- 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
- 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.