Recommended Immunization for Adults
These include:
- Influenza
vaccine.
- All adults should be immunized every year.
- All adults, including pregnant women and people with hives-only allergy to eggs can receive the inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV).
- Adults aged 18–64 years can receive the IIV or RIV. The RIV vaccine does not contain any egg protein.
- Adults aged 65 years or older can receive the high-dose or adjuvanted IIV.
- Tetanus,
diphtheria, and acellular pertussis (Td, Tdap) vaccine.
- Pregnant women should receive 1 dose of Tdap vaccine during each pregnancy. The dose should be obtained regardless of the length of time since the last dose. Immunization is preferred during the 27th to 36th week of gestation.
- An adult who has not previously received Tdap or who does not know his or her vaccine status should receive 1 dose of Tdap. This initial dose should be followed by tetanus and diphtheria toxoids (Td) booster doses every 10 years.
- Adults with an unknown or incomplete history of completing a 3-dose immunization series with Td-containing vaccines should begin or complete a primary immunization series including a Tdap dose. The first 2 doses should be received at least 4 weeks apart, and the third dose 6–12 months after the second dose.
- Adults should receive a Td booster every 10 years.
- Varicella
vaccine.
- An adult without evidence of immunity to varicella should receive 2 doses 4–8 weeks apart, or a second dose if he or she has previously received 1 dose.
- Pregnant females who do not have evidence of immunity should receive the first dose after pregnancy. This first dose should be obtained before leaving the health care facility. The second dose should be obtained 4–8 weeks after the first dose.
- All healthcare workers should have evidence of immunity to varicella.
- Adults with cancer or those who are on therapy to suppress the immune system should not receive the varicella vaccine.
- Human
papillomavirus (HPV) vaccine.
- Females aged 13–26 years who have not received the vaccine previously should obtain the 3-dose series. Females should receive the second dose 1–2 months after the first dose, and the third dose 6 months after the first dose.
- The vaccine is not recommended for use in pregnant females. However, pregnancy testing is not needed before receiving a dose. If a female is found to be pregnant after receiving a dose, no treatment is needed. In that case, the remaining doses should be delayed until after the pregnancy.
- Males aged 13–21 years who have not received the vaccine previously should receive the 3-dose series. Males aged 22–26 years may also receive a 3 dose series. Males should receive the second dose 1–2 months after the first dose, and the third dose 6 months after the first dose.
- Adult females up to age 26 years and adult males up to age 21 years who initiated the HPV vaccine series before age 15 years and received 2 doses at least 5 months apart do not need an additional dose of the vaccine.
- Adult females up to age 26 years and adult male up to age 21 years who initiated the HPV vaccine series before 15 years but only received 1 dose or 2 doses less than 5 months apart should receive 1 additional dose of the vaccine.
- Immunization is recommended through the age of 26 years for any male who has sex with males and did not get any or all doses earlier.
- Immunization is recommended for any person with an immunocompromised condition through the age of 26 years if he or she did not get any or all doses earlier.
- Zoster
vaccine.
- One dose is recommended for adults aged 60 years or older unless certain conditions are present.
- Measles,
mumps, and rubella (MMR) vaccine.
- Adults born before 1957 generally are considered immune to measles and mumps.
- Adults born in 1957 or later should have 1 or more doses of MMR vaccine unless there is a contraindication to the vaccine or there is laboratory evidence of immunity to each of the three diseases.
- A routine second dose of MMR vaccine should be obtained at least 28 days after the first dose for students attending postsecondary schools, health care workers, or international travelers.
- People who received inactivated measles vaccine or an unknown type of measles vaccine during 1963–1967 should be revaccinated with 1 or 2 doses of MMR vaccine.
- People who received inactivated mumps vaccine or an unknown type of mumps vaccine before 1979 and are at high risk for mumps infection should consider immunization with 2 doses of MMR vaccine.
- For females of childbearing age, rubella immunity should be determined. If there is no evidence of immunity, females who are not pregnant should receive 1 dose of MMR. If there is no evidence of immunity, females who are pregnant should receive 1 dose of MMR after pregnancy and before leaving the healthcare facility.
