Adult Immunization Schedule by Medical Condition and Other Indication

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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	¶	See notes ¶			¶
IIV4 or RIV4	1 dose annually ¶
LAIV4	Contraindicated ±					Precaution |				1 dose annually ¶
Tdap or Td	1 dose Tdap each pregnancy ¶	1 dose Tdap, then Td or Tdap booster every 10 yrs ¶
MMR	Contraindicated* ±	Contraindicated ±		1 or 2 doses depending on indication ¶
VAR	Contraindicated* ±	Contraindicated ±		^	2 doses ¶
RZV	•	2 doses at age ≥19 years ¶			2 doses at age ≥50 yrs ¶
HPV	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)	•	1 dose PCV15 followed by PPSV23 OR 1 dose PCV20 ¶								(see notes) §
HepA	§		¶		2, 3, or 4 doses §			depending ¶	on vaccine §		¶
HepB	3 doses (see notes) ¶	2, 3, or 4 doses depending on vaccine or condition ¶
MenACWY	1 or 2 §		doses depending on indication, see notes ¶			for booster recommendations §
MenB	Precaution |	2 or 3 doses §			depending on ¶	vaccine and indication, see notes for booster recommendations §
Hib	•	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.