococcal vaccine: The footnote "was edited to clarify which persons need either one or two doses of vaccine and to provide greater clarity regarding which patients should receive meningococcal conjugate (MeanACWY-D) versus the meningococcal polysaccharide (MenACWY-CRM)."

One member of the Advisory Committee on Immunization Practices reports relevant financial relationships with Sanofi Pasteur, GlaxoSmithKline, Merck, Novartis, and Pfizer but declares that all relationships with industry were terminated before he became a voting member, and one member who reports receiving a grant from Merck.

Ann Intern Med. 2014;160:190-197.


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