CDC issues adult vaccine schedule. (Influenza Vaccine well Stocked for Season).

WASHINGTON -- For the first time, a comprehensive adult immunization schedule is available to prompt physicians, as well as consumers, when individuals aged 19 years and older require vaccinations.

But while the color-coded schedule, released in October by the Centers for Disease Control and Prevention, should raise awareness of adult immunization requirements, it's unlikely to change practice anytime soon given low reimbursement for many of the vaccinations, experts said at a press conference sponsored by the National Foundation for Infectious Diseases.

The schedule represents a harmonization of existing recommendations from various medical specialty societies and the CDC. But importantly, this is the first time they're all in one place, explained Dr. William Schaffner, a professor of medicine in infectious diseases division at Vanderbilt University, Nashville.

The only vaccine universally recommended for every adult regardless of health status is a tetanus-diphtheria booster every 10 years, following three primary doses. All other vaccinations including influenza; pneumococcal polysaccharide; hepatitis A and B; measles, mumps, and rubella; varicella; and meningococcal polysaccharide are advised depending on the patient's age and/or medical, behavioral, occupational, or susceptibility status.

Separate charts spell out requirements for healthy, low-risk individuals and higher-risk patients such as pregnant women and those with medical conditions such as diabetes, heart disease, immunodeficiencies, HIV renal disease, or splenectomies. (The charts appear on pages 39 and 40.)

Much like the pediatric immunization schedule, which hangs prominently in exam rooms and waiting areas, the idea of the charts is to help providers easily assess the vaccination needs of patients during office visits, then administer the vaccinations.

But unlike pediatricians, whose patients have regular physicals and interactions with institutions that require immunizations such as day care facilities and schools, health care providers treating adults have to take advantage of every opportunity to assess vaccination requirements, including when patients come in with an illness, said Dr. Walter A. Orenstein, director of the National Immunization Program at the CDC.