Before you vaccinate adults, consider their H-A-L- O! How do I use H-A-L- O?

What is H-A-L- O? As shown below, its an easy-to-use chart that can make a definitive decision about vaccinating your patient, its important Though some H-A-L-O factors can be easily
help you make an initial decision about vaccinating a patient based on four that you refer to the more detailed information found in the Immunization determined (e.g., age, pregnancy), you will
factors the patients Health condition, Age, Lifestyle, and Occupation. Action Coalitions Summary of Recommendations for Adult Immunization, need to ask your patient about the presence
In some situations, though, you can vaccinate a patient without considering located at www.immunize.org/catg.d/p2011.pdf or the complete vaccine or absence of others. Once you determine
these factors. For example, all adults need a dose of Tdap as well as annual recommendations of the Centers for Disease Control and Preventions which of the factors apply, scan down each
vaccination against influenza, and any adult who wants protection against Advisory Committee on Immunization Practices (ACIP) at www.cdc.gov/ column of the chart to see at a glance which
hepatitis A or hepatitis B can be vaccinated. Note that not all patients who vaccines/hcp/acip-recs/index.html. vaccinations are possibly indicated.
mention one or more H-A-L-O factors will need to be vaccinated. Before you

H-A-L- O checklist of factors that indicate a possible need for adult vaccination

H Health Factors
A Age Factors
L Lifestyle Factors
O Occupational
or other factors

Adults in institutional settings

(for stem cell transplant, see ACIPs General

Not in a long-term, mutually

monogamous relationship

People who live or work in

Recommendations on Immunization)
Certain chronic diseases

candidate/recipient

an area of an outbreak
international adoptee
Born outside the U.S.

International traveler

(e.g., chronic care, correctional)

Cochlear implant
Immunosuppressed

non- injecting drugs

Certain lab workers

User of injecting or

Healthcare worker
Men who have sex
History of STD

Organ transplant

Cigarette smoker

College students
Close contact of
(including HIV)

Alcoholism
Asplenia

CSF leaks

with men
Pregnant

Vaccine
Anyone of any age who
HepA wants to be protected
Anyone of any age who
HepB wants to be protected
Hib
HPV (females) Through 26 yrs
Routine through age 21; for
HPV (males) age 2226: risk groups and
others who want to be protected

IPV
Influenza Annual vaccination is recommended for all adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .
Meningococcal ACWY
Any adult age 2226 yrs
Meningococcal B who wants to be protected
Routine 1 dose if born after
MMR ? 1956; 2nd dose for some
65 yrs and older
PCV13 (if not previously vaccinated)

PPSV23 65 yrs and older

Tdap A single dose is recommended for all adults; pregnant women should receive Tdap during each pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .
Varicella Completion of a 2-dose series is recommended for non-pregnant adults through age 59 years who do not have evidence of immunity to varicella . . . . . . . . .. . . . . . . .
Zoster 60 yrs and older
? = Vaccination may be indicated depending on degree of immunosuppression
Technical content reviewed by the Centers for Disease Control and Prevention
Immunization Action Coalition Saint Paul, Minnesota 651- 647- 9009 www.immunize.org www.vaccineinformation.org www.immunize.org/catg.d/p3070.pdf Item #P3070 (6/17)