Adult Immunization Indications


• Age   ≥   6 5  
• Give   1   d ose   i f   u nvaccinated  
• 0.5   m L   I M  
• Age   <   6 5   w ith   a ny   o f   t he   f ollowing:  
OR   i f   v accine   h istory   i s  
Previous   a naphylactic  
reaction   t o   t his   v accine   o r  
o Chronic   C ardiac   D isease   ( Excluding   H ypertension)  
o Chronic   P ulmonary   D isease   ( Including   A sthma)  
to   a ny   o f   i ts   c omponents  
Avoid   g iving   w ithin   4  
o Chronic   L iver   D isease  
weeks   o f   Z ostavax   i f  
o Alcoholism  
o Diabetes  
Moderate   o r   S evere   A cute  
o CSF   L eaks  
o Cigarette   S moking  
• Give   a   1 -­‐time   r evaccination  
o Candidates   f or   o r   R ecipients   o f   C ochlear   I mplants  
o People   l iving   i n   s pecial   e nvironments   o r   s ocial   s ettings   ( including  
o Age   ≥   6 5   a nd   1
  d ose  
American   I ndian/Alaska   N atives   a ge   5 0   t hrough   6 4)  
was   g iven   p rior   t o   a ge  
65   a nd   a t   l east   5   y ears  
have   e lapsed  
o Asplenia   ( Anatomic   o r   F unctional)  
o Sickle   C ell   D isease  
o OR  
o Immunocompromising   C onditions  
o Age   1 9   –   6 4   w ho   a re   a t  
HIGHEST   R ISK   o r   h ave  
 HIV   I nfection  
rapid   a ntibody   l oss  
 Leukemia  
 Lymphoma  
given   t hat   a t   l east   5  
 Hodgkin’s   D isease  
years   h ave   e lapsed  
 Multiple   M yeloma  
 Generalized   M alignancy  
 Chronic   R enal   F ailure  
 Nephrotic   S yndrome  
o Immunosuppressive   C hemo   ( Including   C orticosteroids)  
o Organ   o r   B one   M arrow   T ransplant   P ts  
All   a dults   w ho   w ant   t o   b e   p rotected   f rom   H ep   B  
3   D oses   a t   0 ,   1 ,   a nd   6  
• 1   m L   I M  
Household   c ontacts   a nd   s ex   p artners   o f   H BsAg-­‐Positive   P eople  
month   s chedule  
• Previous   a naphylactic  
• Shake   w ell   p rior   t o  
Hepatitis   B  
Must   b e   a t   l east   4   w eeks  
reaction   t o   t his   v accine   o r   t o  
withdrawal   a nd   u se  
Injecting   D rug   U sers  
between   d oses   1   a nd   2  
any   o f   i ts   c omponents  
• Hemodialysis—use   2   m L  
Sexually   A ctive   P eople   n ot   i n   a   l ong   t erm,   m onogamous   r elationship  
Must   b e   a t   l east   8   w eeks  
Men   w ho   h ave   s ex   w ith   m en  
between   d oses   2   a nd   3  
Brands   m ay   b e   u sed  
Pts   w ith   H IV  
• Moderate   o r   S evere   A cute  
Overall   m ust   b e   a t   l east  
People   s eeking   S TD   e valuation   o r   t reatment  
16   w eeks   b etween   d oses  
Hemodialysis   P atients   a nd   t hose   w ith   r enal   d isease   t hat   m ay   r esult   i n  
1   a nd   3  
Healthcare   p ersonnel   a nd   p ublic   s afety   w orkers   w ho   a re   e xposed   t o  
NEVER   r estart   a   s eries   f or  
those   w ho   h ave   f allen   b ehind.  
Clients/Staff   o f   i nstitutions   f or   t he   d evelopmentally   d isabled  
Continue   w here   y ou   l eft   o ff.  
Inmates   o f   l ong-­‐term   c orrectional   f acilities  
Certain   I nternational   T ravelers  
• Adult   h emodialysis   p atients  
People   w ith   C hronic   L iver   D isease  
need   2   m L   I M   a t   0 ,   1 ,   2 ,   a nd  
12   m onths  
NOTE:   s hould   p rovide   s erologic   s creening   f or   i mmigrants   f rom   e ndemic  
areas.   I f   p t   i s   c hronically   i nfected,   a ssure   a ppropriate   d isease   m anagement.  
For   s ex   p artners   a nd   h ousehold   c ontacts   o f   H BsAg-­‐Pos   P atients,   p rovide  
serologic   s creening   A ND   a dminister   i nitial   d ose   o f   H epB   v accine   a t   s ame  


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