Overview
Clinical Meaning
The clinician prescribes and administers adult immunizations according to the National Advisory Committee on Immunization (NACI) guidelines in Canada.
The clinician prescribes and administers adult immunizations according to the National Advisory Committee on Immunization (NACI) guidelines in Canada. Key vaccines: influenza (annually for all adults, particularly high-risk groups -- immunocompromised, chronic disease, healthcare workers, pregnant women; quadrivalent inactivated or recombinant preferred, high-dose or adjuvanted formulations for adults 65 and older); pneumococcal (PCV20 or PCV15 followed by PPSV23 for adults 65 and older and high-risk adults -- immunocompromised, chronic lung/heart/liver/kidney disease, diabetes, asplenia, cochlear implants); herpes zoster (Shingrix -- recombinant adjuvanted, two-dose series for adults 50 and older, immunocompromised adults 18 and older; superior to the live Zostavax with 97% efficacy versus 51%); Td/Tdap (Tdap once in adulthood if not previously received, Td booster every 10 years; Tdap in every pregnancy at 27-32 weeks to provide passive antibody transfer to the neonate); HPV (Gardasil 9 for adults up to age 26, shared decision-making for ages 27-45). The clinician assesses immunization history, identifies contraindications (anaphylaxis to vaccine component, live vaccines in immunocompromised patients except specific exceptions, pregnancy for live vaccines), manages vaccine hesitancy with evidence-based motivational interviewing, recognizes and manages adverse...