2019 adult vaccine schedule released: ACIP highlights influenza, hepatitis A, hepatitis B

  • Kim DK et al
  • Ann Intern Med
  • 4 Feb 2019

  • curated by Liz Scherer
  • Clinical Essentials
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  • The Advisory Committee on Immunization Practices (ACIP) has released its 2019 immunization schedule for adults >19 years, which highlights key changes for influenza, HBV, and hepatitis A virus (HAV).

Why this matters

  • Determine vaccine recommendations by age, comorbid conditions, special situations.
  • Incorporate vaccination assessments within routine patient flow.
  • See schedule, full recommendations.

Key points

  •  2019 schedule has been revised for clarity/brevity; additionally, when appropriate, recommendations differentiate between routine and special situations.
  • Influenza: any licensed, age-, health-appropriate vaccine can be used.
    • Live attenuated influenza vaccine (LAIV, FluMist Quadrivalent) is an option for adults aged 49 years (except persons with immunocompromising conditions [see list]).
    • Contraindication: patients with history of Guillain-Barré 6 weeks after previous influenza vaccine dose.
  • HBV: Single-antigen recombinant HBV vaccine with a novel cytosine-phosphate-guanine 10-18 oligodeoxynucleotide adjuvant (Heplisav-B) is recommended for HBV prevention in adults aged >18 years.
    • Routine administration is 2 doses, >4 weeks apart; substitution in a 3-dose series with a different vaccine is acceptable, but vaccine from same manufacturer should be used to complete series when feasible.
  • HAV: homelessness is a new indication for routine, 2-dose single-antigen HAV vaccine (Havrix) or 3-dose combined HAV, HBV vaccine (Twinrix).
  • Any not at-risk person may be vaccinated.

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