Adult Immunization Schedule by Medical Condition and Other Indication
Recommendations for Ages 19 Years or Older, United States, 2024
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¶ = Recommended for all adults who lack documentation of vaccination, OR lack evidence of immunity
§ = Not recommended for all adults, but recommended for some adults based on either age OR increased risk for or severe outcomes from disease
^ = Recommended based on shared clinical decision-making
| = Recommended for all adults, and additional doses may be necessary based on medical condition or other indications. See Notes.
± = Precaution: Might be indicated if benefit of protection outweighs risk of adverse reaction
# = Contraindicated or not recommended *Vaccinate after pregnancy, if indicated
• = No Guidance/Not Applicable
Vaccine | Pregnancy | Immuno-compromised (excluding HIV infection) |
HIV infection CD4 percentage and count |
Men who have sex with men | Asplenia, complement deficiency | Heart or lung disease | Kidney failure, End-stage renal disease or on dialysis | Chronic liver disease; alcoholisma | Diabetes | Healthcare Personnelb | |
---|---|---|---|---|---|---|---|---|---|---|---|
<15% or <200mm3 | ≥15% and ≥200mm3 | ||||||||||
COVID-19 ![]() |
¶ | See notes¶ | ¶ | ||||||||
IIV4 ![]() |
1 dose annually¶ | ||||||||||
![]() LAIV4 ![]() |
# | 1 dose annually if age 19-49 years§ | # | 1 dose annually if age 19-49± | years§ | ||||||
RSV ![]() |
Seasonal administration. See notes¶ | See notes^ | ^ | See notes^ | |||||||
Tdap or Td ![]() |
Tdap: 1 dose each pregnancy| | 1 dose Tdap, then Td or Tdap booster every 10 yrs¶ | |||||||||
MMR ![]() |
*# | # | 1 or 2 doses depending on indication¶ | ||||||||
VAR ![]() |
*# | # | See notes¶ | ¶ | |||||||
RZV ![]() |
• | See notes¶ | § | ||||||||
HPV ![]() |
*# | 3 dose series if indicated§ | § | ||||||||
Pneumococcal ![]() |
• | ¶ | § | ¶ | § | ||||||
HepA ![]() |
§ | • | ¶ | • | ¶ | • | |||||
HepB ![]() |
See notes¶ | § | ¶ | § | ¶ | ¶ | ¶ | ||||
Age ≥ 60 years^ | |||||||||||
MenACWY ![]() |
• | | | • | | | • | ||||||
MenB ![]() |
± | • | | | • | |||||||
Hib ![]() |
• | HSCT: 3 dosesc| | • | Asplenia: 1 dose¶ | • | ||||||
Mpox ![]() |
See notes§ | § | See notes§ | § | See notes§ |
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.
Additional information
- For calculating intervals between doses, 4 weeks = 28 Intervals of ≥4 months are determined by calendar months.
- Within a number range (e.g., 12–18), a dash (–) should be read as “through.”
- Vaccine doses administered ≤4 days before the minimum age or interval are considered valid. Doses of any vaccine administered ≥5 days earlier than the minimum age or minimum interval should not be counted as valid and should be repeated. The repeat dose should be spaced after the invalid dose by the recommended minimum interval. For further details, see Table 3-2, Recommended and minimum ages and intervals between vaccine doses, in General Best Practice Guidelines for Immunization.
- Information on travel vaccination requirements and recommendations is available at cdc.gov/travel/.
- For vaccination of persons with immunodeficiencies, see Table 8-1, Vaccination of persons with primary and secondary immunodeficiencies, in General Best Practice Guidelines for Immunization.
- For information about vaccination in the setting of a vaccine-preventable disease outbreak, contact your state or local health department.
- The National Vaccine Injury Compensation Program (VICP) is a no-fault alternative to the traditional legal system for resolving vaccine injury claims. All vaccines included in the adult immunization schedule except PPSV23, RSV, RZV, Mpox, and COVID-19 vaccines are covered by the National Vaccine Injury Compensation Program (VICP). Mpox and COVID-19 vaccines are covered by the Countermeasures Injury Compensation Program (CICP). For more information, see www.hrsa.gov/vaccinecompensation or www.hrsa.gov/cicp.
Addendum – Adult Recommended Immunization Schedule for ages 19 years or older, United States, 2024
In addition to the recommendations presented in the previous sections of this immunization schedule, ACIP has approved the following recommendations by majority vote since October 26, 2023. The following recommendations have been adopted by the CDC Director and are now official. Links are provided if these recommendations have been published in Morbidity and Mortality Weekly Report (MMWR).
Vaccines
Vaccines
Recommendations
Recommendations
Effective Date of
Recommendation*
Effective Date of
Recommendation*
No new vaccines or vaccine recommendations to report
No new vaccines or vaccine recommendations to report
*The effective date is the date when the CDC director adopted the recommendation and when the ACIP recommendation became official.
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 | ||
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-CRM | Menveo® |
MenACWY-TT | MenQuadfi® | |
Meningococcal serogroup B vaccine | MenB-4C | Bexsero® |
MenB-FHbp | Trumenba® | |
Meningococcal serogroup A, B, C, W, Y vaccine | MenACWY-TT/MenB-FHbp | Penbraya™ |
Mpox vaccine | Mpox | Jynneos® |
Pneumococcal conjugate vaccine | PCV15 | Vaxneuvance™ |
PCV20 | Prevnar 20™ | |
Pneumococcal polysaccharide vaccine | PPSV23 | Pneumovax 23® |
Poliovirus vaccine | IPV | Ipol® |
Respiratory syncytial virus vaccine | RSV | Arexvy® Abrysvo™ |
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 child and adolescent immunization schedule will be published in an upcoming MMWR in early 2024.