Adult Immunization Schedule by Medical Condition and Other Indication

Recommendations for Ages 19 Years or Older, United States, 2024

Purpose

Guide health care providers in determining recommended vaccines for specific medical or other indications.

How to use the schedule

Vaccines in the Adult Immunization Schedule

To make vaccination recommendations, healthcare providers should:

  1. Determine recommended vaccine by age (Table 1 - By Age)
  2. Assess need for additional recommended vaccinations by medical condition or other indication (Table 2 - By Medical Condition)
  3. Review vaccine types, dosing frequencies and intervals, and considerations for special situations (Notes)
  4. Review contraindications and precautions for vaccine types (Appendix)
  5. Review new or updated ACIP guidance (Addendum)
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Compliant version of the schedule

Ages 19 Years or Older

Legend

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
Always use this table in conjunction with Table 1 and the Notes that follow. Medical conditions or indications are often not mutually exclusive. If multiple medical conditions or indications are present, refer to guidance in all relevant columns. See Notes for medical conditions or indications not listed.
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 more info icon. See notes
IIV4 more info icon. or RIV4 1 dose annually
LAIV4 more info icon. 1 dose annually if age
19–49 years		 1 dose annually if age 19–49 years
RSV more info icon. Seasonal administration. See notes See notes See notes
Tdap or Td more info icon. Tdap: 1 dose each pregnancy 1 dose Tdap, then Td or Tdap booster every 10 yrs
MMR more info icon. * 1 or 2 doses depending on indication
VAR more info icon. * See notes
RZV more info icon. See notes
HPV more info icon. * 3 dose series if indicated
Pneumococcal more info icon.
HepA more info icon.
HepB more info icon. See notes
Age ≥ 60 years
MenACWY more info icon.
MenB more info icon.
Hib more info icon. HSCT: 3 dosesc Asplenia: 1 dose
Mpox more info icon. See notes See notes See notes
  1. Precaution for LAIV4 does not apply to alcoholism.
  2. See notes for influenza; hepatitis B; measles, mumps, and rubella; and varicella vaccinations.
  3. Hematopoietic stem cell transplant.

To make vaccination recommendations, healthcare providers should:

  1. Determine recommended vaccine by age (Table 1 - By Age)
  2. Assess need for additional recommended vaccinations by medical condition or other indication (Table 2 - By Medical Condition)
  3. Review vaccine types, dosing frequencies and intervals, and considerations for special situations (Notes)
  4. Review contraindications and precautions for vaccine types (Appendix)
  5. 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.

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Content Source:
National Center for Immunization and Respiratory Diseases