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Recommended Adult Immunization Schedule: United States, 2011(1) FREE

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

The 2011 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, 2011. Ann Intern Med. 2011:154:168-73.

For a list of members 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: Dr. Chilton: Support to travel to meetings for the study or other purposes: Centers for Disease Control and Prevention. Dr. Coyne-Beasley: Consultancy: sanofi-pasteur; Payment for lectures including service on speakers bureaus: sanofi-pasteur. Dr. Ehresmann: Consulting fee or honorarium (money to institution): Centers for Disease Control and Prevention; Support to travel to meetings for the study or other purposes (money to institution): Centers for Disease Control and Prevention. Dr. Englund: Support to travel to meetings for the study or other purposes: Centers for Disease Control and Prevention; Grants/grants pending (money to institution): Novartis, Medimmune, ADMA; Other (money to institution): National Institutes of Health, Bill & Melinda Gates Foundation. Dr. Keitel: Consulting fee or honorarium: Centers for Disease Control and Prevention; Support to travel to meetings for the study or other purposes: Centers for Disease Control and Prevention; Grants/grants pending: Exxon Mobil Research Club; Grants/grants pending (money to institution): Novartis, Protein Sciences; Stock/stock options: Pfizer (since divested), Schering-Plough (since divested). Dr. Marcy: Consultancy: ACIP; Consultancy (money to institution): ACIP; Payment for development of educational presentations: Medical Education Speakers' Network, National Foundation for Infectious Diseases, Rady Children's Hospital San Diego, Phoenix Children's Hospital, Symposia Medicus. Dr. Rosenbaum: Consulting fee or honorarium: Centers for Disease Control and Prevention; Support to travel to meetings for the study or other purposes: Centers for Disease Control and Prevention. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-2789.

Corresponding Author: Abigail Shefer, MD, 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, ams7@cdc.gov.


Ann Intern Med. 2011;154(3):168-173. doi:10.7326/0003-4819-154-3-201102010-00006
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This article has been corrected. For original version, click "Original Version (PDF)" in column 2.

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 2010, ACIP approved the Adult Immunization Schedule for 2011, which includes several changes. The notation for seasonal influenza vaccine in the figure and footnotes was changed to reflect the expanded recommendation for annual influenza vaccination for everyone 6 months of age or older, which was approved by ACIP in February 2010. In October 2010, ACIP issued a permissive recommendation for use of the tetanus, diphtheria, pertussis (Tdap) vaccine in adults aged 65 years or older; approved the recommendation that Tdap can be administered regardless of how much time has elapsed since the last tetanus and diphtheria (Td)–containing vaccine; and approved a recommendation for a 2-dose series of meningococcal vaccine in adults with certain high-risk medical conditions. The vaccines listed in the Figure have been reordered to keep all universally recommended vaccines together (for example, influenza, Td/Tdap, varicella, human papillomavirus [HPV], and zoster).

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Figure.
Recommended Adult Immunization Schedule: United States, 2011.
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Clarifications were made to the footnotes for the measles, mumps, rubella (MMR); HPV; and Haemophilus influenzae type B (Hib) vaccines and for revaccination with pneumococcal polysaccharide (PPSV). A statement has been added to the box at the bottom of the footnotes to clarify that a vaccine series does not need to be restarted, regardless of the time that has elapsed between doses.

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 2011

The seasonal influenza footnote (footnote 1) is revised and shortened to reflect a recommendation for vaccination of all person 6 months of age or older, including all adults. The high-dose influenza vaccine (Fluzone, sanofi-pasteur, Swiftwater, Pennsylvania), licensed in 2010 for adults aged 65 years or older, is mentioned as an option in this age group.

The Td/Tdap vaccine footnote (footnote 2) has language added to indicate that persons aged 65 years or older who have close contact with an infant younger than 12 months should get vaccinated with the Tdap vaccine and notes that all persons aged 65 years or older may get vaccinated with the Tdap vaccine. Also added is the recommendation to administer Tdap regardless of interval since the last Td-containing vaccine.

The HPV vaccine footnote (footnote 4) has language added to the introductory sentences to indicate that either quadrivalent (HPV4) vaccine or bivalent (HPV2) vaccine is recommended for females.

The MMR vaccine footnote (footnote 6) has been revised mainly by consolidating common language that had previously been part of each of the 3 vaccine-component sections into 1 introductory statement.

The revaccination with PPSV footnote (footnote 8) clarifies that 1-time revaccination after 5 years applies only to persons with indicated chronic conditions who are aged 19 through 64 years.

The meningococcal conjugate vaccine (MCV4) footnote (footnote 9) has language added to indicate that a 2-dose series of meningococcal conjugate vaccine is recommended for adults with anatomical or functional asplenia or persistent complement component deficiencies and adults with HIV infection who are vaccinated. In addition, language has been added that a single dose of meningococcal vaccine is still recommended for those with other indications. Finally, language has been added to clarify that MCV4 is a quadrivalent vaccine.

The language for the selected conditions for the Hib vaccine footnote (footnote 12) has been shortened to clarify which high-risk persons may 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.

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), National Center for Immunization and Respiratory Diseases, 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; Tamera Coyne-Beasley, MD, MPH, University of North Carolina, Chapel Hill, North Carolina; Jeffrey Duchin, MD, University of Washington, Seattle, Washington; 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; Renée Jenkins, MD, Howard University College of Medicine, Washington, DC; Franklyn N. Judson, MD, University of Colorado, Denver, Colorado; Wendy A. Keitel, MD, Baylor College of Medicine, Houston, Texas; Michael S. Marcy, MD, Southern California Permanente Medical Group, Los Angeles, California; Cody H. Meissner, MD, Tufts Medical Center, Boston, Massachusetts; Sarah Rosenbaum, JD, The George Washington University, Washington, DC; Mark H. Sawyer, MD, University of California, San Diego, School of Medicine, San Diego, California; and Jonathan Temte, MD, PhD, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

‡ Deceased.

Figures

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Figure.
Recommended Adult Immunization Schedule: United States, 2011.
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