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Figura 1. Recommended Immunizations for Adults with Medical Conditions, United States, 2002-2003
*Covered by the Vaccine Injury Compensation Program.
- If pregnancy is at 2nd or 3rd trimester during influenza season.
- Although chronic liver disease and alcoholism are not indicator conditions for influenza vaccination, give 1 dose annually if the patient is > 50 years, has other indications for influenza vaccine, or if the patient requests vaccination.
- Asthma is an indicator condition for influenza but not for pneumococcal vaccination.
- For all persons with chronic liver disease.
- Revaccinate once after 5 years or more have elapsed since initial vaccination.
- Persons with impaired humoral but not cellular immunity may be vaccinated. MMWR 1999; 48 (RR-06): 1-5.
- Hemodialysis patients: Use special formulation of vaccine (40 ug/mL) or two 1.0 mL 20 ug doses given at one site. Vaccinate early in the course of renal disease. Assess antibody titers to hep B surface antigen (anti-HBs) levels annually. Administer additional doses if anti-HBs levels decline to <10 milliinternational units (mlU)/ mL.
- Also administer meningococcal vaccine.
- Elective splenectomy: vaccinate at least 2 weeks before surgery.
- Vaccinate as close to diagnosis as possible when CD4 cell counts are highest.
- Withhold MMR or other measles containing vaccines from HIV-infected persons with evidence of severe immunosuppression. MMWR 1996; 45: 603-606, MMWR 1992; 41 (RR-17): 1-19.
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