Adult Immunization Schedule by Medical Condition and Other Indication (Compliant)

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¶ = Recommended for all adults who lack documentation of vaccination, OR lack evidence of immunity
§ = Not recommended for all adults, but recommended for some adults based on either age OR increased risk for or severe outcomes from disease
^ = Recommended based on shared clinical decision-making
| = Recommended for all adults, and additional doses may be necessary based on medical condition or other indications. See Notes.
± = Precaution: Might be indicated if benefit of protection outweighs risk of adverse reaction
# = Contraindicated or not recommended *Vaccinate after pregnancy, if indicated
• = No Guidance/Not Applicable

Vaccine	Pregnancy	Immuno-compromised (excluding HIV infection)	HIV infection CD4 percentage and count		Men who have sex with men	Asplenia, complement deficiency	Heart or lung disease	Kidney failure, End-stage renal disease or on dialysis	Chronic liver disease; alcoholisma	Diabetes	Health care Personnelb
			<15% or <200mm3	≥15% and ≥200mm3
COVID-19	¶	See Notes|		¶	¶
Influenza inactivated Influenza recombinant	¶	Solid organ transplant (See Notes)¶	1 dose annually¶
LAIV3	#				1 dose annually if age 19–49 years§	#	1 dose annually if age 19–				49 years±§
RSV	Seasonal administration. (See Notes)¶	See Notes§		§		See notes§			Liver disease (See Notes)§	See Notes§	§
Tdap or Td	Tdap: 1 dose each pregnancy|	1 dose Tdap, then Td or Tdap booster every 10 yrs¶
MMR	*#	#
VAR	*#	#		See Notes¶	¶
RZV	•	See Notes¶			§
HPV	*#	3-dose series if indicated§			§
Pneumococcal	•	¶			§	¶					§
HepA	§	•	¶			•			¶	•
HepB	See Notes	§	¶			§		¶		¶	¶
										Age ≥ 60 years^
MenACWY	•		|		•	|	•
MenB	±	•				|	•
Hib	•	HSCT: 3 dosesc|	•			Asplenia: 1 dose¶	•
Mpox	See Notes§	§			See Notes§	§					See Notes§
IPV	±	Complete 3-dose series if incompletely vaccinated. Self–report of previous doses acceptable (See Notes)¶

1. Precaution for LAIV3 does not apply to alcoholism.
2. See notes for influenza; hepatitis B; measles, mumps, and rubella; and varicella vaccinations.
3. Hematopoietic stem cell transplant.