Adult immunizations--a practical approach for clinicians: Part II

Occupational indications for hepatitis B vaccine include employment in health care services, public safety organizations (e.g., police force) and institutions for the developmentally disabled. Hepatitis B vaccine should also be given to persons having multiple sexual partners, persons abusing injectable drugs, persons receiving hemodialysis and persons recently found to have a sexually transmitted disease. Unimmunized adults should receive enhanced inactivated polio vaccine, not oral polio vaccine. Office procedures that facilitate immunizations include the provision of educational information to patients, standing orders to allow nursing personnel to administer vaccines and feedback to physicians about immunization status and rates.