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Recommended Adult Immunization Schedule: United States, 2010* FREE

Advisory Committee on Immunization Practices
[+] Article and Author Information

* The 2010 ACIP Adult Immunization Schedule appeared simultaneously in Annals of Internal Medicine and MMWR Recommendations and Reports. Readers who wish to cite the schedule should use the following citation: Advisory Committee on Immunization Practices. Recommended Adult Immunization Schedule: United States, 2010. Ann Intern Med. 2010:152:36-9.

For a list of the Advisory Committee on Immunization Practices, see the Appendix.


From the Centers for Disease Control and Prevention, Atlanta, Georgia.


Potential Conflicts of Interest: To assure the integrity of the ACIP, the U.S. Department of Health and Human Services has taken steps to assure that there is technical compliance with ethics statutes and regulations regarding financial conflicts of interest. Concerns regarding the potential for the appearance of a conflict are addressed, or avoided altogether, through both pre-and postappointment considerations. Individuals with particular vaccine-related interests will not be considered for appointment to the committee. Potential nominees are screened for conflicts of interest, and if any are found, they are asked to divest or forgo certain vaccine-related activities. In addition, at the beginning of each ACIP meeting, each member is asked to declare his or her conflicts. Members with conflicts are not permitted to vote if the conflict involves the vaccine or biologic being voted upon. Members of the ACIP have disclosed the following: Grants received: J. Englund (MedImmune, Sanofi Pasteur, Novartis); W.A. Keitel (Novartis). Payments made to Tufts Medical Center for participation in clinical trials: C.H. Meissner (MedImmune, Wyeth).

Corresponding Author: Carol Friedman, DO, Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Mailstop E52, Atlanta, GA 30333; e-mail, cxf7@cdc.gov.


Ann Intern Med. 2010;152(1):36-39. doi:10.7326/0003-4819-152-1-201001050-00008
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The Advisory Committee on Immunization Practices (ACIP) annually reviews the Recommended Adult Immunization Schedule (Figure) to ensure that the schedule reflects current recommendations for the licensed vaccines. In October 2009, ACIP approved the Adult Immunization Schedule for 2010, which includes several changes. A bivalent human papillomavirus vaccine (HPV2) was licensed for use in females in October 2009. The ACIP recommends vaccination of females with either HPV2 or the quadrivalent human papillomavirus vaccine (HPV4). HPV4 was licensed for use in males, and the ACIP used a permissive recommendation for use of this vaccine in males. Introductory sentences were added to the footnotes for measles, mumps, rubella, influenza, pneumococcal, hepatitis A, hepatitis B, and meningococcal vaccines. Clarifications were made to the footnotes for measles, mumps, rubella, influenza, hepatitis A, meningococcal, and Haemophilus influenzae type B (Hib) vaccines, and schedule information was added to the hepatitis B vaccine footnote.

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Figure.
Recommended Adult Immunization Schedule: United States, 2010.
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This schedule has also been approved by the American Academy of Family Physicians, American College of Obstetricians and Gynecologists, and American College of Physicians.

Changes in the Schedule for 2010

The 2010 schedule differs from the previous schedule as follows:

The HPV footnote (footnote 2) has been revised to include language that a bivalent HPV vaccine (HPV2) has been licensed for use in females. Either HPV2 or HPV4 can be used for vaccination of females aged 19 through 26 years. In addition, language has been added to indicate that ACIP used a permissive recommendation for use of HPV4 in males.

To reduce redundancy, the measles, mumps, rubella (MMR) footnote (footnote 5) has been revised by moving sentences from the measles and mumps components-specific sections, indicating that adults born before 1957 generally are immune, to the beginning of the MMR footnote. The MMR footnote has been revised to clarify which adults born during or after 1957 do not need 1 or more doses of MMR for the measles and mumps components. Interval dosing information has been added to indicate that a second dose of MMR should be administered 4 weeks after the first dose. The MMR footnote has been revised to clarify that women who do not have documentation of rubella vaccination should receive a dose of MMR. A section has been added to highlight recommendations for vaccinating health care personnel born before 1957 routinely and during outbreaks.

The influenza footnote (footnote 6) has been revised to distinguish between seasonal and pandemic influenza by adding the term seasonal.

The hepatitis A footnote (footnote 9) has been revised to include an indication for the hepatitis A vaccine for unvaccinated persons who anticipate close contact with an international adoptee.

The hepatitis B footnote (footnote 10) has been revised to include schedule information for the 3-dose hepatitis B vaccine.

The meningococcal vaccine footnote (footnote 11) has been revised to clarify that the meningococcal conjugate vaccine (MCV4) is preferred for adults aged 55 years or younger and that the meningococcal polysaccharide vaccine (MPSV4) is preferred for adults aged 56 years or older. The footnote has been revised to clarify that revaccination with MCV4 is recommended for adults previously vaccinated with MCV4 or MPSV4 and a new example of who is at increased risk is provided. Information has been added on who does not need to be revaccinated.

The selected conditions for Hib footnote (footnote 12) has been revised to clarify which high-risk persons can receive 1 dose of Hib vaccine.

The Adult Immunization Schedule is available in English and Spanish at www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm. General information about adult vaccination is available at www.cdc.gov/vaccines/default.htm. The ACIP statements for specific vaccines are available at www.cdc.gov/vaccine/pubs/acip-list.htm. Instructions for reporting adverse events to the Vaccine Adverse Event Reporting System are available at www.vaers.hhs.gov or by telephone (800-822-7967).

Appendix: Members of the Advisory Committee on Immunization Practices

Carol J. Baker, MD (Chairman), Baylor College of Medicine, Houston, Texas; Larry K. Pickering, MD (Executive Secretary), Centers for Disease Control and Prevention, Atlanta, Georgia; Lance Chilton, MD, University of New Mexico School of Medicine, Albuquerque, New Mexico; Paul Cieslak, MD, Oregon Public Health Division, Portland, Oregon; Kristen R. Ehresmann, RN, MPH, Minnesota Department of Health, St. Paul, Minnesota; Janet Englund, MD, Children's Hospital and Regional Medical Center, Seattle, Washington; Carol Friedman, DO (Lead Staff, ACIP Adult Immunization Working Group), Centers for Disease Control and Prevention, Atlanta, Georgia; Franklyn N. Judson, MD, University of Colorado Health Science Center, Denver, Colorado; Wendy A. Keitel, MD, Baylor College of Medicine, Houston, Texas; Susan M. Lett, MD, MPH, Massachusetts Department of Public Health, Jamaica Plain, Massachusetts; Michael S. Marcy, MD, Harbor-UCLA Medical Center, Torrance, California; Cody H. Meissner, MD, Tufts Medical Center, Boston, Massachusetts; Georgia; Kathleen Neuzil, MD, MPH, University of Washington, Seattle, Washington; Mark H. Sawyer, MD, UCSD School of Medicine and Rady Children's Hospital San Diego, San Diego, California; Ciro Valent Sumaya, MD, MPHTM, Texas A&M Health Science Center, College Station, Texas; and Jonathan Temte, MD, PhD, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

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Figure.
Recommended Adult Immunization Schedule: United States, 2010.
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