The 2015 adult immunization schedule is similar to last year’s schedule, with one major change, according to the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.
The 13-valent pneumococcal conjugate vaccine in series with the 23-valent pneumococcal polysaccharide vaccine is now recommended for all adults over 65, rather than being recommended only if another risk was presen
While incidence of invasive pneumococcal diseases caused by PCV13 serotypes has dropped 50% since 2010 because of indirect effects from pediatric vaccination efforts, 20%-25% of invasive pneumococcal diseases in people aged older than 65 years are still caused by PCV13 serotypes, the ACIP noted (Ann. Intern. Med. 2015;162:214-223 [doi:10.7326/M14-2755]).
The committee recommends that adults over 65 who have not already had PCV13 should receive the vaccine, followed by a dose of PPSV23 6-12 months later. Additional doses of PPSV23 are recommended if other risk factors are present. The footnotes for pneumococcal vaccinations also have been revised to provide guidance for physicians seeking appropriate vaccination decisions for individual patients.
In the influenza vaccination footnotes, all adults can now receive recombinant influenza vaccine, previously only recommended for adults aged 18-49. Several contraindications for the live attenuated influenza vaccine have been reclassified as precautions, including influenza antiviral use within the last 48 hours; asthma and chronic lung diseases; diabetes; and cardiovascular, renal, and hepatic diseases.
While the Affordable Care Act requires that all vaccines recommended by ACIP be covered with no copayment for the patient as preventive care services, the same is not true for Medicare. Medicare currently covers only one dose of pneumococcal vaccine. A rule change will be necessary before Medicare can cover the recommended vaccinations; such a change could take more than a year to go into effect, Dr. Sandra Fryhofer, the American College of Physicians’ liaison to the ACIP, said in a related editorial (Ann. Intern. Med. 2015;162:235-6 [doi:10.7326/M14-2547]).
The ACIP schedule can be found on the CDC website.