The Recommended Adult Immunization Schedule: United States, 2016 has been released by the Advisory Committee on Immunization Practices (ACIP), published in the Annals of Internal Medicine.
The full schedule, footnotes, and table detailing contraindications and precautions are available on the Annals of Internal Medicine’s website (http://annals.org/article.aspx?articleid=2484895) and on the CDC’s website (http://www.cdc.gov/vaccines/schedules/hcp/adult.html).
For 2016’s schedule, the ACIP made the following specific changes from 2015’s recommendations:
- Interval change for 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) from “6 to 12 months” to “at least 1 year” for immunocompetent adults aged ≥65 years. Adults aged ≥19 years with anatomical or functional asplenia, cerebrospinal fluid leak, or cochlear implant or who are immunocompromised should receive PPSV23 at least 8 weeks after PCV13.
- Serogroup B meningococcal (MenB) vaccine series should be administered to persons aged ≥10 years who are at increased risk for serogroup B meningococcal disease. Those at increased risk include persons with anatomical or functional asplenia or persistent complement component deficiencies, microbiologists who are routinely exposed to isolates of Neisseria meningitidis, and persons identified at increased risk because of a serogroup B meningococcal disease outbreak. MenB vaccine series may be administered to adolescents and young adults aged 16 through 23 years (preferred age is 16 through 18 years) to provide short-term protection against most strains of serogroup B meningococcal disease.
- Nine-valent human papillomavirus (HPV) vaccine (9vHPV) was added to the 2016 adult immunization schedule. This vaccine can be used for routine vaccination against HPV as 1 of 3 HPV vaccines (bivalent HPV vaccine [2vHPV], quadrivalent HPV vaccine [4vHPV], and 9vHPV) recommended for females and 1 of 2 HPV vaccines (4vHPV and 9vHPV) recommended for males.1
Some additional changes to the schedules were made, including:
- Revising the dosing in the “Hepatitis A” indication bar from 2 to “2 or 3 doses depending on vaccine” in order to account for the hepatitis A and hepatitis B combination vaccine
- Revising the dosing in the “Pneumococcal polysaccharide (PPSV23)” indicated bar from “1 or 2” to “1, 2, or 3 doses depending on indication”
- Revising the dosing in the “Haemophilus influenzae type b (Hib)” indication bar from “1 or 3” to “3 doses, post-HSCT [hemapoietic stem cell transplant] recipients only” and “1 dose” for all other adults for whom this vaccine is recommended1
Additional changes were made to the footnotes to reflect new recommendations for different patient populations, including certain high-risk groups. The footnotes include updated recommendations for the administration of the MenACWY, MenB, and HPV vaccines.
The ACIP emphasized the important role that clinicians play in their patients’ vaccine adherence. “A recommendation by an adult patient’s health care provider for needed vaccines is a strong predictor of the patient receiving recommended vaccines,” they wrote.
The 2016 schedule was approved by the American College of Physicians, American Academy of Family Physicians, American College of Nurse-Midwives, and American College of Obstetricians and Gynecologists.The full ACIP recommendations for each vaccine are available on the CDC’s website (http://www.cdc.gov/vaccines/hcp/acip-recs/index.html).
- Kim DK, Bridges CB, Harriman KH, et al. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older: United States, 2016. Ann Intern Med. 2016;164(3):184-194. doi:10.7326/M15-3005.