Immunization Update 2014: A Focus on Medical
Indications for Vaccines in Adults
Clicking the "View this Article" button will open the issue as a resizable PDF. To take the test for
the issue, return to this Introduction page and click the "Take the Test" button. The Introduction
page will remain open after you open this issue.
You may need to re-size or close the issue in order
to see the Introduction page.
The Healthy People 2020 report, published by the U.S. Department and Health and Human Services, includes targets for reducing vaccine-preventable disease rates and increasing vaccination rates in all age groups. According to the report, the routine childhood vaccination schedule prevents 14 million cases of disease, and reduces direct healthcare costs by $9.9 billion for each group of individuals vaccinated during the year they were born. Despite vaccines being one of the most cost-effective clinical preventive services, approximately 42,000 adults and 300 children in the U.S. die each year from vaccine-preventable diseases. There have been a number of recent measles and pertussis outbreaks in communities with pockets of unvaccinated and under-vaccinated children.
In order to meet the Healthy People 2020 targets, all healthcare providers should remain up-to-date on vaccine recommendations and play an active role in immunizations. The Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) update their recommendations for routine immunizations annually, while vaccine-specific recommendations are typically updated every 3-5 years (except influenza, which is updated yearly). Additionally, the CDC publishes the General Recommendations on Immunization and the Epidemiology and Prevention of Vaccine-Preventable Diseases (otherwise known as “The Pink Book”), which are considered core references for vaccine providers. The updated ACIP-recommended immunization schedule for adults was published in the Annals of Internal Medicine in February 2014; the schedules for children, adolescents, and adults are available online.
Vaccines for adults are recommended on the basis of age, medical conditions, lifestyle, occupation, and travel. This review will focus on specific recommendations and considerations for adults 19 years of age and older who have altered immunocompetence, common chronic medical conditions, and selected health characteristics or concerns. Further information for these and other special groups can be found in the ACIP recommendations. (See Tables 1-3.)
Publication Date: 04/18/2014
Expiration Date: 04/18/2017
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based
This program was developed by The Rx Consultant and published by Continuing Education Network, Inc.
The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and
is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased,
balanced information to health care practitioners.
Programs developed by The Rx Consultant are written by health care providers with expertise in the topic
area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure
that every program presents information that is current, accurate, relevant to "real world" health care
providers, and written in an easy reading, "plain English" style.
Jeff Goad PharmD, MPH, Richard Dang, PharmD, and Hovik Mekhjian, PharmD
Dr. Dang and Dr. Mekhjian report no financial or personal relationship with any commercial interest
producing, marketing, reselling, or distributing a product or service that appears in this issue. Dr. Goad reports being on
the speakers bureau for Merck & Co., Inc
This accredited program is targeted to
Goals & Objectives
At the conclusion of this program, participants will be able to:
- State the age, indications and usual dosing regimens for routine adult vaccinations, including influenza vaccine, pneumococcal vaccines, Tdap/Td, and at least 2 others.
- Discuss specific vaccine indications and contraindications for: patients with immune competence-altering conditions including HIV infection and asplenia;
patients with diabetes, cardiovascular disease, or chronic lung, liver, or kidney disease;
pregnant women; and men who have sex with men.
- Outline the recommendations for influenza vaccination in patients with egg allergy. Name 3 other vaccine components that can cause allergic reactions, and at least 1 vaccine that contains each respective component.
The Rx Consultant is a publication of Continuing Education Network, Inc.
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a
provider of continuing pharmacy education.
Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.
ACPE Universal Activity Number: 0428-0000-14-006-H01-P
Exam & Credit Statement Procedures
Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and
Editorial and Review Board
Chief Editor and CE Administrator
Terry M. Baker, PharmD
Tracy Farnen, PharmD
James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA
Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA
Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA
Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System
Adjunct Clinical Professor
College of Pharmacy
Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Visiting Associate Professor and Lecturer
Samuel Merritt University
Pamela Mausner, MD
Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Senior Editorial Advisor
Gerard Hatheway, PharmD, PhD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD
Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners
Meuleman, RN, C, MS
About the Rx Consultant
The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to
educate patients about drugs and manage drug therapy. The reader is responsible for confirming
the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.
Any hardware that supports Microsoft Windows, Apple Mac OS, iOS, or Android, and meets the software requirements.
Browser that supports TLS 1.1 + and PDF files.
This includes Microsoft Internet Explorer 11, Google Chrome 38, Google Android OS 5.0 Browser, Apple Safari (version 7 for desktop, 5 for mobile), Mozilla Firefox 27, newer versions of these browsers, as well as some earlier versions that may require additional configuration.
Adobe Acrobat Reader is recommended, and is required for some browsers.
Note: TLS 1.1 and 1.2 support is required for browser security. Click here for TLS browser support details.
Required. Broadband recommended. (T1, DSL, Cable, G4 or higher.)