Adult Immunization Schedule by Age
Recommendations for Ages 19 Years or Older, United States, 2024
Legend
Recommended vaccination for adults who meet age requirement, lack documentation of vaccination, or lack evidence of immunity
Recommended vaccination for adults with an additional risk factor or another indication
Recommended vaccination based on shared clinical decision-making
No recommendation/Not applicable
Vaccine | 19-26 years | 27-49 years | 50-64 years | ≥65 years | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
COVID-19 ![]() |
1 or more doses of updated (2023-2024 Formula) vaccine (See notes) | ||||||||||||
Influenza inactivated (IIV4) or Influenza recombinant (RIV4) ![]() |
1 dose annually | ||||||||||||
![]() Influenza live attenuated (LAIV4) ![]() |
![]() 1 dose annually |
||||||||||||
Respiratory Syncytial Virus (RSV) ![]() |
Seasonal administration during pregnancy. (See notes) | ≥60 years | |||||||||||
Tetanus, diphtheria, pertussis (Tdap or Td) ![]() |
1 dose Tdap each pregnancy; 1 dose Td/Tdap for wound management (See notes) | ||||||||||||
1 dose Tdap, then Td or Tdap booster every 10 years | |||||||||||||
Measles, mumps, rubella (MMR) ![]() |
1 or 2 doses depending on indication (if born in 1957 or later) |
For healthcare personnel, (See notes) |
|||||||||||
Varicella (VAR) ![]() |
2 doses (if born in 1980 or later) |
2 doses | |||||||||||
Zoster recombinant (RZV) ![]() |
2 doses for immunocompromising conditions (See notes) | 2 doses | |||||||||||
Human papillomavirus (HPV) ![]() |
2 or 3 doses depending on age at initial vaccination or condition | 27 through 45 years | |||||||||||
Pneumococcal (PCV15, PCV20, PPSV23) ![]() |
See Notes | ||||||||||||
See Notes | |||||||||||||
Hepatitis A (HepA) ![]() |
2, 3, or 4 doses depending on vaccine | ||||||||||||
Hepatitis B (HepB) ![]() |
2, 3, or 4 doses depending on vaccine or | condition | |||||||||||
Meningococcal A, C, W, Y (MenACWY) ![]() |
1 or 2 doses depending on indication, See notes for booster recommendations | ||||||||||||
Meningococcal B (MenB) ![]() |
2 or 3 doses depending on vaccine and indication, See notes for booster recommendations | ||||||||||||
19 through 23 years | |||||||||||||
Haemophilus influenzae type b (Hib) ![]() |
1 or 3 doses depending on indication | ||||||||||||
Mpox ![]() |
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.
Appendix – Guide to Contraindications and Precautions to Commonly Used Vaccines
Adapted from Table 4-1 in Advisory Committee on Immunization Practices (ACIP) General Best Practice Guidelines for Immunization: Contraindication and Precautions, Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2023–24 Influenza Season, Contraindications and Precautions for COVID-19 Vaccination, and Contraindications and Precautions for JYNNEOS Vaccination.
- When a contraindication is present, a vaccine should NOT be administered. Kroger A, Bahta L, Hunter P. ACIP General Best Practice Guidelines for Immunization.
- When a precaution is present, vaccination should generally be deferred but might be indicated if the benefit of protection from the vaccine outweighs the risk for an adverse reaction. Kroger A, Bahta L, Hunter P. ACIP General Best Practice Guidelines for Immunization.
- Vaccination providers should check FDA-approved prescribing information for the most complete and updated information, including contraindications, warnings, and precautions. See Package inserts for U.S.-licensed vaccines.
- See package inserts and FDA EUA fact sheets for a full list of vaccine ingredients. mRNA COVID-19 vaccines contain polyethylene glycol (PEG).
Other Vaccines
- When a contraindication is present, a vaccine should NOT be administered. Kroger A, Bahta L, Hunter P. ACIP General Best Practice Guidelines for Immunization. www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html
- When a precaution is present, vaccination should generally be deferred but might be indicated if the benefit of protection from the vaccine outweighs the risk for an adverse reaction. Kroger A, Bahta L, Hunter P. ACIP General Best Practice Guidelines for Immunization. www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html
- Vaccination providers should check FDA-approved prescribing information for the most complete and updated information, including contraindications, warnings, and precautions. Package inserts for U.S.-licensed vaccines are available at www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states.
- For information on the pregnancy exposure registries for persons who were inadvertently vaccinated with Heplisav-B or PreHevbrio while pregnant, please visit heplisavbpregnancyregistry.com/ or www.prehevbrio.com/#safety.
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.
Report
- Suspected cases of reportable vaccine-preventable diseases or outbreaks to the local or state health department
- Clinically significant postvaccination reactions to the Vaccine Adverse Event Reporting System or 800‑822‑7967
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
- Complete Advisory Committee on Immunization Practices (ACIP) recommendations
- ACIP Shared Clinical Decision-Making Recommendations
- General Best Practice Guidelines for Immunization
- Vaccine information statements
- Manual for the Surveillance of Vaccine-Preventable Diseases
(including case identification and outbreak response)