NCLEX Review Guide: Growth & Development - Adulthood Immunizations

Routine Adult Vaccines (19+ years)

• Influenza vaccine should be administered annually to all adults without contraindications, preferably before flu season begins in October.
• Td/Tdap booster is required every 10 years, with at least one dose of Tdap replacing Td for pertussis protection.
• COVID-19 vaccination follows current CDC guidelines with primary series and recommended boosters based on age and risk factors.
• MMR vaccine is indicated for adults born in 1957 or later without evidence of immunity, particularly healthcare workers and international travelers.

Young Adults (19-26 years)

• HPV vaccine series is recommended through age 26 if not previously completed, with shared clinical decision-making for ages 27-45.
• Meningococcal vaccine is indicated for college students living in dormitories and military recruits.
• Pregnancy screening is essential before live vaccines (MMR, varicella) as these are contraindicated during pregnancy.

Middle-Aged Adults (50-64 years)

• Zoster vaccine (Shingrix) is recommended starting at age 50, given as a 2-dose series 2-6 months apart.
• High-dose influenza vaccine may be preferred for adults 65+ due to enhanced immune response.

Older Adults (65+ years)

• Pneumococcal vaccines include PCV15 or PCV20, with PPSV23 administered based on specific protocols and timing intervals.
• Immunocompromised status requires modified vaccination schedules and contraindications for live vaccines.

High-Risk Groups

• Healthcare workers require annual influenza, MMR, varicella, and hepatitis B vaccines with documented immunity or vaccination.
• Immunocompromised patients should receive inactivated vaccines but avoid live vaccines (MMR, varicella, zoster, intranasal influenza).
• Pregnant women should receive Tdap during each pregnancy (27-36 weeks) and annual influenza vaccine.