Previously unvaccinated older children should be vaccinated within five years of initiation of routine childhood vaccination programs. Although rates differ, a reasonable cutoff age in many areas is 10 to 15 years. Vaccination of children before they enter school should receive highest priority, followed by vaccination of older children who have not been vaccinated. Prevaccination serologic testing is not indicated for vaccination of previously unvaccinated children. Men who have sex with men .
Vaccination is recommended for men who have sex with men.
This includes both adolescents and adults. Prevaccination testing is not indicated for the vaccination of adolescents in this group, but may be warranted for adults, especially those over 40 years of age. Illegal-drug users . Vaccination is recommended for injecting and noninjecting illegal-drug users if local epidemiologic and surveillance data indicate current or past outbreaks in persons with such risk behaviors. Prevaccination testing is not indicated for adolescents but may be warranted in these adults.