{"id":268,"date":"2014-02-06T15:24:54","date_gmt":"2014-02-06T15:24:54","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=268"},"modified":"2017-08-21T13:02:01","modified_gmt":"2017-08-21T13:02:01","slug":"primary-care-corner-with-dr-geoffrey-modest-new-adult-immunization-guidelines-2014","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/02\/06\/primary-care-corner-with-dr-geoffrey-modest-new-adult-immunization-guidelines-2014\/","title":{"rendered":"Primary Care Corner with Dr. Geoffrey Modest: New adult immunization guidelines 2014"},"content":{"rendered":"<p>MMWR\/ACIP (advisory committee on immunization practices) just came out with 2014 adult immunization guidelines (see\u00a0<a title=\"http:\/\/www.cdc.gov\/mmwr\/pdf\/wk\/mm63e0203a2.pdf\nCtrl+Click to follow link\" href=\"http:\/\/www.cdc.gov\/mmwr\/pdf\/wk\/mm63e0203a2.pdf\" target=\"_blank\">http:\/\/www.cdc.gov\/mmwr\/pdf\/wk\/mm63e0203a2.pdf<\/a>\u00a0). also, article in annals of internal medicine with guidelines and charts (see\u00a0<a title=\"http:\/\/annals.org\/article.aspx?articleid=1819123\nCtrl+Click to follow link\" href=\"http:\/\/annals.org\/article.aspx?articleid=1819123\" target=\"_blank\">http:\/\/annals.org\/article.aspx?articleid=1819123<\/a>).\u00a0not a lot of changes, but:<\/p>\n<p>&#8211;Hib vaccine recommendations updated &#8212; major change is <i>not recommending<\/i> Hib vaccine for HIV-positive (had been <i>to consider<\/i> Hib vaccination). (i have been giving Hib vaccine to HIV-positive patients because of older case studies suggesting higher incidence of invasive Hib infection in HIV-positive people. seems like this is really not indicated). also not include meningococcal vaccine for HIV-positive (there was a recommendation, though not reflected in the above documents, that HIV-positive MSM get meningococcal vaccine, given the recent meningococcal outbreak in new york in MSM). they do reinforce the combo of PCV-13 and PPSV23, the 2 pneumococcal vaccines, in HIV-positive patients.<\/p>\n<p>&#8211;flu: okay to use RIV (recombinant influenza vaccine) and IIV (inactivated influenza vaccine) in egg-allergic patients with hives-only allergy (RIV contains no egg protein and can be used in adults aged 18-49)<\/p>\n<p>&#8211;Tdap &#8212; no change really, just reinforced using once in people over age 11, followed by Td every 10 years. i wonder if they will change the once-only recommendation given serologic and clinical evidence of waning pertussis immunity within a few years after immunization. they do recommend Tdap vaccine in pregnant women for each pregnancy, esp in range of 27-36 wk gestation<\/p>\n<p>geoff<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2014 immunization guidelines [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/02\/06\/primary-care-corner-with-dr-geoffrey-modest-new-adult-immunization-guidelines-2014\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":148,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[14283],"tags":[],"class_list":["post-268","post","type-post","status-publish","format-standard","hentry","category-archive"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/268","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/users\/148"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/comments?post=268"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/268\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/media?parent=268"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/categories?post=268"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/tags?post=268"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}