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Adult vaccination recommendations take into account the individual's risk for certain diseases. Some recommendations apply to the general public, others to older adults or people with certain underlying diseases or conditions, and others target certain groups' behaviour and environment, e.g., travelling, work environment, or social environment.
General recommendations for adult vaccination:
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It is no longer available as a single-component vaccine but with diphtheria and pertussis, or diphtheria, pertussis, and polio.
The toxin-producing bacterium C. tetani is found in the soil in Iceland and worldwide. Infection is most associated with wounds contaminated with soil, especially in rural areas where livestock have left waste. Vaccination is recommended every ten years if there is a risk of infection during travel. Still, when the risk of infection is high, e.g. following an injury that is contaminated with soil or other dirt, it is often considered to vaccinate if 5-7 years have passed or if it is uncertain how long has passed. If an utterly unvaccinated person develops such a wound, a tetanus antibody should be administered at the time of wound care, as there is no specific treatment for tetanus, which can be painful, chronic, and life-threatening. Antibodies are made from the blood of vaccinated humans or animals.
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It is not available as a single-component vaccine but with tetanus and pertussis, or tetanus, pertussis, and polio.
The toxigenic forms of C. diphtheriae that can cause diphtheria are endemic in large parts of the world, and vaccination is recommended every ten years in connection with travel in general. Still, the reality is that it is usually done in connection with travel to countries in Africa, Asia, and South America. However, the infection does exist in A-Europe, and imported infection within the European Union member countries has been noticeable in the past year.
Unvaccinated children sickened by toxigenic C. diphtheriae can be treated with specific antibodies if diagnosed in time, but they must then be imported separately. Antibodies are made from the blood of vaccinated humans or animals.
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It is hardly available as a single-component vaccine, most commonly given with tetanus, diphtheria, and pertussis.
Vaccination is recommended every ten years concerning travel to endemic areas or where there has been a recent epidemic. Afghanistan and Pakistan are the only countries where natural poliovirus is still endemic. In many parts of the world, however, outbreaks have occurred due to a weakened virus from a live vaccine when participation in vaccinations is insufficient. A live vaccine has not been used in this country, but an inactivated vaccine. It protects a vaccinated person against polio but does not prevent the virus from entering the gastrointestinal tract, which can then be contagious even if the person does not get sick with polio. A live vaccine must, therefore, be used to reduce the spread of such outbreaks, and a new, more weakened version of it is expected on the market to reduce the likelihood of further outbreaks. In the year 2022, paralysis occurred in a young, unvaccinated man in New York state in the United States, and a virus that can cause epidemics in unvaccinated people was persistently detected in sewage in London, so vaccination has been temporarily recommended if ten years have passed since the previous vaccination, due to all travel.
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People born between 1974 and 1987 have not received universal vaccination with MMR. A history of measles or mumps cannot be stated for this age group. Vaccination can reduce serious illness from measles and mumps, even in middle age, and it is recommended that people considered susceptible to either disease consider vaccination. One dose is sufficient after the age of 12.
Recommendations for priority vaccination groups:
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Pneumonia vaccination: One dose of polysaccharide vaccine or 20-valent protein-based vaccine if polysaccharide vaccine is unavailable or according to medical advice. If individuals have previously received a pneumococcal vaccine before their 60th birthday, vaccination is recommended (according to pneumococcal vaccination guidelines) (Icelandic).
Influenza vaccination: Annual vaccination against influenza in autumn.
COVID-19 vaccination: Vaccination against COVID-19 according to further instructions in each case.
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A pertussis vaccination (with a trivalent vaccine containing tetanus and diphtheria or a quadrivalent vaccine containing tetanus, diphtheria, and poliomyelitis): After 18 weeks of pregnancy during each pregnancy (first vaccination of the child). Vaccination done in the first trimester protects newborns much less against pertussis, and it is recommended to be repeated later in pregnancy.
Influenza vaccination: Annual influenza vaccination during the autumn, irrespective of gestational age.
