Immunization guidelines in the United States: new vaccines and new recommendations for children, adolescents, and adults.

It is increasingly apparent that prevention, rather than treatent, of infectious diseases offers significant health and economic enefits to individuals and populations. Combined with the increasng virulence of some pathogens, and the increasing rates of ntimicrobial resistance, as well as the tremendous costs associted with treating disease once it has occurred, vaccines are a highly ost-effective public health strategy. Despite this, and the widespread availability of vaccines in the S, an estimated annual average of 50,000 Americans die of potenially vaccine-preventable diseases each year, with more than 99% f these deaths occurring in adults. This means that at the start f each year, 1 out of every 7000 Americans will die of a disase that might be prevented by already existing and available accines. Several factors commonly conspire to prevent routine immuization, including cost, lack of knowledge and awareness, missed pportunities, and the lack of a systems-level approach to providng vaccines. Excellent resources are available for setting up an mmunization program and are available from the American Colege of Physicians at http://www.acponline.org/aii/index.html and rom the CDC at http://www.cdc.gov/vaccines/. In addition, a free nd very helpful smart phone app is available through the iTunes tore (ACP Immunization Advisor). The purpose of the annual immunization guidelines is to provide n evidence-based schedule of routine immunizations demontrated to be safe and effective, based on age and concurrent edical conditions. This is the approved official schedule for use in he US, and allows all clinicians to provide vaccines in a harmonious anner regardless of geographic location. The schedule is develped by a federal advisory committee (the Advisory Committee on mmunization Practices – ACIP), which consists of experts in vacciology, public health, infectious diseases, and related disciplines. These new recommendations describe each vaccine, its use, ndications and contraindications, background data, and other nformation, and can be accessed at http://www.immunize. rg/catg.d/p2010.pdf. The full adult immunization schedule is vailable at http://www.cdc.gov/vaccines/schedules/downloads/ dult/adult-schedule-bw.pdf. These schedules can be found in ppendix A. Below we provide brief commentary on the major changes cliicians should be aware of: