Vaccination of Adults in General Medical Practice

Brian Desmarais — Fri, 03 Jan 2020 19:37:26 +0000

Date Added:

January 3, 2020

Journal/Publication:

Mayo Clinic Proceedings

Publication Date:

January 1, 2020

Issue:

Volume:

Pages:

169–183

URL:

Vaccination of Adults in General Medical Practice

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1016/j.mayocp.2019.02.024

Keywords

adult immunization

A review of adult immunization recommendations from Mayo. James W. Mold, MD, MPH

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In vaccinating adults, clinicians face 2 types of challenges: (1) staying current on recommendations for influenza, pneumococcal, hepatitis A and B, zoster, and other vaccines and (2) addressing systemic barriers to implementing practices that increase vaccination rates. Although adult immunization rates remain suboptimal, there has been much good news in adult vaccination recently. New high-dose and adjuvanted influenza vaccines help improve immune response and may reduce influenza complications in older adults. The new recombinant zoster vaccine offers significantly more efficacy against zoster outbreaks and postherpetic neuralgia than zoster vaccine live. Pertussis vaccine given during the third trimester of pregnancy may prevent between 50% and 90% of pertussis infections in infants. Shorter time for completion (1 vs 6 months) of new, adjuvanted hepatitis B vaccine may increase adherence. Clinicians can address systemic barriers to increasing vaccination rates in their clinics and health care systems by following the Centers for Disease Control and Prevention's Standards for Adult Immunization Practice. Clinicians can help increase vaccination rates by writing standing orders and by advocating for nurses or medical assistants to receive training and protected time for assessing and documenting vaccination histories and administration. Strong recommendations that presume acceptance of vaccination are effective with most patients. Communication techniques similar to motivational interviewing can help with vaccine-hesitant patients. Clinicians, as experts on providing preventive services, can educate community leaders about the benefits of immunization and can inform vaccine experts about challenges of implementing vaccination recommendations in clinical practice and strategies that can work to raise vaccination rates.

Author/s:

Hunter, P., Fryhofer, S.A., Szilagyi, P.

Chapter 16: Pertussis

Tracy Ashby — Fri, 07 Dec 2018 06:00:00 +0000

Date Added:

December 7, 2018

Journal/Publication:

Epidemiology and Prevention of Vaccine-Preventable Diseases, aka "Pink Book"

Publisher:

Centers for Disease Control and Prevention

Publication Date:

January 1, 2015

Pages:

261-278

URL:

Epidemiology and Prevention of Vaccine-Preventable Diseases

Type:

Meta-analyses, Reviews, and Guidelines, Meta-analyses, Reviews, and Guidelines

Keywords

MeSH

trimethoprim, sulfamethoxazole drug combination

This is a chapter on Bordetella pertussis from the Pink Book on infectious diseases. Several key points regarding pertussis in adults:

Immunization is not 100% effective but usually diminishes disease severity
In immunized adults, pertussis causes URI symptoms plus cough that can last for weeks
Antibiotics (macrolides or Bactrim) reduce contagion but have little effect on symptoms

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Pertussis, or whooping cough, is an acute infectious disease caused by the bacterium Bordetella pertussis. Outbreaks of pertussis were first described in the 16th century, and the organism was first isolated in 1906.

In the 20th century, pertussis was one of the most common childhood diseases and a major cause of childhood mortality in the United States. Before the availability of pertussis vaccine in the 1940s, more than 200,000 cases of pertussis were reported annually. Since widespread use of the vaccine began, incidence has decreased more than 80% compared with the prevaccine era.

Pertussis remains a major health problem among children in developing countries, with 195,000 deaths resulting from the disease in 2008 (World Health Organization estimate).

Author/s:

Hamborsky, Jennifer, Kroger, Andrew, Wolfe, Charles S.