Immunizations

Emma Francis

Vaccine

Recommendation

COVID-19 Recommended for:
  • Previously vaccinated, age ≥65: 1 dose most updated vaccine
  • Previously vaccinated, age 18-64: 1 dose most updated vaccine for pts at high risk for severe infection; otherwise shared decision making
  • Unvaccinated adults: age ≥65, 2 doses most updated vaccine; age 19-64, 1 dose most updated vaccine
Influenza Recommended annually for all adults.
Respiratory Syncytial Virus (RSV) Recommended 1-time dose for all adults age ≥75.
  • If age 60-74 yrs: 1 time dose for those at high risk for severe RSV (chronic disease, BMI>40, nursing home residents, etc.).
  • Pregnant at 32 to 36 weeks gestation from Sept-Jan: 1 time dose
***NOT covered by Medicare in clinic***
Tetanus, diphtheria, pertussis (Tdap or Td) Recommended for all adults: Td or Tdap booster q10 years.
  • For clean/minor wounds, administer only if >10 years since last tetanus vaccine
  • For all other wounds, administer if >5 years since last tetanus vaccine
***NOT covered by Medicare in clinic***
Measles, mumps, rubella (MMR) Usually given in childhood, recommended for nonpregnant adults without evidence of immunity (1 dose). See CDC website for guidance in specific scenarios including healthcare workers.
Varicella (VAR) Usually given in childhood, recommended for all adults without evidence of immunity (2-dose series 4-8 weeks apart).
Zoster recombinant (RZV) Recommended for adults >50: 2 dose series 2-6 months apart.
***NOT covered by Medicare in clinic***
Human Papillomavirus (HPV) Recommended for all persons through 26 yrs: 3-dose series if vaccination initiated at age 15 or older.
  • Age 27-45: shared decision making
See CDC website for guidance in specific situations.
Pneumococcal (PCV15, PCV20, PPSV23) Recommended for all adults ≥50: 1 dose PCV20 or PCV21 (stocked in clinic) if not previously vaccinated.
Hepatitis A Recommended for all adults who request vaccination or those at risk for infection/severe infection (liver disease, HIV, MSM, IVDU, unhoused, etc): 2-dose series HepA (Havrix 6-12mo apart) or 3-dose series HepA-HepB (Twinrix 0, 1, 6 mo apart)
Hepatitis B Recommended to complete vaccine series for all adults aged 19-59: 2-dose (Heplisav-B 4 wks apart), 3-dose (Engerix-B, PreHevbrio, or Recombivax at 0, 1, 6 m), or 4-dose series (Twinrix accelerated schedule).
  • Age ≥60: may receive without risk factors; should receive with known risk factor (liver disease, HIV, sexual exposure risk, IVDU, incarceration, etc.).
Meningococcal A, C, W, Y (MenACWY) Recommended for:
  • Patients with asplenia, HIV, complement deficiencies, complement inhibitor medication: 2-dose primary series 8 wks apart, booster at 5 yrs, then q5 yrs following if risk remains.
  • Pts regularly traveling to countries with endemic meningococcal disease: 1 dose, booster at 5 years, then q5 yrs if risk remains.
  • First-year college students who live in residential housing or military: 1 dose.
Haemophilus influenzae type b (Hib) Recommended for adults with anatomic or functional asplenia (1 dose if not received previously) and stem cell transplant recipients (3-dose series starting 6-12 mo after transplant).
For travel-specific immunization guidance, reference: https://wwwnc.cdc.gov/travel
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