Table 2. Recommended Immunization Schedule for Adults Aged 19 Years or Older by Medical Conditions and Other Indications, United States, 2019

Always make recommendations by determining needed vaccines based on age (Table 1), assessing for medical conditions and other indications (Table 2), and reviewing special situations (Notes).

Legend

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

Precaution—vaccine might be indicated if benefit of protection outweighs risk of adverse reaction

Delay vaccination until after pregnancy if vaccine is indicated

Contraindicated—vaccine should not be administered because of risk for serious adverse reaction

No recommendation

adult conditions vaccine schedule
Vaccine Pregnancy Immuno-compromised
(excluding HIV infection)
HIV infection
CD4 count
Asplenia, complement deficiencies End-stage renal disease, on hemodialysis Heart or lung disease, alcoholism1 Chronic
liver disease
Diabetes Health care personnel2 Men who have sex with men
<200 ≥200
IIV more info icon. or RIV 1 dose annually
more info icon.
LAIV more info icon.
CONTRAINDICATED PRECAUTION more info icon.
1 dose annually
Tdap or Td more info icon. 1 dose Tdap each pregnancy 1 dose Tdap, then Td booster every 10 yrs
MMR more info icon. CONTRAINDICATED 1 or 2 doses depending on indication
VAR more info icon. CONTRAINDICATED 2 doses
RZV(preferred) more info icon. DELAY 2 doses at age ≥50 yrs
more info icon.
ZVL more info icon.
CONTRAINDICATED more info icon.
1 dose at age ≥60 yrs
HPV more info icon. Female DELAY 3 doses through age 26 yrs 2 or 3 doses through age 26 yrs
HPV more info icon. Male 3 doses through age 26 yrs 2 or 3 doses through age 21 yrs 2 or 3 doses through age 26 yrs
PCV13 more info icon. 1 dose
PPSV23 more info icon. 1, 2,or 3 doses depending on age and indication
HepA more info icon. 2 or 3 doses depending on vaccine
HepB more info icon. 2 or 3 doses depending on vaccine
MenACWY more info icon. 1 or 2 doses depending on indication, then booster every 5 yrs if risk remains
MenB more info icon. PRECAUTION 2 or 3 doses depending on indication
Hib more info icon. 3 doses HSCT3 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.

Notes

Recommended Adult Immunization Schedule, for ages 19 years or older, United States, 2019

For vaccine recommendations for persons age 0 through 18 years, see the Child and Adolescent Immunization Schedule.

Haemophilus influenzae type b vaccination

Special situations

Hepatitis A vaccination

Routine vaccination

Special situations

Hepatitis B vaccination

Routine vaccination

Special situations

Human papillomavirus vaccination

Routine vaccination

Special situations

Influenza vaccination

Routine vaccination

Special situations

Measles, mumps, and rubella vaccination

Routine vaccination

Special situations

Meningococcal vaccination

Special situations for MenACWY

Special situations for MenB

Pneumococcal vaccination

Routine vaccination

Special situations

Tetanus, diphtheria, and pertussis vaccination

Routine vaccination

Special situations

Varicella vaccination

Routine vaccination

Special situations

Zoster vaccination

Routine vaccination

Special situations

 

Vaccines in the Adult Immunization Schedule*

adult vaccine schedule
Vaccines Abbreviations Trade names
Haemophilus influenzae type b Hib ActHIB
Hiberix
Hepatitis A vaccine HepA Havrix
Vaqta
Hepatitis A and hepatitis B vaccine HepA-HepB Twinrix
Hepatitis B vaccine HepB Engerix-B
Recombivax HB
Heplisav-B
Human papillomavirus vaccine HPV vaccine Gardasil 9
Influenza vaccine, inactivated IIV  Many brands
Influenza vaccine, live attenuated LAIV FluMist Quadrivalent
Influenza vaccine, recombinant RIV Flublok Quadrivalent
Measles, mumps, and rubella vaccine MMR M-M-R II
Meningococcal serogroups A, C, W, Y vaccine MenACWY Menactra
Menveo
Meningococcal serogroup B vaccine MenB-4C
MenB-FHbp
Bexsero
Trumenba
Pneumococcal 13-valent conjugate vaccine PCV13  Prevnar 13
Pneumococcal 23-valent polysaccharide vaccine PPSV23  Pneumovax
Tetanus and diphtheria toxoids Td Tenivac
Td vaccine
Tetanus and diphtheria toxoids and acellular pertussis vaccine Tdap Adacel
Boostrix
Varicella vaccine VAR  Varivax
Zoster vaccine, recombinant RZV  Shingrix
Zoster vaccine live ZVL  Zostavax

*Administer recommended vaccines if vaccination history is incomplete or unknown. Do not restart or add doses to vaccine series for 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 (ACPExternal file_external ), American Academy of Family Physicians (AAFPExternal file_external ), American College of Obstetricians and Gynecologists (ACOGExternal file_external ), and American College of Nurse-Midwives (ACNMExternal file_external ).

The comprehensive summary of the ACIP recommended changes made to the adult immunization schedule can be found in the February 8, 2019 MMWR.


Page last reviewed: February 5, 2019