The 2018 Recommended Immunization Schedule for Adults Aged 19 or Older from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) includes a couple of key changes especially relevant to urgent care providers who offer immunization services. As of now, among other updates, ACP recommends:

• Recombinant zoster vaccine (RZV; Shingrix) to prevent shingles in adults as follows:
• Two doses of RZV 2 to 6 months apart to adults age ≥50 years and older with competent immune systems regardless of a history of herpes zoster or receipt of the zoster vaccine live (ZVL; Zostavax)
• Two doses of RZV 2 to 6 months apart to previous recipients of ZVL at least 2 months after ZVL
• For persons age ≥60 years and older, administer RZV or ZVL, with RZV the preferred option
• An additional dose of measles, mumps, and rubella (MMR) vaccine during a mumps outbreak to at-risk adults previously vaccinated with ≤2 doses of a mumps-containing vaccine. The ACIP stresses this should not be a determination made by an individual provider, but at the discretion of public health officials during a mumps outbreak (which readers of JUCM News may recall occurred in various populations, including dorm-living college students on various campuses, last year).

The complete schedule is available on the Annals of Internal Medicine website.