- Unvaccinated health care workers born before 1957 who lack laboratory evidence of measles, mumps, or rubella immunity or laboratory confirmation of disease should consider 2 doses of MMR 18 days apart for measles or mumps, or 1 dose of MMR for rubella.
- Pneumococcal
vaccines.
- All adults aged 65 years and older should receive 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polyscaccharide vaccine (PPSV23) at least 1 year after PCV13.
- An adult aged 19 years or older who has certain medical conditions and has not been previously immunized should receive 1 dose of PCV13 vaccine. This PCV13 should be followed with a dose of pneumococcal polysaccharide (PPSV23) vaccine. The PPSV23 vaccine dose should be obtained at least 8 weeks after the dose of PCV13 vaccine.
- An adult aged 19 years or older who has certain medical conditions and previously received 1 or more doses of PPSV23 vaccine should receive 1 dose of PCV13. The PCV13 vaccine dose should be obtained 1 or more years after the last PPSV23 vaccine dose.
- PPSV23 vaccination should happen in all adults aged 19–64 who smoke cigarettes.
- People with an immunocompromised condition and certain other conditions should receive both PCV13 and PPSV23 vaccines.
- When indicated, people who have unknown immunization and have no record of immunization should receive PPSV23 vaccine.
- People who received 1–2 doses of PPSV23 before age 65 years should receive another dose of PPSV23 vaccine at age 65 years or later if at least 5 years have passed since the previous dose.
- Doses of PPSV23 are not needed for people immunized with PPSV23 at or after age 65 years.
- Meningococcal
vaccine.
- Adults with asplenia or persistent complement component deficiencies should receive 2 doses of quadrivalent meningococcal conjugate (MenACWY-D) vaccine. The doses should be obtained at least 2 months apart. Revaccination should occur every 5 years. A 2-dose or 3-dose series of serogroup B meningococcal (MenB)vaccine should also be obtained.
- Microbiologists working with certain meningococcal bacteria, military recruits, people at risk during an outbreak, and people who travel to or live in countries with a high rate of meningitis should be immunized. Revaccination is recommended every 5 years if the risk for infection remains.
- Adults with HIV infection who have not been previously vaccinated should receive a 2-dose MenACWY series with doses at least 2 months apart. If 1 dose was received previously, a second dose should be obtained at least 2 months later. Revaccination is recommended every 5 years.
- A first-year college student up through age 21 years who is living in a residence hall should receive a dose if he or she did not receive a dose on or after his or her 16th birthday.
- Adults aged 16–23 years may receive 2 doses of MenB vaccine for short-term protection against most strains of serogroup B meningococcal disease.
- Hepatitis
A vaccine.
- Adults who wish to be protected from this disease, have certain high-risk conditions, work with hepatitis A-infected animals, work in hepatitis A research labs, or travel to or work in countries with a high rate of hepatitis A should be immunized.
- Adults who were previously unvaccinated and who anticipate close contact with an international adoptee during the first 60 days after arrival in the United States from a country with a high rate of hepatitis A should be immunized.
- The vaccine may be given as a 2 or 3-dose series by itself or in combination with the hepatitis B vaccine (HepB).
- Hepatitis
B vaccine.
- Adults who wish to be protected from this disease, may be exposed to blood or other infectious body fluids, are household contacts or sex partners of hepatitis B positive people, are clients or workers in certain care facilities, or travel to or work in countries with a high rate of hepatitis B should be immunized.
- Adults with chronic liver disease, such as hepatitis C infection, cirrhosis, fatty liver disease, alcoholic liver disease, autoimmune hepatitis, and elevated liver chemistry levels should be vaccinated.
- Pregnant women who are at risk for hepatitis B virus infection during pregnancy should be immunized.
- The vaccine may be given as a 3-dose series by itself or in combination with the hepatitis A vaccine (HepA).
- Haemophilus
influenzae type b (Hib)
vaccine.
- A previously unvaccinated person with asplenia or sickle cell disease or having a scheduled splenectomy should receive 1 dose of Hib vaccine. This should happen at least 14 days before the procedure.
- Regardless of previous immunization, a recipient of a hematopoietic stem cell transplant should receive a 3-dose series, with at least 4 weeks between doses, 6–12 months after his or her successful transplant.
- Hib vaccine is not recommended for adults with HIV infection.
