Adult Immunization Schedule by Medical Condition and Other Indication
Recommendations for Ages 19 Years or Older, United States, 2023
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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
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 ¶ |
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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 ¶ | § |