Clinical Question:
What changes have been made to the recommendations for immunization of adults by the United States Advisory Committee on Immunization Practices?

Bottom Line:
There are 2 minor changes to the recommendations for adult immunizations: (1) The new guidelines recommend 2 doses of varicella vaccine for adults born after 1980 who have not had documented varicella infection or herpes zoster; and (2) smokers and adults with asthma have been added to the list of people younger than 65 years who should receive the pneumococcal vaccine. (LOE = 5)

Reference:
Advisory Committee on Immunization Practices. Recommended adult immunization schedule; United States, 2009. Ann Intern Med 2009;150(1):40-44.  [PMID:19124819]

Study Design:
Practice guideline

Setting:
Various (guideline)

Synopsis:
The United States Advisory Committee on Immunization Practices (ACIP) meets yearly to review recommendations for vaccinations; these guidelines, subsequently published by the Centers for Disease Control, are usually endorsed without comment by professional societies; in this case, these adult immunization guidelines were approved by the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Physicians. The committee has not changed the recommendation regarding every-10-year revaccination of adults with tetanus/diptheria, emphasizing that 1 of these boosters should include pertussis vaccination (Tdap), despite the United Kingdom guidelines recommendations specify only 3 boosters after the initial childhood series. The 2 changes are minor and are buried in the footnotes to the figure, which can be downloaded at: http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm. The new guidelines recommend 2 doses of varicella vaccine (instead of 1) for adults born after 1980 who have not had documented varicella infection or herpes zoster. Also, the group has added additional indications for pneumococcal vaccine in people younger than 65 years who are smokers or who have asthma, continuing to recommend 1 or 2 doses for patients with a wide range of chronic diseases.

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