Adult Immunization

At every preventive, chronic-care, preconception, transplant, dialysis, oncology, HIV, and medication-management visit, document age, prior vaccine products and dates, pregnancy status, immune status, occupational exposure, travel or outbreak exposure, asplenia, complement deficiency or complement-inhibitor therapy, and prior severe vaccine reactions. The ACIP adult schedule is a consolidated summary, but its tables, notes, appendix, and interim addendum must be used together because indications and contraindications are vaccine-specific. CDC+1CDCAdvisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older — United States, 2025 | MMWRCDCAdult Immunization Schedule by Medical Condition and Other Indication (Addendum updated July 2, 2025) | Vaccines & Immunizations | CDC

When documentation is incomplete or unavailable, administer vaccines indicated by age, risk, or condition rather than waiting to reconstruct the record. Do not restart or add doses solely because the interval since a previous dose exceeded the recommended interval. CDCCDCAdult Immunization Schedule Notes | Vaccines & Immunizations - CDC

Before any live vaccine, actively screen for pregnancy, severe immunodeficiency, recent antibody-containing blood products, and—in the case of varicella-containing vaccines—recent acyclovir, famciclovir, or valacyclovir exposure. These factors change whether vaccination should proceed, be deferred, or require a product-specific timing plan. CDCCDCChild Immunization Schedule Appendix | Vaccines & Immunizations | CDC

For adults with moderate or severe immunocompromise, use the condition-specific adult schedule rather than a generic age-only pathway. The schedule specifically distinguishes immunocompromise excluding HIV from HIV categories stratified by CD4 percentage and count, and flags circumstances in which additional doses may be needed. CDCCDCAdult Immunization Schedule by Medical Condition and Other Indication (Addendum updated July 2, 2025) | Vaccines & Immunizations | CDC

For 2024-2025 COVID-19 vaccination, adults aged 6 months through 64 years with moderate or severe immunocompromise are recommended to receive a second dose 6 months after the first dose, with a minimum interval of 2 months. Additional doses—three or more during the season—may be given through shared clinical decision-making at intervals of at least 2 months after the most recent dose. Protection against COVID-19-associated emergency department, urgent care, and hospital care waned to approximately zero by 4-6 months in older-adult analyses, supporting attention to interval timing in patients at highest consequence of infection. CDCCDCAdvisory Committee on Immunization Practices (ACIP) Evidence to Recommendations (EtR) for Use of Additional Doses of 2024-2025 COVID-19 Vaccines in Older Adults and People who are Moderately or Severely Immunocompromised | ACIP | CDC

Give recombinant zoster vaccine to adults aged 19 years and older who are or will be immunocompromised, including persons with HIV regardless of CD4 count, as 2 doses separated by 2-6 months; the minimum interval is 4 weeks. Repeat a dose given sooner than the minimum interval. CDCCDC[PDF] Recommended Adult Immunization Schedule | CDC

For HIV care, determine hepatitis A immunity with HAV IgG when relevant. In patients who are HAV IgG-negative, give HepA as 2 doses at 0 and 6-12 months with Havrix or at 0 and 6-18 months with Vaqta. For patients without immunity to both HAV and HBV, an option is HepA plus 2 doses of HepB-CpG; if HepB-CpG is unavailable, use combined HepA-HepB vaccine at 0, 1, and 6 months. clinicalinfo hivclinicalinfo hivImmunizations for Preventable Diseases in Adults and Adolescents ...

Do not equate all HIV infection with a live-vaccine contraindication, but do not give MMR to patients with severe immunodeficiency. The adult condition schedule separates HIV strata by CD4 percentage and absolute count, and the MMR contraindication includes severely immunocompromised HIV infection. CDC+1CDCAdult Immunization Schedule by Medical Condition and Other Indication (Addendum updated July 2, 2025) | Vaccines & Immunizations | CDCCDCChild Immunization Schedule Appendix | Vaccines & Immunizations | CDC

For influenza prevention, administer 1 dose of inactivated or recombinant influenza vaccine annually to adults, including persons with HIV and patients with medical conditions represented in the adult condition schedule. The schedule identifies live attenuated influenza vaccine as an option only for adults aged 19-49 years in the listed eligible populations; use the appendix and product-specific contraindications before selecting a live product. CDC+1CDCAdult Immunization Schedule by Medical Condition and Other Indication (Addendum updated July 2, 2025) | Vaccines & Immunizations | CDCCDCChild Immunization Schedule Appendix | Vaccines & Immunizations | CDC

For adults aged 65 years and older, schedule a second 2024-2025 COVID-19 vaccine dose 6 months after the prior dose, with a minimum interval of 2 months. Do not apply obsolete booster schedules in place of the current seasonal recommendation. CDCCDCAdvisory Committee on Immunization Practices (ACIP) Evidence to Recommendations (EtR) for Use of Additional Doses of 2024-2025 COVID-19 Vaccines in Older Adults and People who are Moderately or Severely Immunocompromised | ACIP | CDC

For RSV prevention, adults aged 50-59 years who are at increased risk of severe RSV disease should receive a single RSV vaccine dose. Adults already vaccinated against RSV are not recommended to receive another dose at this time. RSV vaccine may be administered with any licensed product in this age group. CDC+1CDC[PDF] Recommended Adult Immunization Schedule | CDCCDCACIP Recommendations - CDC

