Updated adult immunization recommendations for the October 2007 through September 2008 season include the addition of zoster vaccine and the differentiation of HIV patients based on their CD4+ T-lymphocyte counts.
Developed by the Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention, the schedule can be found at www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm
Zoster vaccine is newly recommneded for persons aged 60 years or more, regardless of whether they report a prior episode of herpes zoster. However, the vaccine is contraindicated in pregnancy, immunocompromising conditions, and HIV patients with CD4+ T-lymphocyte counts of fewer than 200 cells/mcL. The vaccine is neither recommended nor contraindicated for HIV patients with higher CD4+ T-lymphocyte counts, according to the document.
Varicella vaccine is now recommended for persons of any age in whom there is no evidence of immunity. This recommendation includes persons infected with HIV if their CD4+ T-lymphocyte counts are at least 200 cells/mcL; the vaccine is contraindicated in HIV-infected patients with lower counts, as well as in pregnant women and in patients with other immunocompromising conditions.
Influenza vaccine recommendations now include people with asplenia.