Measles/Mumps/Rubella One dose is given to adults born in 1957 or later and not previously immunized. A second dose may be required in some work or school settings.

Varicella Two doses are given to individuals >/ =13 years of age who have not had chicken pox. The second dose is given 1-2 months after the first.

Influenza Vaccine is administered yearly to individuals >/= 65 years of age; to younger people with chronic medical problems, such as heart disease and diabetes; and to those who work or live with high-risk persons.

Streptococcus pneumoniae Vaccine is usually given once to individuals >/= 65 years of age. A repeat dose may be given 5 years later for those at highest risk. Immunization is also recommended for younger people with chronic medical problems such as heart disease, diabetes, renal failure, and sickle cell anaemia, and for those who work or live with high risk persons.

Use of vaccine in special circumstances.

Pregnancy Routine immunization is best avoided.

Breast feeding Neither killed nor live vaccines affects safety of breast feeding for either mother or infant.

Occupational exposure Hepatitis B / Rubella vaccine recommended for susceptible health care workers. Measles, Varicella and Influenza vaccines also advised in special situations.

HIV infection Live attenuated vaccines such as BCG and OPV are contraindicated.

Post exposure immunization Advised for Measles, Tetanus, Hepatitis A, Hepatitis B and Rabies.

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