Purpose
Guide health care providers in determining recommended vaccines for specific medical or other indications.
How to use the schedule
To make vaccination recommendations, healthcare providers should:
- Determine recommended vaccine by age (Table 1 - By Age)
- Assess need for additional recommended vaccinations by medical condition or other indication (Table 2 - By Medical Condition)
- Review vaccine types, dosing frequencies and intervals, and considerations for special situations (Notes)
- Review contraindications and precautions for vaccine types (Appendix)
- Review new or updated ACIP guidance (Addendum)
Ages 19 Years or Older
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 | Healthcare Personnelb | |
---|---|---|---|---|---|---|---|---|---|---|---|
<15% or <200mm3 | ≥15% and ≥200mm3 | ||||||||||
COVID-19 | See notes | ||||||||||
IIV4 or RIV4 | 1 dose annually | ||||||||||
LAIV4 | 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 | ||||||||
Tdap or Td | Tdap: 1 dose each pregnancy | 1 dose Tdap, then Td or Tdap booster every 10 yrs | |||||||||
MMR | * | 1 or 2 doses depending on indication | |||||||||
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 |
- Precaution for LAIV4 does not apply to alcoholism.
- See notes for influenza; hepatitis B; measles, mumps, and rubella; and varicella vaccinations.
- Hematopoietic stem cell transplant.
To make vaccination recommendations, healthcare providers should:
- Determine recommended vaccine by age (Table 1 - By Age)
- Assess need for additional recommended vaccinations by medical condition or other indication (Table 2 - By Medical Condition)
- Review vaccine types, dosing frequencies and intervals, and considerations for special situations (Notes)
- Review contraindications and precautions for vaccine types (Appendix)
- Review new or updated ACIP guidance (Addendum)
Additional Information
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 adult immunization schedule can be found in the January 11, 2024 MMWR.
Report
- Suspected cases of reportable vaccine-preventable diseases or outbreaks to your state or local health department
- Clinically significant adverse events to the Vaccine Adverse Event Reporting System (VAERS) at www.vaers.hhs.gov 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 (including contraindications and precautions)
- Vaccine information statements
- Manual for the Surveillance of Vaccine-Preventable Diseases
(including case identification and outbreak response)