Vaccinations in Adults Clinical Practice Guidelines (ACIP, 2020)

Advisory Committee on Immunization Practices (ACIP)

This is a quick summary of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

March 02, 2020

The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) has released an updated schedule for vaccination in adults, which includes changes for administration of several vaccines, including those for influenza, human papillomavirus (HPV), hepatitis A and B, and meningitis B, as well as the pneumococcal 13-valent conjugate (PCV13) vaccine .[1]

PCV13 Vaccine

The PCV13 vaccine is no longer recommended for routine vaccination in immunocompetent adults.

Immunocompromised adults aged 19 years or older: Recommended in adults with immunocompromising conditions, cerebrospinal fluid leak, or cochlear implant

Immunocompetent adults aged 65 years or older: Need for vaccination based on shared decision making between patient and clinician (ie, no longer routinely recommended for all adults ≥65 years)

Human Papillomavirus

Catch-up immunization is recommended in persons aged 15-26 years (previous cutoff age in men was 21 years).

The ACIP advises considering vaccination in some patients aged 27-45 years who have not been adequately vaccinated.

Influenza

For the 2019-2020 influenza season, routine influenza vaccination is recommended in all persons aged 6 months or older who have no contraindications. In areas with more than one appropriate available option, the ACIP does not recommend any product over another.

Hepatitis A

Routine hepatitis A vaccination is recommended in all persons aged 1 year or older who have HIV infection, regardless of their level of immune suppression.

Hepatitis B

For hepatitis B vaccine, pregnant women at risk for infection or an adverse infection-related pregnancy outcome have been added to the list of vulnerable patients who may benefit from vaccination.

Whereas older formulations are safe, the ACIP does not recommend the HepB-CpG (Heplisav-B) vaccine during pregnancy because of lacking safety data.

Meningitis B

Persons aged 10 years or older who have complement deficiency, who use a complement inhibitor, who have asplenia, or who are microbiologists should receive a meningitis B vaccine dose 1 year following completion of a primary series. Afterward, they should receive booster doses every 2-3 years as long as their risk is elevated.

Vaccination should be discussed with individuals aged 16-23 years even if they are not at an increased risk for meningococcal disease.

Persons aged 10 years or older who are at increased risk during an outbreak should receive a one-time booster dose if at least one year has elapsed since completion of a meningitis B primary series.

Td/Tdap Vaccine

The ACIP now recommends that either the diphtheria and tetanus toxoids (Td) or tetanus and reduced diphtheria toxoids/acellular pertussis (Tdap vaccine) be administered in cases in which just the Td vaccine is currently recommended; that is, for the 10-year booster shot and for tetanus prophylaxis in wound management and the catch-up immunization schedule, including for pregnant women.

Varicella

Vaccination against varicella should be considered in individuals with HIV infection who do not have evidence of varicella immunity and whose CD4 counts are ≥200 cells/µL.

For more information, please go to Vaccinations - Adult.

For more Clinical Practice Guidelines, please go to Guidelines.

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