The 2019 adult immunization schedules have been approved by the Advisory Committee on Immunization Practices (ACIP) of the CDC.

An article in American Family Physician recently discussed the changes, including a new recommended hepatitis B vaccine. HepB-CpG is recommended in a two-dose series (0, 1 month) for people aged 18 years and older. The author is Pamela G. Rockwell, DO, of the University of Michigan Medical School, who serves as liaison to the ACIP for the American Academy of Family Physicians.

The report notes that data are limited on the safety and immunogenicity effects when HepB-CpG is interchanged with hepatitis B vaccines from other manufacturers, advising, “When feasible, the same manufacturer’s vaccines should be used to complete the series. However, vaccination should not be deferred when the manufacturer of the previously administered vaccine is unknown or when the vaccine from the same manufacturer is unavailable.”

In addition, the review points out the lack of HepB-CpG in pregnant women, suggesting that “available human data on HepB-CpG administered to pregnant women are insufficient to inform assessment of vaccine-associated risks in pregnancy. Until safety data are available for HepB-CpG, health care professionals should continue to vaccinate pregnant women needing hepatitis B vaccination with a vaccine from a different manufacturer.”

The ACIP added the homeless to the list of groups who should receive the hepatitis A vaccine. The recommendation is that all adults at increased risk of hepatitis A should receive two doses given 6 to 18 months apart. Those groups include::

• Those who travel to places where hepatitis A is common
• Men who have sex with men
• Those who use drugs (with or without needles)
• Patients receiving treatment for certain bleeding disorders (e.g., hemophilia)
• Parents adopting a child from a country where hepatitis A is common
• People working with animals that have hepatitis A, or who work in a hepatitis A research laboratory
• People who are homeless.

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