COVID-19 vaccination: Vaccination against COVID-19 irrespective of gestational age, according to further instructions in each case.
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HPV vaccination: All vaccines are considered, but activity against wart viruses is preferred, at least one dose or as directed (up to age 27).
Vaccination against hepatitis A and B according to instructions (can be given together or separately).
Vaccination against Mpox according to special instructions.
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Asthma treated routinely:
Influenza vaccination: Annual influenza vaccination 2024-2025.
Heart, lung, kidney and liver disease, diabetes:
Pneumonia vaccination: See pneumococcal vaccination guidelines (Icelandic). One dose of protein-based vaccine AND one dose of polysaccharide vaccine six months later. If a polysaccharide vaccine is given before 60, it is repeated at least five years after the previous dose.
Influenza vaccination: Annual influenza vaccination in the autumn
COVID-19 vaccination: Vaccination against COVID-19, according to further instructions in each case.
In addition, if the patient is on hemodialysis due to kidney failure or requires frequent blood transfusions:
Vaccination against hepatitis B according to leaflet.
HIV-positive individuals:
Pneumonia vaccination: See pneumococcal vaccination guidelines (Icelandic). One dose of protein-based vaccine AND one dose of polysaccharide vaccine six months later. If a polysaccharide vaccine is given before 60, it is repeated at least five years after the previous dose.
Influenza vaccination: Annual influenza vaccination in the autumn.
COVID-19 vaccination: Vaccination against COVID-19, according to further instructions in each case.
HPV vaccination: The most widely available vaccine, at least two doses six months apart (up to age 45), is recommended.
Immunosuppressive disorders and treatments in general (including cancer treatment):
Pneumonia vaccination: See pneumococcal vaccination guidelines (Icelandic). One dose of protein-based vaccine AND one dose of polysaccharide vaccine six months later. If a polysaccharide vaccine is given before 60, it is repeated at least five years after the previous dose.
Influenza vaccination: Annual influenza vaccination in the autumn.
COVID-19 vaccination: Vaccination against COVID-19, according to further instructions in each case.
Immunosuppressive diseases and treatments which increase, in particular, the risk of infections due to encapsulated bacteria (including sickle cell anemia, splenomegaly, and MBL deficiency):
Pneumonia vaccination: See pneumococcal vaccination guidelines (Icelandic). One dose of protein-based vaccine AND one dose of polysaccharide vaccine six months later. If a polysaccharide vaccine is given before 60, it is repeated at least five years after the previous dose.
Influenza vaccination: Annual influenza vaccination in the autumn.
COVID-19 vaccination: Vaccination against COVID-19, according to further instructions in each case.
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Households of hepatitis B infected persons:
Hepatitis B vaccination (paid by institutions which vaccinate)
Note! Not only for newborns of infected mothers.
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Upon employment and annually after that, the vaccination status of healthcare practitioners must be reviewed, and vaccination must be offered by the following:
MMR twice, regardless of age at first dose. Minimum four weeks between doses. MMR can be given a third time to healthcare practitioners if >10 years have passed since the last dose, and there is an ongoing mumps or measles outbreak, with dissemination among the vaccinated.
A pertussis vaccination (with a trivalent tetanus-diphtheria vaccine or quadrivalent tetanus-, diphtheria- and poliomyelitis vaccine): Every ten years.
Hepatitis B vaccination: 3 doses per lifetime; revaccination is not recommended.
Influenza vaccination: Annual influenza vaccination during the autumn. Reduces the risk of infecting vulnerable individuals with influenza by healthy workers with low symptoms.
COVID-19 vaccination: Vaccination against COVID-19 according to further instructions in each case.
For employees at particular risk of infection, it is also possible to offer:
Vaccination against Mpox/smallpox according to specific instructions (laboratory workers handling susceptible samples, staff on reception teams in case of outbreaks).
Vaccination against meningococcal meningitis (laboratory workers analysing meningococcal disease, possibly emergency department workers in case of the epidemic).
Vaccination against pneumococcus (all workers from 60 years of age).
Service provider
Directorate of Health