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Understanding MOC Requirements
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April 11-13, 2019
Internal Medicine Meeting 2019
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Adults also should ask their internist about other
immunizations they might need
The following statement is attributable to Molly Cooke, MD,
FACP, president of the American College of Physicians:
PHILADELPHIA, October 3, 2013 -- With flu season approaching,
now is a perfect time for all adults, especially people with
chronic conditions and the elderly, to get a flu shot and take that
opportunity to talk with their doctor about other immunizations,
also called vaccinations, they might need.
Widespread immunization is one of the great public health
achievements of the last 100 years, eradicating or significantly
reducing the incidence of many life-threatening diseases such as
measles, polio, and chickenpox, and enabling people to live longer
Yet immunization rates remain startlingly low for adults in the
U.S., resulting in unnecessarily high rates of dangerous,
preventable illnesses like flu, pneumonia, and whooping cough that
jeopardize the health and wellness of our nation. Hundreds of
thousands of adults in the United States get sick, miss work, or
die every year because of vaccine-preventable diseases or their
ACP endorses the Advisory Committee on Immunization Practices (ACIP) Adult
Immunization Schedule and offers the following immunization
ACP recommends that all
health care providers (HCPs) be immunized against influenza,
diphtheria, pertussis (whooping cough), and other diseases
according to the ACIP Adult Immunization Schedule. ACP's policy
exempts HCPs for medical reasons or a religious objection to
Below is information about a few immunizations that adults and
their physicians should make sure are up to date. Keeping up with
immunizations is a safe, effective, easy way for adults to protect
themselves, their families and friends, and their communities from
life-threatening diseases. If you can't get a flu shot or other
immunizations for medical reasons, talk to your doctor about other
ways of protecting yourself.
Every adult should get a flu vaccination every year, especially
seniors and those with chronic conditions. This contagious
respiratory illness can cause mild to severe illness or death. More
than 200,000 people in the U.S. are hospitalized each year from
flu-related illness. Older adults, specifically those 65 years of
age and older, typically account for 60 percent of these
flu-related hospitalizations each year and about 90 percent of
Only 38.8 percent of adults 18 years old and older were
immunized during the 2011-12 flu season, A recent study conducted
by researchers from Vanderbilt University Medical Center in
collaboration with CDC found that flu vaccination reduced the risk
of flu-related hospitalization by 71.4 percent among adults of all
ages and by 76.8 percent in study participants 50 years of age and
older during the 2011-12 flu season.
Mild egg allergy is no longer a contraindication but patients
with an egg allergy should get the inactivated flu vaccine, and if
you have an immune system disorder or are pregnant, talk with your
Many patients are surprised when I propose giving them the
one-shot vaccination for diphtheria, tetanus, and pertussis. "I am
sure that I have had the tetanus shot," they say, and they are
right. Universal vaccination of school children has made both
diphtheria (a dangerous upper respiratory tract infection) and
tetanus ("lockjaw") vanishingly rare. However, pertussis is a
growing problem among adults because the immunity for it is not as
durable as it is for diphtheria and tetanus.
According to the latest data from the National Health
Information Survey in 2011, only about 13 percent of adults
reported getting a Tdap vaccination. While pertussis is not the
lethal condition in adults that it can be in little children and
does not typically produce the characteristic "whoop," it is a
miserable illness. In some parts of the world, whooping cough's
informal name is "100-days cough." I have seen robust people
completely exhausted by the relentless wracking cough; it is not
uncommon that patients with pertussis vomit from the cough and some
actually break ribs.
While pertussis typically affects infants and young children and
can be fatal -- especially in babies under the age of 1 -- they
usually are infected by older siblings, parents, or caregivers who
might not even realize they have the disease. Beyond immunizing
children, the surest way to protect them is for adults to get
vaccinated, especially pregnant women, anyone in contact with
infants, and health care professionals.
The major types of pneumococcal disease are pneumonia,
bacteremia (blood infection), and meningitis (infection of the
covering of the brain and spinal cord). Annually, about 900,000
Americans get pneumonia, the most common form of pneumococcal
disease in adults, and 45,000 to 65,000 die from it.
If you have chronic health conditions, ask your doctor if you
need to get vaccinated. Everyone over 65 should have received this
vaccine once. Some patients will need more than one shot depending
on underlying conditions. According to the National Health
Information Survey, only 20 percent of adults aged 19-64 years at
high risk for pneumococcal disease received the vaccine.
The American College of Physicians (www.acponline.org) is the largest medical
specialty organization and the second-largest physician group in
the United States. ACP members include 137,000 internal medicine
physicians (internists), related subspecialists, and medical
students. Internal medicine physicians are specialists who apply
scientific knowledge and clinical expertise to the diagnosis,
treatment, and compassionate care of adults across the spectrum
from health to complex illness. Follow ACP on Twitter and Facebook .