Discuss neurologic safety when RSV vaccination is being considered in a patient with prior Guillain-Barré syndrome or an individual concern about neurologic events. ACIP noted a small number of inflammatory neurologic events, particularly Guillain-Barré syndrome, in clinical trials of both GSK and Pfizer RSV vaccines in older adults; this is a risk-benefit conversation rather than a blanket contraindication in the cited guidance. CDCCDC[PDF] RSV Vaccination in Older Adults: Work Group Interpretations - CDC

Do not administer MMR to a patient with prior severe allergic reaction to a vaccine component or prior dose, severe immunodeficiency, or pregnancy. Severe immunodeficiency includes hematologic and solid tumors, chemotherapy, congenital immunodeficiency, long-term immunosuppressive therapy, and severely immunocompromised HIV infection. CDCCDCChild Immunization Schedule Appendix | Vaccines & Immunizations | CDC

If MMR is otherwise indicated but the patient received an antibody-containing blood product within the preceding 11 months, defer vaccination for the product-specific interval. A history of thrombocytopenia or thrombocytopenic purpura and a need for tuberculin skin testing or interferon-gamma release assay are precautions requiring timing review rather than automatic exclusion. CDCCDCChild Immunization Schedule Appendix | Vaccines & Immunizations | CDC

For pregnancy, give 1 dose of Tdap during each pregnancy. Do not use MMR during pregnancy; manage nonimmune status by vaccinating after pregnancy when indicated. RZV has no ACIP recommendation for use during pregnancy, and delaying it until after pregnancy should be considered. CDC+2CDCAdult Immunization Schedule by Medical Condition and Other Indication (Addendum updated July 2, 2025) | Vaccines & Immunizations | CDCCDCChild Immunization Schedule Appendix | Vaccines & Immunizations | CDCCDC[PDF] Recommended Adult Immunization Schedule | CDC

For M-M-R II, administer a 0.5 mL dose by intramuscular or subcutaneous route. The routine labeled childhood schedule is first dose at 12-15 months and second dose at 4-6 years; when a second dose is given before age 4 years, maintain a minimum interval of 1 month. After reconstitution, administer immediately or refrigerate at 2-8°C protected from light for no more than 8 hours, then discard. fdafda[PDF] Package Insert - Measles, Mumps, and Rubella Virus Vaccine Live

For persons aged 10 years and older at increased risk for serogroup B meningococcal disease, administer MenB-4C as a 3-dose series at 0, 1-2, and 6 months. Increased-risk groups include anatomic or functional asplenia, complement component deficiencies, complement-inhibitor use, routine microbiology exposure to Neisseria meningitidis isolates, and persons at increased risk during an outbreak. CDCCDCACIP Recommendations - CDC

For healthy persons aged 16-23 years, MenB vaccination is a shared clinical decision-making option. When both MenACWY and MenB are indicated at the same visit, a MenABCWY product may be used. Do not substitute the shared-decision pathway for the higher-risk primary series in asplenia, complement disorders, complement-inhibitor therapy, laboratory exposure, or outbreak settings. CDCCDCACIP Recommendations - CDC

For HIV patients without HAV immunity, choose a documented HepA formulation and schedule rather than simply recording a nonspecific hepatitis vaccine recommendation: Havrix is given at 0 and 6-12 months, whereas Vaqta is given at 0 and 6-18 months. If both HAV and HBV immunity are absent, HepA plus two doses of HepB-CpG is an option; combined HepA-HepB at 0, 1, and 6 months is an alternative when HepB-CpG is unavailable. clinicalinfo hivclinicalinfo hivImmunizations for Preventable Diseases in Adults and Adolescents ...

Inspect injectable vaccine products visually for particulate matter and discoloration whenever the solution and container permit; do not administer a vaccine if either is present. For multidose influenza vaccine preparations, return the vial to 2-8°C between uses, do not freeze, and follow the labeled discard requirements. fdafda[PDF] Individuals using assistive technology may not be able to fully - FDA

For M-M-R II, use the entire approximately 0.5 mL reconstituted dose and administer by intramuscular or subcutaneous route. If reconstitution is not immediately followed by administration, retain the dose at 2-8°C, protect it from light, and discard it after 8 hours. fdafda[PDF] Package Insert - Measles, Mumps, and Rubella Virus Vaccine Live

Document product, dose, route, site, date, indication, planned next dose, and any precaution reviewed. For patients needing serial doses, schedule the next date before they leave; this is particularly important for RZV, COVID-19 vaccination in immunocompromised persons, MenB-4C, HepA, and combined HepA-HepB regimens. CDC+3CDC[PDF] Recommended Adult Immunization Schedule | CDCCDCAdvisory Committee on Immunization Practices (ACIP) Evidence to Recommendations (EtR) for Use of Additional Doses of 2024-2025 COVID-19 Vaccines in Older Adults and People who are Moderately or Severely Immunocompromised | ACIP | CDCclinicalinfo hivImmunizations for Preventable Diseases in Adults and Adolescents ...CDCACIP Recommendations - CDC