Adult Immunization Schedule by Medical Condition and Other Indication
Recommendations for Ages 19 Years or Older, United States, 2022
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¶ = Recommended vaccination for adults who meet age requirement, lack documentation of vaccination, or lack evidence of past infection
§ = Recommended vaccination for adults with an additional risk factor or another indication
^ = Recommended vaccination based on shared clinical decision-making
| = Precaution—vaccination might be indicated if benefit of protection outweighs risk of adverse reaction
± = Contraindicated or not recommended—vaccine should not be administered. *Vaccinate after pregnancy.
• = No recommendation/ Not applicable
Vaccine | Pregnancy | Immuno-compromised (excluding HIV infection) |
HIV infection CD4 count |
Asplenia, complement deficiencies | End-stage renal disease, or on hemodialysis | Heart or lung disease; alcoholisma |
Chronic liver disease |
Diabetes | Healthcare personnelb | Men who have sex with men | |
---|---|---|---|---|---|---|---|---|---|---|---|
<15% or <200mm3 | ≥15% and ≥200mm3 | ||||||||||
COVID-19 ![]() |
¶ | See notes ¶ | ¶ | ||||||||
IIV4 ![]() |
1 dose annually ¶ | ||||||||||
![]() LAIV4 ![]() |
Contraindicated ± | Precaution | | ![]() 1 dose annually ¶ |
||||||||
Tdap or Td ![]() |
1 dose Tdap each pregnancy ¶ | 1 dose Tdap, then Td or Tdap booster every 10 yrs ¶ | |||||||||
MMR ![]() |
Contraindicated* ± | Contraindicated ± | 1 or 2 doses depending on indication ¶ | ||||||||
VAR ![]() |
Contraindicated* ± | Contraindicated ± | ^ | 2 doses ¶ | |||||||
RZV ![]() |
• | 2 doses at age ≥19 years ¶ | 2 doses at age ≥50 yrs ¶ | ||||||||
HPV ![]() |
Not Recommended* ± | 3 doses through age 26 yrs ¶ | 2 or 3 doses through age 26 years depending on age at initial vaccination or condition ¶ | ||||||||
Pneumococcal (PCV15, PCV20,PPSV23) ![]() |
• | 1 dose PCV15 followed by PPSV23 OR 1 dose PCV20 ¶ | (see notes) § | ||||||||
HepA ![]() |
§ | ¶ | 2, 3, or 4 doses § | depending ¶ | on vaccine § | ¶ | |||||
HepB ![]() |
3 doses (see notes) ¶ | 2, 3, or 4 doses depending on vaccine or condition ¶ | |||||||||
MenACWY ![]() |
1 or 2 § | doses depending on indication, see notes ¶ | for booster recommendations § | ||||||||
MenB ![]() |
Precaution | | 2 or 3 doses § | depending on ¶ | vaccine and indication, see notes for booster recommendations § | |||||||
Hib ![]() |
• | 3 doses HSCTc recipients only ¶ | § | 1 dose ¶ | § |
- Precaution for LAIV does not apply to alcoholism.
- See notes for influenza; hepatitis B; measles, mumps, and rubella; and varicella vaccinations.
- Hematopoietic stem cell transplant.
Administer recommended vaccines if vaccination history is incomplete or unknown. Do not restart or add doses to vaccine series if there are extended intervals between doses. The use of trade names is for identification purposes only and does not imply endorsement by the ACIP or CDC.
Notes
For vaccine recommendations for persons 18 years of age or younger, see the Recommended Child and Adolescent Immunization Schedule.
Vaccines in the Adult Immunization Schedule
Vaccine | Abbreviation(s) | Trade name(s) |
---|---|---|
COVID-19 vaccine | 1vCOV-mRNA | Comirnaty®/Pfizer- BioNTech COVID-19 Vaccine |
SPIKEVAX®/Moderna COVID-19 Vaccine | ||
2vCOV-mRNA | Pfizer-BioNTech COVID-19 Vaccine, Bivalent | |
Moderna COVID-19 Vaccine, Bivalent | ||
1vCOV-aPS | Novavax COVID-19 Vaccine | |
Haemophilus influenzae type b vaccine | Hib | ActHIB® Hiberix® PedvaxHIB® |
Hepatitis A vaccine | HepA | Havrix® Vaqta® |
Hepatitis A and hepatitis B vaccine | HepA-HepB | Twinrix® |
Hepatitis B vaccine | HepB | Engerix-B® Heplisav-B® PreHevbrio® Recombivax HB® |
Human papillomavirus vaccine | HPV | Gardasil 9® |
Influenza vaccine (inactivated) | IIV4 | Many brands |
Influenza vaccine (live, attenuated) | LAIV4 | FluMist® Quadrivalent |
Influenza vaccine (recombinant) | RIV4 | Flublok® Quadrivalent |
Measles, mumps, and rubella vaccine | MMR | M-M-R II® Priorix® |
Meningococcal serogroups A, C, W, Y vaccine | MenACWY-D | Menactra® |
MenACWY-CRM | Menveo® | |
MenACWY-TT | MenQuadfi® | |
Meningococcal serogroup B vaccine | MenB-4C | Bexsero® |
MenB-FHbp | Trumenba® | |
Pneumococcal conjugate vaccine | PCV15 | Vaxneuvance™ |
PCV20 | Prevnar 20™ | |
Pneumococcal polysaccharide vaccine | PPSV23 | Pneumovax 23® |
Poliovirus vaccine | IPV | IPOL® |
Tetanus and diphtheria toxoids | Td | Tenivac® Tdvax™ |
Tetanus and diphtheria toxoids and acellular pertussis vaccine | Tdap | Adacel® Boostrix® |
Varicella vaccine | VAR | Varivax® |
Zoster vaccine, recombinant | RZV | Shingrix |
*Administer recommended vaccines if vaccination history is incomplete or unknown. Do not restart or add doses to vaccine series if there are extended intervals between doses. The use of trade names is for identification purposes only and does not imply endorsement by the ACIP or CDC.
This schedule is recommended by the Advisory Committee on Immunization Practices (ACIP) and approved by the Centers for Disease
Control and Prevention (CDC), American College of Physicians (ACP), American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), American College of Nurse-Midwives (ACNM), American Academy of Physician Associates (AAPA), American Pharmacists Association (APhA), and Society for Healthcare Epidemiology of America (SHEA).
The comprehensive summary of the ACIP recommended changes made to the adult immunization schedule can be found in the February 10, 2023 MMWR.