Lam Sum, Jodlowski Tomas Z
St. John's University College of Pharmacy and Allied Health Professions, Department of Clinical Pharmcy Practice, Queens, New York 11439, USA.
Consult Pharm. 2009 May;24(5):380-91. doi: 10.4140/tcp.n.2009.380.
To update senior care pharmacists with current recommendations on influenza, pneumococcal, zoster, and tetanus vaccines for older adults 65 years of age or older.
A search of immunization guidelines on influenza, pneumococcal, zoster, and tetanus infection was performed at various Web sites, including Immunization Action Coalition (www.immunize.org) and the Centers for Disease Control and Prevention (www.cdc.gov). MEDLINE (January 1966 to September 2008) and Pub-Med (January 1955-September 2008) databases and manual bibliographic searches were used to identify additional information. Search terms included influenza, herpes zoster, shingles, pneumococcal pneumonia, pneumovax, tetanus, and vaccine, used alone or in combination.
Relevant English language articles identified from the data sources were evaluated.
Trivalent influenza vaccine is recommended to high-risk groups and persons who are likely to transmit the infection, including selected health care staff and caretakers, adults 50 years of age or older, and those with comorbidities that increase the risk of influenza complications. Pneumococcal vaccine is recommended for all persons 65 years of age or older and those with certain medical conditions. One-time revaccination can be offered to the elderly who initially received the vaccine before they turned age 65 and at least five years passed since the initial vaccination. Zoster vaccine should be offered to all persons 60 years of age or older unless contraindications or precautions exist. Tetanus booster every 10 years should be considered in adults who have completed the primary series. Influenza and pneumococcal vaccines, as well as tetanus booster for post-exposure management, are covered under Medicare Part B. Zoster vaccine is covered under Medicare Part D.
The Advisory Committee on Immunization Practices offers detailed recommendations for the prevention of influenza, invasive pneumococcal disease, zoster, and tetanus infection for target groups.
向老年护理药剂师介绍针对65岁及以上老年人的流感、肺炎球菌、带状疱疹和破伤风疫苗的最新推荐。
在多个网站进行了关于流感、肺炎球菌、带状疱疹和破伤风感染免疫指南的检索，包括免疫行动联盟（www.immunize.org）和疾病控制与预防中心（www.cdc.gov）。使用MEDLINE（1966年1月至2008年9月）和Pub-Med（1955年1月 - 2008年9月）数据库以及手工文献检索来识别其他信息。检索词包括流感、带状疱疹、水痘、肺炎球菌肺炎、肺炎疫苗、破伤风和疫苗，单独使用或组合使用。
对从数据来源中识别出的相关英文文章进行评估。
推荐三价流感疫苗用于高危人群以及可能传播感染的人群，包括特定的医护人员和护理人员、50岁及以上的成年人以及患有增加流感并发症风险合并症的人群。建议65岁及以上的所有人以及患有某些医疗状况的人接种肺炎球菌疫苗。对于65岁之前首次接种疫苗且自首次接种至少已过去五年的老年人，可提供一次重新接种。除非存在禁忌症或预防措施，应为所有60岁及以上的人提供带状疱疹疫苗。完成基础免疫系列的成年人应每10年考虑接种破伤风加强针。医疗保险B部分涵盖流感和肺炎球菌疫苗以及用于暴露后管理的破伤风加强针。医疗保险D部分涵盖带状疱疹疫苗。
免疫实践咨询委员会为目标人群预防流感、侵袭性肺炎球菌疾病、带状疱疹和破伤风感染提供了详细建议。
