Current recommendations also include influenza vaccine for routine annual administration to individuals with chronic illness at any age, to persons living in the same household as chronically ill individuals, and to all adults 50 years of age. Polyvalent pneumococcal polysaccharide vaccine is similarly recommended for adults ≥65 years of age and for all chronically ill persons. Hepatitis B vaccine should be given to adults at high risk from clinical, occupational, behavioral, or travel exposures, including patients undergoing hemodialysis, routine recipients of clotting factors, health care workers exposed to potentially infected blood or blood products, individuals living and working in. | Chapter 116. Immunization Principles and Vaccine Use Part 8 Current recommendations also include influenza vaccine for routine annual administration to individuals with chronic illness at any age to persons living in the same household as chronically ill individuals and to all adults 50 years of age. Polyvalent pneumococcal polysaccharide vaccine is similarly recommended for adults 65 years of age and for all chronically ill persons. Hepatitis B vaccine should be given to adults at high risk from clinical occupational behavioral or travel exposures including patients undergoing hemodialysis routine recipients of clotting factors health care workers exposed to potentially infected blood or blood products individuals living and working in institutions for the mentally handicapped travelers to highly endemic countries persons at excess risk for sexually transmitted diseases injection drug users and household contacts of known carriers of hepatitis B surface antigen. Hepatitis A vaccine is recommended for these same groups and for persons with clotting disorders or chronic liver disease. There are a number of other special-use vaccines whose administration is related to travel and occupational exposures . Japanese B encephalitis typhoid fever yellow fever and rabies specific recommendations for the use of these vaccines in the United States can be found at . gov nip recs . Simultaneous Administration of Multiple Vaccines There are no contraindications to the simultaneous administration of multiple individual vaccines although the use of licensed combination vaccines can significantly reduce the required number of injections during the first 2 years of life. Combination DTaP Hib vaccine should not be used for primary immunization of infants because it results in a blunted suboptimal response to Hib the combination may be used for booster immunizations. Simultaneous administration of the most widely used live and inactivated vaccines has not .
