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PPRNet - Primary (Care) Practices Research Network

Tetanus Vaccine
Vaccinate patients 12 years of age and older every 10 years.
The Center for Disease Control and Prevention (CDC) recommendations for tetanus immunization in adults were revised to include a single dose of Tdap to replace tetanus and diphtheria toxoids vaccine (Td) for booster immunization against tetanus, diphtheria, and pertussis in December 2006. Recommendations suggest that Tdap may be administered within two years of Td.    

Reference: CDC: Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine from the Advisory Committee on Immunization Practices, 2010

Influenza Vaccine
Vaccinate patients 6 months and older annually
As of the 2010-2011 flu season, the CDC now reccomends that everyone 6 months of age or older receive a flu shot annually. Vaccination is especially important for people who are at high risk for serious influenza complications, or those who live with or care for individuals at high risk for such complications.

Reference: CDC: Influenza Vaccination Resources for Health Care Professionals 

Pneumococcal Vaccine

  • Vaccinate all patients 65 years of age or older (including previously unvaccinated patients and patients who have not received the vaccine within 5 years (and were less than 65 years of age at the time of vaccination)
  • Vaccinate High Risk patients who are 18-64 years of age

Persons aged 2-64 years who are at increased risk for pneumococcal disease or its complications if they become infected, should be vaccinated. Persons at increased risk for severe disease include patients with chronic illness such as chronic cardiovascualr disease (e.g. HF or cardiomyopathy), chronic pulmonary disease (e.g. COPD or emphysema) diabetes mellitus, alcoholism, or chronic renal disease. Routine revaccination is not recommended at this time, although a one-time revaccination should be considered in high-risk patients age 2-64 years if at least 5 years have passed since their initial immunization.

Reference: CDC: Pneumococcal Vaccination

Hepatitis A Vaccine
Two vaccinations in patients with liver disease
Although not at increased risk for HAV infection, persons who have chronic liver disease are at increased risk for fulminant hepatitis A. Death certificate data indicate a higher prevalence of chronic liver disease among persons who died of fulminant hepatitis A compared with persons who died of other causes.

Revised ACIP Recommendations on the Prevention of Hepatitis A through Active or Passive Immunization. Recommendations of the Advisory Committee on Immunization Practices

Meningococcal Vaccine
Vaccinate all patients 11-19 years of age
The CDC recommends routine vaccination with meningococcal conjugate vaccine (MCV4) for all personals aged 11-18 years at the earliest opportunity.  Persons aged 11-12 should receive routine vaccination at the 11-12 years health care visit.  For those persons who have not previously received MCV4, vaccination should be administered before high-school entry (at approximately age 15 years).  Routine vaccination with meningococcal vaccine also is recommended for college freshmen living in dormitories and for other populations at increased risk

Reference: CDC: Updated Recommendations for Use of Meningococcal Conjugate Vaccines

Human Papillomavirus (HPV) Vaccine
Vaccinate female patients 9-26 years of age with 3 HPV vaccines
The CDC states that the HPV vaccine is safe and effective for girls and young women ages 9-26 years old, and recommends that all girls ages 11-12 get all three doses to protect against cervical cancer and  precancer. Girls and young women aged 13-26 who have not previously received all three doses, should receive all doses of an HPV vaccine. The best way to ensure the most benefit from an HPV vaccine is to administer all doses before the patient becomes sexually active, but people who have had sexual contact before receiving all three doses of the vaccine if they were not infected before vaccination.

Reference: CDC: HPV Vaccination

Herpes Zoster (Shingles) Vaccine
Vaccinate all patients 60 years of age or older
The CDC recommends that anyone 60 years of age or older receive a shingles vaccine, regardless of whether they recall having had chicken pox or not. Even patients who have had shingles can receive the shingles vaccine, to help prevent further occurences. 

Reference: CDC: Shingles Vaccination



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