ACIP expands indications for Tdap, HPV, hepatitis B vaccinations

The Advisory Committee on Immunization Practices (ACIP) released its sixth annual review of the recommended Adult Immunization Schedule last week.

The recommendations appeared online at Annals of Internal Medicine on Jan. 31.

Important changes include that pregnant women should preferentially receive tetanus, diphtheria and pertussis (Tdap) vaccination after 20 weeks' gestation, instead of the previous recommendation that the vaccine be given postpartum. Other adults who are in close contact with children less than one year old should still get a one-time dose of Tdap vaccine.

The human papillomavirus (HPV) vaccine recommendation now includes routine vaccination of males ages 11 to 12 years, with catch-up vaccination recommended for males ages 13 to 21. HPV vaccine also is recommended for previously unvaccinated males aged 22 to 26 years who are immunocompromised, who test positive for HIV infection or who have sex with men.

ACIP also voted in October 2011 to recommend hepatitis B vaccine for diabetic adults younger than age 60, as soon as possible after diabetes is diagnosed. It can also be considered for diabetics 60 years or older based on a patient's likely need for assisted blood glucose monitoring, likelihood of acquiring hepatitis B and likelihood of immune response to vaccination.

Influenza vaccination was revised to clarify that all persons aged 6 months or older can receive trivalent injectable vaccine and that health care workers who care for persons requiring a protected environment should receive it. Health care workers younger than 50 who have no contraindications may receive either the live attenuated or trivalent forms of the vaccine.

The recommended Adult Immunization Schedule has been approved by ACIP, ACP, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives.