The updated guidelines also provide specific recommendations for vaccination of special groups, including healthcare providers, immunocompromised patients, pregnant women, international travelers, and internationally adopted children.

Study Highlights

• All age-appropriate vaccines should be received per the American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, Advisory Committee on Immunization Practices, and American College of Physicians guidelines, which are issued annually and updated in the Morbidity and Mortality Weekly Report.
• Vaccines not given at recommended age should be given at a subsequent visit without restarting the vaccine series.
• The minimum interval between doses should be used for persons with delayed immunizations or who want an accelerated schedule.
• All indicated appropriate vaccines should be given simultaneously.
• Licensed combination vaccines can be given if indicated, if licensed by the FDA, and if no components are contraindicated.
• Immunization requirements for childcare, school, and nursing homes should be followed.
• Vaccines should be given with other preventive healthcare services.
• Vaccines should be stored and administered per manufacturer and FDA protocols.
• Healthcare providers need to adhere to vaccine contraindications and precautions.
• Vaccine Information Statements for patients and parents are required for each vaccine covered by the National Childhood Vaccine Injury Act.
• Vaccine benefits, safety, and risk information should be provided in a culturally appropriate and easily understandable manner.
• Significant adverse events should be reported to the Vaccine Adverse Event Reporting System.
• Financial recommendations include minimizing patient out-of-pocket expenses and using vaccine-financing programs.
• Barriers to immunizations should be minimized.
• Immunizations should be easily accessible via express services and expanded hours.
• Strategies to improve vaccine coverage are reminder systems; registries; standing orders in clinics, hospitals, and nursing homes; vaccine review at each visit; provision of vaccine records to patients; provider education; assessment of vaccine rates in practices; and awareness of adolescent and adult vaccines.
• Complementary immunization settings, including schools, shopping malls, and pharmacies, are recommended.
• Complementary immunization providers should follow quality standards, provide records to primary care providers and registries, and encourage visits to primary care providers for preventive and therapeutic services.
• All healthcare professionals should receive appropriate immunizations, including tetanus, diphtheria, and pertussis booster dose; measles; mumps; rubella; varicella; hepatitis B; and annual influenza vaccine.
• Hospitals, clinics, and offices should ensure that healthcare professionals receive appropriate immunizations and perform annual assessment.
• Immunocompromised patients might have increased risk for morbidity and mortality from infections, consequences from immunizations, or inadequate response to immunizations.
• Household contacts of immunocompromised persons should receive appropriate immunizations.
• For pregnant women, providers should be aware of routinely recommended vaccines, contraindications, and precautions.
• After delivery, women should receive any recommended vaccine that could not be given during pregnancy.
• For persons who travel, vaccine considerations include immunization and medical history, itinerary, season, travel living conditions, travel mode and purpose, amount of time before departure, and whether vaccines are required or recommended.
• For internationally adopted children without written documentation of vaccines, the alternatives are antibody titers or reimmunization.