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

adult conditions vaccine schedule
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 more info icon. See notes
IIV4 more info icon. or RIV4 1 dose annually ¶
Or icon.
LAIV4 more info icon.
Contraindicated ± Precaution | Or icon.
1 dose annually ¶
Tdap or Td more info icon. 1 dose Tdap each pregnancy ¶ 1 dose Tdap, then Td or Tdap booster every 10 yrs ¶
MMR more info icon. Contraindicated* ± Contraindicated ± 1 or 2 doses depending on indication ¶
VAR more info icon. Contraindicated* ± Contraindicated ± ^ 2 doses ¶
RZV more info icon. 2 doses at age ≥19 years ¶ 2 doses at age ≥50 yrs ¶
HPV more info icon. 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) more info icon. 1 dose PCV15 followed by PPSV23 OR 1 dose PCV20 ¶ (see notes) §
HepA more info icon. § 2, 3, or 4 doses § depending ¶ on vaccine §
HepB more info icon. 3 doses (see notes) ¶ 2, 3, or 4 doses depending on vaccine or condition ¶
MenACWY more info icon. 1 or 2 § doses depending on indication, see notes for booster recommendations §
MenB more info icon. Precaution | 2 or 3 doses § depending on ¶ vaccine and indication, see notes for booster recommendations §
Hib more info icon. 3 doses HSCTc recipients only ¶ § 1 dose ¶ §
  1. Precaution for LAIV does not apply to alcoholism.
  2. See notes for influenza; hepatitis B; measles, mumps, and rubella; and varicella vaccinations.
  3. 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.

COVID-19 vaccination

Haemophilus influenzae type b vaccination

Hepatitis A vaccination

Hepatitis B vaccination

Human papillomavirus vaccination

Influenza vaccination

Measles, mumps, and rubella vaccination

Meningococcal vaccination

Pneumococcal vaccination

Polio vaccination

Tetanus, diphtheria, and pertussis (Tdap) vaccination

Varicella vaccination

Zoster vaccination

Vaccines in the Adult Immunization Schedule

adult vaccine 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.