Immunization Programs for Infants, Children, Adolescents, and Adults: Clinical Practice Guidelines by the Infectious Diseases Society of America

Abstract

Evidence-based guidelines for immunization of infants, children, adolescents, and adults have been prepared by an Expert Panel of the Infectious Diseases Society of America (IDSA). These updated guidelines replace the previous immunization guidelines published in 2002. These guidelines are prepared for health care professionals who care for either immunocompetent or immunocompromised people of all ages. Since 2002, the capacity to prevent more infectious diseases has increased markedly for several reasons: new vaccines have been licensed (human papillomavirus vaccine; live, attenuated influenza vaccine; meningococcal conjugate vaccine; rotavirus vaccine; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis [Tdap] vaccine; and zoster vaccine), new combination vaccines have become available (measles, mumps, rubella and varicella vaccine; tetanus, diphtheria, and pertussis and inactivated polio vaccine; and tetanus, diphtheria, and pertussis and inactivated polio/Haemophilus influenzae type b vaccine), hepatitis A vaccines are now recommended universally for young children, influenza vaccines are recommended annually for all children aged 6 months through 18 years and for adults aged > or = 50 years, and a second dose of varicella vaccine has been added to the routine childhood and adolescent immunization schedule. Many of these changes have resulted in expansion of the adolescent and adult immunization schedules. In addition, increased emphasis has been placed on removing barriers to immunization, eliminating racial/ethnic disparities, addressing vaccine safety issues, financing recommended vaccines, and immunizing specific groups, including health care providers, immunocompromised people, pregnant women, international travelers, and internationally adopted children. This document includes 46 standards that, if followed, should lead to optimal disease prevention through vaccination in multiple population groups while maintaining high levels of safety.

Adolescent Vaccination-Coverage Levels in the United States: 2006–2009

“…It is possible that, for this population, alternative venues such as schools would be appropriate. [17][18][19] Results from our review of NIS-Teen data provide a glimpse into provider practices and identify several areas for improvement. Vaccination coverage could have been Ͼ80% for Td/ TdaP and MenACWY and as high as 74% for the first dose of HPV had providers taken advantage of existing vaccination visits and administered all indicated vaccines.…”

“…Administering all indicated vaccines during the same visit is a recommended standard of child and adolescent immunization 20 and is endorsed by numerous professional organizations. [17][18][19] Efforts at the practice level should focus on removing the barriers that prevent providers from offering simultaneous vaccinations.…”

Inequalities in vaccination coverage for young females whose parents are informal caregivers

“…We used Poisson regression with robust variance to estimate overall and subgroup-specific (i.e., by age group, racial/ethnic group, and insurance subgroup given evidence of potential differences in vaccine uptake by these factors) 11,12 HPV and influenza vaccination prevalence ratios (PR) and corresponding 95% confidence limits (CL) 13 comparing females whose parents were informal caregivers with females whose parents were not informal caregivers. We identified a minimal sufficient set of covariates for adjustment to reduce confounding bias using the back-door criterion in a directed acyclic graph.…”

Immunizing Parents and Other Close Family Contacts in the Pediatric Office Setting

“…Limited access to immunizations has been identified as one of the primary barriers to adult immunization. 32 One study reported that alternative locations for immunization, such as the workplace, can successfully address the issue of inconvenience in the vaccination decision. 33 Parents visit the pediatric office frequently with their infants and young children, where most vaccines needed for immunization of both children and adults are available.…”