COMMENTARY

Hot Topics in Adult Immunization, 2014

Sandra Adamson Fryhofer, MD

November 18, 2014

Sandra Adamson Fryhofer, MD
Adjunct Associate Professor of Medicine, Emory University School of Medicine, Atlanta, Georgia; Past President, American College of Physicians

Hot Topics in Adult Immunization

This issue of Staying Well focuses on hot topics in adult immunization and is inspired by IDWeek 2014, the combined annual meeting of an alphabet soup of infectious diseases organizations: IDSA (Infectious Diseases Society of America), SHEA (Society for Healthcare Epidemiology of America), HIVMA (HIV Medicine Association), and PIDS (Pediatric Infectious Diseases Society).

As the American College of Physicians' adult immunization liaison to ACIP (Advisory Committee on Immunization Practices), I was asked to update this esteemed group of attendees—researchers, clinicians, quality and patient safety practitioners, epidemiologists, and public health officials—on hot topics in adult immunization at the 2014 meeting in Philadelphia.^[1]

As we review what's hot, remember that ACIP recommendations are now evidence-based using the GRADE (Grading of Recommendations Assessment, Development and Evaluation)protocol. ACIP recommendations do not become official until published in the Centers for Disease Control and Prevention's (CDC's) MMWRMorbidity and Mortality Weekly Report and are not always consistent with the US Food and Drug Administration's (FDA's) licensing parameters—a fact that is often confusing for practitioners.^[2]

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Hot Topics in Adult Immunization
New Pneumococcal (PCV13) Recommendations: Hot! Hot! Hot!
Flu Vaccination 2014: Very Spicy! (Lots of Choices)
New Meningococcal B Vaccine: "It's SMOKIN'!"
HPV Vaccination: Prospects for Greater Protection on the Horizon
References

Table 1. Adults Who Need PPSV23 Vaccination ^[6]
All adults aged 65 years or older Adults younger than 65 years with: Chronic lung disease (including chronic obstructive pulmonary disease, emphysema, and asthma) Chronic cardiovascular diseases Diabetes mellitus Chronic renal failure, the nephrotic syndrome Chronic liver disease (including cirrhosis), alcoholism Cochlear implants, cerebrospinal fluid leaks Immunocompromising conditions (including HIV) Functional/anatomical asplenia (including sickle cell disease and other hemoglobinopathies Residents of nursing homes or long-term care facilities Smokers When indicated, if uncertain of vaccination status, vaccinate

Source: Centers for Disease Control and Prevention (CDC)

Table 2. Adults Who Need PPSV23 Revaccination ^[6]
All immunocompromised adults need one-time PPSV23 revaccination. For patents younger than 65 years: One-time PPSV23 revaccination after 5 years for high risk: Chronic renal failure, the nephrotic syndrome Sickle cell disease Splenectomy Immunocompromised patients When previously vaccinated patients reach 65 years of age: One-time PPSV23 revaccination, if more than 5 years have passed since the last vaccination and the patient was younger than 65 years at time of primary vaccination.

Source: Centers for Disease Control and Prevention (CDC)

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