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INTRODUCTION

  • Vaccines are unrivaled in the twenty-first century for their effects on longevity, economic savings, and quality of life.

    • – Although most vaccines developed in the twentieth century targeted common acute infectious diseases of childhood, more recently developed vaccines prevent chronic conditions prevalent among adults (e.g., human papillomavirus vaccines for cervical and anogenital cancers, herpes zoster vaccine).

  • Seventeen diseases are now preventable through vaccines routinely administered in the United States, and rates of vaccine-preventable diseases of childhood are at historic lows.

  • Vaccines protect the immunized individual (a direct effect). Many also confer herd immunity (an indirect effect), in which transmission of infections to unimmunized populations is reduced.

  • Immunization programs are associated with controlling, eliminating, or eradicating a disease.

    • – Smallpox is the only human infection to be eradicated, although ongoing efforts are targeting the global eradication of polio.

  • The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) makes recommendations for the administration of vaccines approved by the FDA for use in children and adults (Fig. 206-1).

    • – Pregnant women and immunocompromised pts should not receive live-virus vaccines.

  • Administering immunizations to adults involves a number of processes, such as deciding whom to vaccinate, assessing vaccine contraindications and precautions, providing vaccine information statements (VISs), ensuring appropriate storage and handling of vaccines, administering vaccines, and maintaining vaccine records.

FIGURE 206-1

Recommended adult immunization schedules, United States, 2018. Additional information, including footnotes for each vaccine, contraindications, and precautions, can be found at https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html. The recommendations in this schedule were approved by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP), the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), the American College of Obstetricians and Gynecologists (ACOG), and the American College of Nurse-Midwives (ACNM). For complete statements by the ACIP, visit www.cdc.gov/vaccines/hcp/acip-recs/.

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