What vaccinations are recommended for prevention of diseases?

Recommended Vaccinations for Disease Prevention

The Advisory Committee on Immunization Practices (ACIP) strongly recommends routine vaccination against hepatitis B, influenza, measles, mumps, rubella, varicella, pneumococcal disease, tetanus, diphtheria, and pertussis for adults based on age and risk factors to prevent significant morbidity and mortality. 1

Core Adult Vaccinations

For All Adults:

• Influenza vaccine: Annual vaccination for all adults regardless of age or health status 1

  • Available as inactivated vaccine for most adults
  • Live attenuated intranasal vaccine (FluMist) may be used for healthy, non-pregnant adults ≤49 years who are not immunocompromised

• Tetanus, diphtheria, and pertussis (Td/Tdap):

  • Tdap once as an adult (replacing one Td dose)
  • Td booster every 10 years thereafter 1
  • Those without documentation of a complete series should receive a 3-dose series

Age-Based Recommendations:

• Adults 19-26 years:

  • HPV vaccine: Recommended for women through age 26; may be administered to men through age 26 1, 2

• Adults ≥50 years:

  • Zoster (shingles) vaccine: Recommended for adults ≥60 years to prevent herpes zoster and post-herpetic neuralgia 1, 2

• Adults ≥65 years:

  • Pneumococcal vaccines: Recommended for all adults ≥65 years 1
    • Pneumococcal polysaccharide vaccine (PPSV23)
    • One-time revaccination after 5 years for those who received initial dose before age 65

Risk-Based Recommendations

Medical Conditions:

• Pneumococcal vaccines: Recommended for adults <65 years with:

  • Chronic lung, heart, liver disease
  • Diabetes mellitus
  • Alcoholism
  • Immunocompromising conditions
  • Functional or anatomic asplenia
  • Cochlear implants or CSF leaks 1

• Hepatitis A vaccine: Recommended for:

  • Persons with chronic liver disease
  • Recipients of clotting factor concentrates 1

• Hepatitis B vaccine: Recommended for:

  • Persons with end-stage renal disease
  • Persons with HIV infection
  • Persons with chronic liver disease 1

Behavioral Risk Factors:

• Hepatitis A vaccine:

  • Men who have sex with men
  • Injection drug users 1

• Hepatitis B vaccine:

  • Sexually active persons not in long-term monogamous relationships
  • Injection drug users
  • Men who have sex with men 1

Occupational Risk Factors:

• Hepatitis A vaccine:

  • Persons working with HAV in laboratory settings 1

• Hepatitis B vaccine:

  • Healthcare personnel and public safety workers exposed to blood 1

• Influenza vaccine:

  • Healthcare personnel
  • Employees of long-term care facilities 1

Travel-Related Recommendations:

• Hepatitis A vaccine:

  • Travelers to countries with high or intermediate HAV endemicity 1

• Other travel vaccines (based on destination):

  • Yellow fever, typhoid, Japanese encephalitis, etc. 1

Special Populations

Immunocompromised Persons:

• Annual influenza vaccination is strongly recommended 1
• Pneumococcal vaccination is recommended; consider revaccination after 6 years 1
• Live vaccines (MMR, varicella, live attenuated influenza) are generally contraindicated 1
• Asymptomatic HIV-infected persons may receive MMR if not severely immunosuppressed 1

Pregnant Women:

• Influenza vaccine is recommended and considered safe during pregnancy 1
• Tdap is recommended during each pregnancy
• Live vaccines should be avoided during pregnancy 1

Common Pitfalls and Considerations

1. Undervaccination: Adult vaccination rates remain well below Healthy People 2020 targets for most vaccines 3, 4. Healthcare providers should assess vaccination status at every visit.

2. Missed opportunities: Every healthcare encounter is an opportunity to update a patient's vaccination status 1.

3. Misconceptions about vaccine safety: Many adults decline vaccination due to concerns about safety or interactions with underlying conditions 1.

4. Lack of documentation: Maintaining accurate vaccination records is essential for proper vaccination timing and avoiding unnecessary doses.

5. Failure to revaccinate: Some vaccines require boosters or revaccination after certain intervals, particularly for high-risk individuals 1.

The implementation of comprehensive vaccination programs throughout life is essential for disease prevention and maintaining public health 5, 6. Healthcare providers should proactively assess vaccination status, recommend appropriate vaccines, and administer them during routine clinical visits.