Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older — United States, 2019

David K. Kim, MD; Paul Hunter, MD

Disclosures

Morbidity and Mortality Weekly Report. 2019;68(5):115-118. 

In This Article

Abstract and Introduction

Introduction

In October 2018, the Advisory Committee on Immunization Practices (ACIP)* voted to recommend approval of the Recommended Immunization Schedule for Adults, Aged 19 Years or Older, United States, 2019. The 2019 adult immunization schedule, available at https://www.cdc.gov/vaccines/schedules, summarizes ACIP recommendations in two tables and accompanying notes. The 2019 adult immunization schedule has been approved by the CDC Director, the American College of Physicians, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Nurse-Midwives.

ACIP's recommendations on use of each vaccine are developed after in-depth reviews of vaccine-related data, including disease epidemiology and burden, vaccine efficacy and effectiveness, vaccine safety, quality of evidence, feasibility of program implementation, and economic analyses of immunization policy.[1] The adult immunization schedule is published annually to consolidate and summarize updates to ACIP recommendations on vaccination of adults and assist health care providers in implementing current ACIP recommendations. The use of trade names of vaccines in this report and in the adult immunization schedule is for identification purposes only and does not imply endorsement by ACIP or CDC.

For further guidance on the use of vaccines in the adult immunization schedule, health care providers should refer to the full ACIP recommendations at https://www.cdc.gov/vaccines/hcp/acip-recs/index.html. Changes in recommended use of vaccines can occur between annual updates to the adult immunization schedule. These changes, if made, are available at https://www.cdc.gov/vaccines/acip/recommendations.html.§ Printable versions of the 2019 adult immunization schedule and instructions for ordering printed copies are available at https://www.cdc.gov/vaccines/schedules/hcp/adult.html#note.

The 2019 adult immunization schedule is a product of extensive formal usability testing of 2017 and 2018 adult immunization schedules, including in-depth interviews with 48 primary care physicians, nurse practitioners, physician assistants, pharmacists, nurses, and medical assistants, who reported being familiar with the adult immunization schedule, and an Internet survey of 251 internal medicine and family medicine physicians to assess their impressions and preferences on redesigned drafts of the adult immunization schedule.[2] In addition to incorporating new ACIP recommendations on influenza, hepatitis A, and hepatitis B vaccinations, each vaccination section in the 2019 adult immunization schedule was revised for clarity, brevity, and, for vaccines that also appear in the 2019 child and adolescent immunization schedule,[3] consistency between the two schedules. Because usability testing found that providers rarely used the table of contraindications and precautions for vaccines recommended for adults that was a part of previous iterations of the adult immunization schedule, the table was removed from the 2019 adult immunization schedule. Information on vaccine contraindications and precautions is available at https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs.

* Recommendations for routine use of vaccines in children, adolescents, and adults are developed by ACIP. ACIP is chartered as a federal advisory committee to provide expert external advice and guidance to the CDC Director on use of vaccines and related agents for the control of vaccine-preventable diseases in the civilian population of the United States. Recommendations for routine use of vaccines in adults are approved by the American Academy of Family Physicians, American College of Nurse-Midwives, American College of Obstetricians and Gynecologists, and American College of Physicians. ACIP recommendations approved by the CDC Director become agency guidelines on the date published in the Morbidity and Mortality Weekly Report. Additional information about ACIP is available at https://www.cdc.gov/vaccines/acip.
Past immunization schedules are available at https://www.cdc.gov/vaccines/schedules/past.html.
§ CDC encourages organizations that previously have relied on copying the adult immunization schedule on their websites to use syndication instead, as a more reliable method for displaying the most current and accurate adult immunization schedule. Use of content syndication requires a one-time step that ensures an organization's website displays the adult immunization schedule as soon as it is published or revised. The syndication code for the adult immunization schedule and instructions for its use can be found at https://www.cdc.gov/vaccines/schedules/syndicate.html. CDC also offers technical assistance for implementing this form of content syndication (e-mail request to ncirdwebteam@cdc.gov). Changes in ACIP recommendations in the adult immunization schedule before the next scheduled annual update, if any, are available at https://www.cdc.gov/vaccines/schedules/hcp/adult.html.

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