Table 1.
Adult Immunization Schedule for Patients With Gastrointestinal Conditions
| Vaccine | Dosing schedule | |
|---|---|---|
| Standard dose quadrivalent influenza vaccine, inactivated | 1 dose seasonally for all patients aged 18–64 years | |
| High dose influenza vaccine, inactivated or adjuvanted influenza vaccine, inactivated | 1 dose seasonally all of those ≥65 years | |
| Influenza live attenuated | Not indicated for those on immunosuppressive therapy | |
| Tetanus, diphtheria, pertussis | If previously immunized, single dose of Tdap, then Td or Tdap every 10 years, as well as Tdap during third trimester of each pregnancy | |
| Zoster recombinant (preferred) | 2 dose series for all ≥50 years administered 2–6 months apart | |
| Zoster live | Use only if immediate immunization is necessary, RZV is unavailable, and patient is immunocompetent. Not available in US after July 1, 2020. | |
| Human papillomavirus | Age 18–26 years, 3 doses 0, 1–2, and 6 months | Age 27–45 years, 3 doses if likely to have new sexual partners |
| Pneumococcal conjugate 13 valent & polysaccharide 23 valent | For all patients initiating or on immunosuppression: a single dose of PCV13 followed by PPSV23 in 8 weeks; may repeat PPSV23 after 5 years plus For patients with chronic liver disease age 18–64 years: a single dose of PPSV23 A single dose of PPSV23 for all ages 65 and older. |
|
| Hepatitis A | 2 dose series Hep A (Havrix or Vaqta 6–12 months apart) or 3 doses series Hep A-Hep B (Twinrix at 0, 1, 6 months) | |
| Hepatitis B | Engerix or Recombivax: 3 dose series on 0-, 1-, 6-month schedulea 3 dose series Hep A-Hep B (Twinrix at 0, 1, 6 months) |
Heplisav: 2 dose series (HepB-CpG) at 0 and 1 montha |
| Meningococcal A, C, W, Y (Men ACWY); MenB | Adults with risk factorsb should receive immunization. If risk factors continue to be present, MenACWY every 5 years; MenB 1 year after completing series and then every 2–3 years. | |
| Measles, mumps, rubella live attenuated | 2 doses at least 4 weeks apart if previously did not receive any MMR or 1 dose if previously received 1 dose MMR. Contraindicated in those receiving systemic immunosupppresion. | |
| Varicella live attenuated | No history of disease or vaccine or no laboratory evidence of immunity, 2 doses 4–8 weeks apart. Contraindicated in those receiving systemic immunosupppresion. | |
Hep A, hepatitis A vaccine; Hep B, hepatitis B vaccine, LAIV, influenza live attenuated; MMR, measles, mumps, and rubella; PCV13, 13 valent pneumococcal conjugate vaccine; PPSV23, 23 valent pneumococcal polysaccharide vaccine; RZV, recombinant zoster vaccine; Td; tetanus diphtheria; Tdap, tetanus diphtheria acellular pertussis; VAR, varicella; ZVL, zoster live; 9vHPV, human papillomavirus 9 valent.
Check antibody to the surface antigen (anti-HBs) 4–8 weeks after completing series.
Those in college residence halls if routine adolescent immunization missed, military recruits, outbreaks, and specific immunocompromising conditions, including asplenia, complement deficiency, and human immunodeficiency virus.