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April 28, 2016

Immunizations for Adult Women

By Dr. Dyanne Tappin

Vaccinations are important for adult women and should be reviewed at every annual preventive health appointment. Important vaccinations for women include the following: Tetanus, diphtheria with or without pertussis; influenza; human papilloma virus (HPV); measles-mumps-rubella; hepatitis A and B; pneumococcal; and meningococcal. Below is an overview of these vaccinations. More specific questions should be discussed with your provider.

Tetanus, Diphtheria, with or without pertussis (Td, Tdap): Women 11 years or older who have not received Tdap vaccine or for whom vaccine status is unknown should receive a dose of Tdap followed by tetanus and diphtheria toxoids (Td) booster doses every 10 years thereafter. Tdap can be administered regardless of interval since the most recent tetanus or diphtheria toxoid-containing vaccine. One dose of Tdap vaccine should be given to pregnant women during each pregnancy (preferably during 27 to 36 weeks’ gestation) regardless of interval since prior Td or Tdap vaccination.

Influenza: The flu vaccine is recommended for all adult women, including pregnant women, on an annual basis. The inactivated vaccine is available in injection form, whereas the nasal spray is the Live attenuated influenza vaccine (LAIV [FluMist]) is an option for healthy, non-pregnant persons aged 2 through 49 years.

Human Papilloma Virus: The three vaccinations for the human papilloma virus are the following: bivalent HPV vaccine [2vHPV], quadrivalent HPV vaccine [4vHPV], and 9-valent HPV vaccine [9vHPV]. The bivalent, quadrivalent, or 9-valent is recommended in a 3-dose series for routine vaccination at age 11 or 12 years and for those aged 13 through 26 years, if not previously vaccinated.

Measles-Mumps-Rubella: Women born before 1957 are generally considered immune to measles and mumps. All adults born in 1957 or later should have documentation of 1 or more doses of MMR vaccine unless they have a medical contraindication to the vaccine or laboratory evidence of immunity to each of the 3 diseases. For women of childbearing age, regardless of birth year, rubella immunity should be determined. If there is no evidence of immunity, women who are not pregnant should be vaccinated. Pregnant women who do not have evidence of immunity should receive MMR vaccine upon completion of pregnancy and before discharge from the healthcare facility.

Hepatitis A: This vaccine for women seeking protection from hepatitis A virus (HAV) infection and persons with any of the following indications: those who use injection or noninjection illicit drugs; those who work with HAV-infected primates or with HAV in a research laboratory setting; those with chronic liver disease and persons who receive clotting factor concentrates; traveling to or working in countries that have high or intermediate prevalence of hepatitis A; and unvaccinated women who anticipate close personal contact with an international adoptee during the first 60 days after arrival in the United States from a country with high or intermediate prevalence of hepatitis A.

Hepatitis B: Vaccination available for those seeking protection against hepatitis B, as well those who are immunocompromised with end-stage renal disease, HIV, chronic liver disease, etc.

Pneumococcal: Adults are recommended to receive 1 dose of 13-valent pneumococcal conjugate vaccine (PCV13) and 1, 2, or 3 doses (depending on indication) of 23-valent pneumococcal polysaccharide vaccine (PPSV23). Women aged 19 through 64 years with chronic heart disease, chronic lung disease, chronic liver disease (including cirrhosis), alcoholism, or diabetes mellitus, or who smoke cigarettes should receive PPSV23. At age ≥65 years, administer PCV13 at least 1 year after PPSV23, followed by another dose of PPSV23 at least 1 year after PCV13 and at least 5 years after the last dose of PPSV23.

Meningococcal: Two different types of vaccinations available. Serogroup A, C, W, and Y meningococcal vaccine is available as a conjugate (MenACWY [Menactra, Menveo]) or a polysaccharide (MPSV4 [Menomune]) vaccine. MenB vaccine is approved for use in persons aged 10 through 25 years. First-year college students aged ≤21 years who live in residence halls should receive a single dose of MenACWY vaccine if they have not received a dose on or after their 16th birthday. Young adults aged 16 through 23 years (preferred age range is 16 through 18 years) may be vaccinated with a series of MenB vaccine to provide short-term protection against most strains of serogroup B meningococcal disease.

Every woman should review her medical history and her immunization record with her provider to make sure she is up to date with all of her vaccinations.

About the Author

Dr. Dyanne Tappin is a member of Rocky Mountain Women’s Health Center on the campus of Salt Lake Regional Medical Center.  She received her undergraduate degree in Chemical Engineering at the Massachusetts Institute of Technology.

Dr. Tappin then earned her Medical Degree at the University of Vermont College of Medicine.  She served a residency in the Department of Obstetrics & Gynecology at Baystate Medical Center at Tufts University in Springfield, Massachusetts. A Fellow of the American College of Obstetrics & Gynecology, Dr. Tappin is also board certified by the American

Board of Obstetrics & Gynecology.  During her studies, she served as a research fellow at the Mayo Clinic, and as a fellow for the Albert Schweitzer Fellowship.  Most recently, Dr. Tappin practiced Obstetrics & Gynecology in Queen Creek, Arizona. Dr. Tappin has a special interest in well woman care, normal and high risk pregnancy, pregnancy planning and contraception, and menopause management. In her leisure time, Dr. Tappin enjoys spending time with her husband and three children. She enjoys reading, writing, and traveling and exploring new cuisines and cultures. Dr. Tappin is accepting new patients, please call Rocky Mountain Women’s Health Center at 801.214.7650.