Aging Q3
Screening and Prevention
ACOVE 6
Out Patient
Recommended vaccinations in patient over 65 years of ageVaccine / Intervals / Contraindications and Precautions
dT
(replace one booster with Tdap if contact with child <12 months) / Every 10 years / Contraindications
• Severe allergic reaction (e.g., anaphylaxis) after a previous vaccine dose or to a vaccine component
For Tdap only: Encephalopathy (e.g., coma, decreased level of consciousness, or prolonged seizures), not attributable to another identifiable cause, within 7 days of administration of previous dose of DTP, DTaP, or Tdap.
Precautions
• Moderate or severe acute illness with or without fever
• Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of tetanus toxoid-containing vaccine
• History of Arthus-type hypersensitivity reaction following a previous dose of tetanus and/or diphtheria toxoid-containing vaccine: defer vaccination until at least 10 years have elapsedsince the previous dose
For Tdap only: Progressive or unstable neurological disorder, uncontrolled seizures, or progressive encephalopathy until a treatment regimen has been established and the condition has stabilized.
Pneumovax / Once after age 65. If < 65 and 5 years have passed – revaccinate once / Contraindication
• Severe allergic reaction (e.g., anaphylaxis) after a previous vaccine dose or to a vaccine component.
Precautions
• Moderate or severe acute illness with or without fever
Influenza / Yearly during flu season / Contraindication
• Severe allergic reaction (e.g., anaphylaxis) after a previous vaccine dose or to a vaccine component, including egg protein
Precautions
• Moderate or severe acute illness with or without fever
• History of GBS within 6 wks of previous influenza vaccine
Zoster / Once after age 60 / Contraindication
• Severe allergic reaction (e.g., anaphylaxis) to a vaccine component
• Known severe immunodeficiency (e.g., from hematologic and solid tumors, receipt of chemotherapy, or long-term immunosuppressive therapy4 or patients with HIV infection who are severely immunocompromised – CD4<200).
Precautions
• Moderate or severe acute illness with or without fever.
• Receipt of specific antivirals (i.e., acyclovir, famciclovir, or valacyclovir) 24 hours before vaccination; if possible, avoid use of these antiviral drugs for 14 days after vaccination.
accessed 8/9/12 rev. 8/10/12
Practice Partner Health Maintenance Templates
Templates can be customized by adding medications and disease states. You can enter codes for “Done Elsewhere” and “Refused”. ASK YOUR PRECEPTOR TODAY!
Exercise Counseling
Elderly patients can build muscle mass, increase endurance, prevent falls, reduce depression and increase functional independence through exercise.
Most patients should aim for aerobic exercise 5 days a week and resistance training 2-3 days per week – start with walking. Exercise prescriptions improve compliance with recommendations. Assess exercise readiness and give patients a prescription.