Table 2. Recommended Immunization Schedule for Adults Aged 19 Years or Older by Medical Conditions and Other Indications, United States, 2021

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).

COVID-19 Vaccination

ACIP recommends use of COVID-19 vaccines within the scope of the Emergency Use Authorization or Biologics License Application for the particular vaccine.  Interim ACIP recommendations for the use of COVID-19 vaccines can be found on the ACIP Vaccine Recommendations and Guidelines page.

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

Recommended vaccination based on shared clinical decision-making

Not recommended/ contraindicated —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,
alcoholism1
Chronic
liver disease
Diabetes Health care personnel2 Men who have sex with men
<2003 ≥2003
IIV more info icon. or RIV4 1 dose annually
more info icon.
LAIV4 more info icon.
NOT RECOMMENDED PRECAUTION more info 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. NOT RECOMMENDED* NOT RECOMMENDED 1 or 2 doses depending on indication
VAR more info icon. NOT RECOMMENDED* NOT RECOMMENDED 2 doses
RZV more info icon. 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
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, 3, or 4 doses depending on vaccine or condition <60 years
≥60 years
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 HSCT3 recipients only 1 dose
  1. Precaution for LAIV4 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

Recommended Adult Immunization Schedule for ages 19 years or older, United States, 2021

For vaccine recommendations for persons 18 years of age or younger, see the Recommended Child/ Adolescent Immunization Schedule.

Additional information

COVID-19 Vaccination

ACIP recommends use of COVID-19 vaccines within the scope of the Emergency Use Authorization or Biologics License Application for the particular vaccine.  Interim ACIP recommendations for the use of COVID-19 vaccines can be found on the ACIP Vaccine Recommendations and Guidelines page.

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

Shared clinical decision-making

Special situations

Influenza vaccination

Routine vaccination

Special situations

Measles, mumps, and rubella vaccination

Routine vaccination

Special situations

Meningococcal vaccination

Special situations for MenACWY

Shared clinical decision-making for MenB

Special situations for MenB

Pneumococcal vaccination

Routine vaccination

Shared clinical decision-making

Special situations

(https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6140a4.htm)

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®
PedvaxHIB®
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 LAIV4 FluMist® Quadrivalent
Influenza vaccine, recombinant RIV4 Flublok Quadrivalent®
Measles, mumps, and rubella vaccine MMR M-M-R® II
Meningococcal serogroups A, C, W, Y vaccine MenACWY-D
MenACWY-CRM
MenACWY-TT
Menactra®
Menveo®
MenQuadfi®
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® 23
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

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 icon), American Academy of Family Physicians (AAFPexternal icon), American College of Obstetricians and Gynecologists (ACOGexternal icon), American College of Nurse-Midwives (ACNMexternal icon), and American Academy of Physician Assistants (AAPAexternal icon).

The comprehensive summary of the ACIP recommended changes made to the adult immunization schedule can be found in the February 12, 2021 MMWR.


Report

Injury Claims
All vaccines included in the adult immunization schedule except pneumococcal 23-valent polysaccharide (PPSV23) and zoster (RZV) vaccines are covered by the Vaccine Injury Compensation Program. Information on how to file a vaccine injury claim is available at www.hrsa.gov/vaccinecompensationexternal icon.

Questions or comments
Contact www.cdc.gov/cdc-info or 800-CDC-INFO (800-232-4636), in English or Spanish, 8 a.m.–8 p.m. ET, Monday through Friday, excluding holidays.

Helpful information


Page last reviewed: February 12, 2021