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Am Fam Physician. 2007;76(10):1434

The 2007–08 adult immunization schedule from the Advisory Committee on Immunization Practices (ACIP) appears on page 1558 of this issue of AFP. Changes to this year's schedule include the addition of the quadrivalent human papillomavirus vaccine (Gardasil) for young women and herpes zoster virus vaccine (Zostavax) for older adults. A second dose of varicella vaccine is also recommended for young adults who have received only one dose.

In a related commentary, Doug Campos-Outcalt, MD, MPA, and Jonathan L. Temte, MD, PhD, liaisons to ACIP for the AAFP, remind physicians that adult immunization rates are far below national goals. In 2005, fewer than 60 percent of adults 65 years and older had been vaccinated against influenza in the previous year. The Healthy People 2010 goal is 90 percent. The Task Force on Community Preventive Services has made several recommendations to help increase vaccination coverage levels, including offering expanded clinic hours for immunizations and the use of standing orders to allow office staff to vaccinate patients. Just as important, as Drs. Campos-Outcalt and Temte point out, physicians must ensure that they and their office staff are fully immunized to reduce the risk of spreading infectious diseases to their patients and community.

Have You Noticed Close-ups?

In April of this year, AFP introduced the department “Close-ups: A Patient's Perspective,” which focuses on the human side of medicine. A patient's story, told in his or her own words, is accompanied by commentary from the patient's physician or another physician and a list of resources to help physicians and patients. The goal is to keep the focus on the person and the nuances of the doctor-patient relationship, rather than just the illness.

Thus far, contributions to this department have presented descriptions of a range of patients' challenges, including caring for an aging spouse at home, living with restless legs syndrome, experiences of recurrent pregnancy loss, and how surviving colon cancer changed one man's life (see page 1442 of this issue). Other Close-ups have commented on the importance of touch, how small gestures of compassion can mean so much, sharing responsibility for making hard decisions, and helping patients come to terms with the impact of illness or injury.

Caroline Wellbery, MD, associate deputy editor, coordinates this feature. She has partnered with Amy Crawford-Faucher, MD, Tony Miksanek, MD, and Jo-Marie Reilly, MD, to contribute the first several submissions. It has been well received by readers, and we look forward to bringing you more Close-ups in the future.

Now It's Your Turn

As always, our goal is to ensure we have developed a useful, interesting feature in AFP. Readers are our first concern, and we do everything we can to ensure that AFP's content is informative, interesting, and valuable to you. We'd like your feedback on this feature, which is published in the second issue of each month. You can see the collection of published Close-ups at You can mail the comment card or send an e-mail to

Do you have a patient who has a story to tell? Detailed submission guidelines for Close-ups (and all AFP departments) are available in the Authors' Guide at If you are interested in sending a “Close-up,” your submission should include a patient story (about 250 words), a commentary (50 to 100 words), an accompanying photograph, a list of resources (e.g., self-help groups, medical organizations, Web sites) for further information about the key points discussed, and all appropriate forms (see the Authors' Guide for more information). Questions about submissions for Close-Ups may be sent to Caroline Wellbery, MD, at

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Copyright © 2007 by the American Academy of Family Physicians.

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