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immunization 2015
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Vaccina ion
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Foundation
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schedule for adult

vaccine type/route target individuals schedule precautions/contraindications
HUMAN PAPILLOMA Recommended for: Bivalent for females only Moderate to severe acute illness
VIRUS (HPV) Females: 9-55 years old From 9 to 13 years old, 2 doses Severe allergic reaction to a vaccine
Recombinant vaccine Males: 10-26 years old (0, 6 or 12 months) component or following a prior dose
Intramuscular May be given as catch up vaccination to 13-21 years old who have Above 13 years old, 3 doses (0, If a woman is found pregnant after initiation of
not been previously vaccinated or who have not completed the 1, 6 months) the vaccine series, remaining doses should be
1. Bivalent (Types 16, 3-dose series delayed until after the pregnancy
18) Quadrivalent for males and
Females only females
2. Quadrivalent (Types 6, 3 doses 0, 2, 6 months
11, 16, 18) Females 14 to 45 years old
Females and males Males 14 to 26 years old
2 doses, 9-13 years old. 0, 6 or
12 months
HERPES ZOSTER Recommended for: Give as a single 0.65 ml SC in the Severe allergic reaction to a vaccine
VACCINE Adult 50 years old and above with or without a prior episode of deltoid area component (gelatin or neomycin) or following a
Herpes Zoster For those with history of herpes prior dose
Live, attenuated VZV Persons with history of zoster (after 6 months to 1 year) zoster, vaccine may be given after
Moderate to severe acute illness
Subcutaneous Persons with chronic medical conditions unless episode these at least 1 year of acute episode
Pregnancy
conditions are contraindications to vaccinate
Immunosuppressed
Chronic renal failure
Recent receipt of blood product
Diabetes mellitus
Thrombocytopenia/ITP
Rheumatoid arthritis
Untreated active tuberculosis
Chronic pulmonary disease
PLHIV with CD4 < 200 cells
MENINGOCOCCAL Recommended for: For immunocompetent, For those with severe allergic reaction to the
Polysaccharide vaccine Those travelling to areas with meningococcal outbreaks single dose 0.5 ml. No vaccine component
(MPSV) Health workers with contacts of meningococcal patients revaccination.
Intramuscular or Those with immunocompromised conditions and complement If immunocompromised, single
Subcutaneous deficiency dose 0.5 ml. Revaccination after 5
Conjugate Functional or anantomic asplenia years if there is risk of exposure.
vaccine(MCV4)
Intramuscular
TYPHOID Recommended for: Intramuscular for primary and Previous anaphylactic reaction to vaccines or
Intramuscular Food handlers such as dietary personnel cooks, waiters, servers, booster single 0.5 ml M dose on its components
VI capsular dieticians, nutritionists the deltiod
polysaccharide Microbiology lab technicians
Persons with intimate exposure to a documented S. typhi carrier or
patient

RABIES Recommended for: Pre-exposure series of 3 injections Moderate or severe acute illness
Intramuscular/ on days 0, 7 & 21 or 28 Intake of corticosteroids, chemotherapeutic
Intradermal Health care workers in hospitals that treat dog bites and rabies cases
Rabies research diagnostics/lab workers IM on the deltoid agents, antimalarials
HDCV Human diploid PVRV - 0.5 ml
cell vaccine (Available Veterinarian and vet students
Field workers PCECV, HDCV - 1.0 ml
upon special request) ID-on the deltoid
PVRV purified vero cell School children in areas with high incidence of rabies
PVRV, PCECV - 0.1 ml
rabies vaccine Booster given only to continuously
PCECV Purified chick exposed individuals
embryo vaccine - single dose IM or ID every 2
years
For post-exposure prophylaxis -
refer to Standard guidelines
Anyone who desires to be protected can receive any of the vaccine unless contraindicated.
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schedule for adult immunization 2015

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Vaccina ion

(Updated as of April 2015)

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9 70 AD-

vaccine type/route target individuals schedule precautions/contraindications

TETANUS, DIPHTHERIA Recommended for all adults particularly: 3 doses (1 Tdap + 2 Td*): Severe allergic reactions to vaccine component
ACELLULAR Pregnant and postpartum 0, 1, 6-12 months or prior dose
PERTUSSIS Tdap every pregnancy during 27-36 weeks gestation Booster every 10 years with Td Moderate to severe illness
Health Care Workers * If Tetanus diphtheria (Td) is not
(Tt, Td, Tdap)
Inactivated vaccine Adolescents available may use Tetanus
Intramuscular Person age 60 and older toxoid (T)

INFLUENZA Recommended for all adults particularly: Single dose annually Persons with severe allergic reaction to a
Quadrivalent inactivated Individuals 50 years of age vaccine component (e.g.egg) or following a
vaccine Health Care Workers prior dose of vaccine
Trivalent inactivated Residents of Chronic care facilities and nursing homes Moderate to severe illness with or without a
vaccine With chronic disorders: fever
Intramuscular Chronic pulmonary diseases (including bronchial asthma) History of GuillainBarre syndrome within 6
Southern Hemisphere Chronic cardiovascular/renal/liver disease weeks following a previous dose of vaccine
strain Neurological Disorder
Chronic metabolic disease
HIV/AIDS
Immunosuppressed
Pregnant women in the 2nd or 3rd trimester without a flu shot in the
last 12 months
Healthy persons providing essential and emergency community services
Students and other persons in institutional settings

