Patient handout

Adult immunization (preventive)

PRODUCTION

1. Your condition

This handout is for adult immunization (preventive). Your care team identified this based on: routine wellness or preventive visit — review immunization status per current acip adult schedule (cdc 2025-26 addendum).

Other reasons your team may use this plan: catch-up immunization for incompletely vaccinated adult — mmr, varicella, hepb, hpv (acip adult schedule 2025-26); immunocompromised patient requiring modified vaccine schedule — live vaccine avoidance, additional pcv/covid doses (acip 2025-26); prenatal visit — tdap (27-36 wk each pregnancy), influenza any trimester, rsv maternal rsvpref (32-36 wk seasonal), avoid live vaccines (kampmann nejm 2023; amirthalingam lancet 2014).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
influenza vaccine (standard-dose, quadrivalent inactivated, IIV4)	0.5 mL	IM	annually	Standard IIV4 for adults 18-64 without a preferred-formulation indication; pregnancy any trimester — IIV only, never LAIV (ACIP 2025-26)
influenza vaccine (high-dose, quadrivalent, HD-IIV4)	0.7 mL	IM	annually	Preferred age ≥65: high-dose IIV (Fluzone HD) had 24.2% relative efficacy vs standard-dose for lab-confirmed influenza (DiazGranados NEJM 2014 25119609)
influenza vaccine (adjuvanted, aIIV4)	0.5 mL	IM	annually	Preferred age ≥65 (MF59-adjuvanted Fluad) as an alternative to high-dose (ACIP 2025-26)
influenza vaccine (recombinant, RIV4)	0.5 mL	IM	annually	Preferred age ≥65 (recombinant Flublok, egg-free); egg allergy is NO LONGER a contraindication for ANY IIV — egg-allergic patients may receive any age-appropriate vaccine (ACIP 2023)

Plan: Influenza vaccine — annual, age-appropriate formulation (ACIP 2025-26; DiazGranados NEJM 2014 25119609)

3. When to call your provider

Contact your care team if any of the following happen:

Anaphylaxis post-vaccination → IM epinephrine, call 911, observe, VAERS (route allergy.anaphylaxis.v1)
GBS within 6 wk of vaccination → VAERS, treat the implicated vaccine as a precaution for future doses (ACIP 2025-26)
Myocarditis/pericarditis after mRNA COVID-19 → cardiology referral; precaution for future mRNA doses, consider protein-subunit (ACIP 2025-26)
Complex immunodeficiency or severe allergy → ID or allergy/immunology referral for individualized vaccine plan (ACIP 2025-26)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

Anaphylaxis within minutes to hours of vaccine administration — urticaria, angioedema, bronchospasm, hypotension (ACIP 2025-26)(life-threatening)
Inadvertent LIVE vaccine (MMR, varicella, LAIV) given to a severely immunocompromised patient or during pregnancy (ACIP 2025-26)

5. Follow-up

Patient education: expected local/systemic reactions (Shingrix grade-3 reactogenicity expected — Lal 25916341), VAERS reporting for adverse events, return precautions (anaphylaxis, fever, neurologic symptoms), next vaccine due dates in patient portal and IIS (ACIP 2025-26)

6. Sources

Guideline: ACIP Recommended Adult Immunization Schedule (CDC; addendum 2025-07-02, amended 2026-04-27 for the April-2025 RSV expansion) + vaccine-specific ACIP MMWR statements