Table 2. Recommended Adult Immunization Schedule by Medical Condition and Other Indications, United States, 2021

¶ = 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
^ = Delay vaccination until after pregnancy if vaccine is indicated
± = Not recommended/ contraindicated —vaccine should not be administered
• = 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,
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.
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. 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¶ § 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.