HEPATITIS A Recommended for: For monovalent Hepatitis A History of severe allergic reaction to a previous
Inactivated vaccine Any person seeking protection from hepatitis A virus (HAV) Infection vaccine (1440 ELISA units/ml/vial) dose of Hepatitis A vaccine or a vaccine
Single antigen or in Men having sex with men (MSM) - 2 doses at 0, 6-12 months component (i.e. 2-phenoxyethanol, yeast)
combination with IV drug users Severe febrille illness
Hepatitis B Persons who receive clotting factor concentrates or with clotting factor For combination Hep A and Hep B
Intramuscular disorders (e.g. hemophiliacs) vaccine regular schedule:
Persons travelling to or working in countries that have high or - 0, 1, 6 months
intermediate endemicity of HAV
Contacts of infected persons
People with chronic liver disease (because of risk of fulminant hepatitis A)
Persons for whom Hepatitis A is an occupational hazard (e.g. health
care workers, some lab workers, food handlers)
Persons employed in child care centers, health care institutions,
institutions for persons with developmental disabilities, schools.
Persons exposed to sewage
Armed forces
Persons working with HAV-infected primates or with HAV in a research
laboratory setting
Travelers from non-endemic areas which include:
Tourist
Immigrants and their children returning to their country of origin to
visit friends or relatives
Military personnel
Missionaries
Others who work or study abroad in countries that have high or
intermediate endemicity of Hepatitis A

HEPATITIS B Recommended for all adults particularly: For Hepatitis B vaccine Severe allergic reactions to vaccine
Inactivated vaccine Those without documented evidence of immunity to Hepatitis B - Regular 3 doses 0, 1, 6 months components (eg. Bakers yeast) or following
Single antigen or Health Care Workers previous dose
in combination with Household contacts and sex partners of persons with chronic HBV - Accelerated schedule Days 0, Moderate or severe acute illness
Hepatitis A infection or carriers 7, 21-30, and at 12 months Pregnancy is not contraindication to
Intramuscular Recipients of blood products vaccination
Sexually active persons For combination Hep A and Hep B
Immigrants from areas of high HbSAg endemicity vaccine
Clients and staff members of institutions for persons with disabilities - Regular 3 doses 0, 1, 6 months
Travelers to countries with high or intermediate prevalence of chronic
Hepatitis B infection
IV drug users
Diabetics
End stage renal disease and on Hemodialysis
Persons with HIV/AIDS
Chronic liver disease

VARICELLA Recommended for all adolescents and adults particularly: 2 doses Severe allergic reactions to vaccine component
Live attenuated vaccine Persons > 13 years old without evidence of immunity 0, 1-2 months (gelatin or neomycin) or to prior dose
Subcutaneous Healthcare workers Moderate to severe acute illness
Teachers Post-exposure Prophylaxis Pregnancy
Non-pregnant women of child-bearing age Given within 72 hours of exposure Immunosuppressed
Travelers Single dose Recent receipt of a blood product
Military personnel Thrombocytopenia/ITP
Untreated active tuberculosis

MEASLES, MUMPS, Recommended for all adolescents and adults particularly: 2 doses Severe allergic reactions to vaccine component
Those without documented evidence of immunity to any one of the 0, 1 month interval (gelatin or neomycin) or to prior dose of MMR
RUBELLA (MMR) Moderate to severe acute illness
Live attenuated components or disease (especially non-pregnant women of child-
bearing age) Pregnancy should be avoided for 1 month
Subcutaneous
Travelers following receipt of vaccine
Immunosuppressed
Persons receiving large daily doses of
corticosteroids for 14 days
Receipt of antibody containing blood products

PNEUMOCOCCAL Recommended for adults: Recommended vaccine PCV13 to An immediate anaphylactic reaction to a
Polysaccharide (PPSV23) Age 50 years and older be given first previous dose of pneumococcal vaccine
- Intramuscular or Adults < 50 years old with: Allergy to a vaccine component: anaphylaxis to
Subcutaneous - Chronic lung disease (including bronchial asthma, tuberculosis) For elderly, immunocompetent phenol or thimerosal
Conjugate (PCV13) - Chronic cardiovascular/renal/liver disease PCV13 then PPSV23 in 6-12 Moderate to severe illness with or without a
- Intramuscular - Diabetes mellitus months fever
- Alcoholism
- Cochlear implants
- CSF fluid leaks For immunocompromised
- Immunocompromised conditions: PCV13 then PPSV23 at least 8
o Functional and anatomic asplenia weeks
o Leukemia and lymphomas
o Generalized malignancy For booster dose
o Transplants Single dose of PPSV23 after 5
o Chemo/radiation therapy years
o HIV/AIDS
- Residents of nursing home or long-term care facilities
- Smokers