by American College of Physicians

The Advisory Committee on Immunization Practices (ACIP) released its 2020 Recommended Immunization Schedule for adults with changes to the administration of the influenza, human papillomavirus (HPV), hepatitis A, hepatitis B, meningococcal B, and pneumococcal conjugate vaccines. The schedule, which can be complex and challenging to implement, features revised content, format, and graphics to make it easier to follow. The complete schedule, including changes in the vaccine notes section, is being simultaneously published in Annals of Internal Medicine and on the Centers for Disease Control and Prevention (CDC) web site.

The schedule is streamlined for ease of reference. Physicians should pay careful attention to the details found in the vaccine notes section, as they clarify who needs what vaccine, when, and at what dose.

In addition to changes in the administration of some vaccines, the 2020 schedule includes new instructions for shared clinical decision-making for several vaccines. First, the HPV vaccine is recommended for some patients aged 27 through 45 who are not adequately vaccinated. Clinicians should consider discussing HPV vaccination with those who are most likely to benefit from it based on a detailed list of considerations. Second, the pneumococcal 13-valent conjugate vaccine (PCV13) should be discussed with adults 65 years or older who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant, and who have not previously received PCV13. And third, clinicians should consider discussing the meningitis B vaccine with adolescents and young adults age 16 through 23 who are not at increased risk for meningococcal disease.

The ACIP is comprised of 15 voting members, ex officio members who represent other federal agencies, and non-voting representatives of liaison organizations, including the American College of Physicians, that bring related immunization expertise. Each year, ACIP reviews the CDC’s Recommended Adult Immunization Schedule to ensure it reflects current clinical recommendations for licensed vaccines. The recommendations are intended to guide physicians and other clinicians about the appropriate vaccines for their adult patients.