Recommended Adult Immunization Schedule 2021 for ages …

1 CS310021-AReport ySuspected cases of reportable vaccine-preventable diseases or outbreaks to the local or state health department yClinically significant postvaccination reactions to the Vaccine Adverse Event Reporting System at or 800-822-7967 Injury claimsAll vaccines included in the Adult Immunization Schedule except pneumococcal 23-valent polysaccharide (PPSV23) and zoster (RZV) vaccines are covered by the Vaccine Injury Compensation Program. Information on how to file a vaccine injury claim is available at or commentsContact or 800-CDC-INFO (800-232-4636), in English or Spanish, 8 8 ET, Monday through Friday, excluding information yComplete Advisory Committee on Immunization Practices (ACIP) recommendations: yGeneral Best Practice Guidelines for Immunization (including contraindications and precautions): yVaccine information statements: yManual for the Surveillance of Vaccine-Preventable Diseases (including case identification and outbreak response).

2 YTravel vaccine recommendations: yRecommended Child and Adolescent Immunization Schedule , United States, 2022: yACIP Shared Clinical Decision-Making Recommendations: Adult Immunization Schedule for ages 19 years or olderHow to use the Adult Immunization schedule1 Determine Recommended vaccinations by age (Table 1)2 Assess need for additional Recommended vaccinations by medical condition or other indication (Table 2)3 Review vaccine types, frequencies, intervals, and considerations for special situations (Notes)4 Review contraindications and precautions for vaccine types (Appendix) Recommended by the Advisory Committee on Immunization Practices ( )

3 And approved by the Centers for Disease Control and Prevention ( ), American College of Physicians ( ), American Academy of Family Physicians ( ), American College of Obstetricians and Gynecologists ( ), American College of Nurse-Midwives ( ), and American Academy of Physician Associates ( ), and Society for Healthcare Epidemiology of America ( ).UNITED STATES2022 Vaccines in the Adult Immunization Schedule *VaccineAbbreviation(s)Trade name(s)Haemophilus influenzae type b vaccineHibActHIB Hiberix PedvaxHIB Hepatitis A vaccineHepAHavrix Vaqta Hepatitis A and hepatitis B vaccineHepA-HepBTwinrix Hepatitis B vaccineHepBEngerix-B Recombivax HB Heplisav-B human papillomavirus vaccineHPVG ardasil 9 Influenza vaccine (inactivated)IIV4 Many brandsInfluenza vaccine (live, attenuated)LAIV4 FluMist QuadrivalentInfluenza vaccine (recombinant)

4 RIV4 Flublok QuadrivalentMeasles, mumps, and rubella vaccineMMRM-M-R II Meningococcal serogroups A, C, W, Y vaccineMenACWY-DMenACWY-CRMMenACWY-TTMen actra Menveo MenQuadfi Meningococcal serogroup B vaccineMenB-4 CMenB-FHbpBexsero Trumenba Pneumococcal 15-valent conjugate vaccinePCV15 Vaxneuvance Pneumococcal 20-valent conjugate vaccinePCV20 Prevnar 20 Pneumococcal 23-valent polysaccharide vaccinePPSV23 Pneumovax 23 Tetanus and diphtheria toxoidsTdTenivac Tdvax Tetanus and diphtheria toxoids and acellular pertussis vaccineTdapAdacel Boostrix Varicella vaccineVARV arivax Zoster vaccine.

5 RecombinantRZVS hingrix* Administer Recommended vaccines if vaccination history is incomplete or unknown. Do not restart or add doses to vaccine series if there are extended intervals between doses. The use of trade names is for identification purposes only and does not imply endorsement by the ACIP or the CDC Vaccine Schedules app for providers at QR code for access to online scheduleVaccine19 26 years27 49 years50 64 years 65 yearsInfluenza inactivated (IIV4) or Influenza recombinant (RIV4)1 dose annuallyInfluenza live, attenuated(LAIV4)1 dose annuallyTetanus, diphtheria, pertussis (Tdap or Td)1 dose Tdap each pregnancy.

6 1 dose Td/Tdap for wound management (see notes)1 dose Tdap, then Td or Tdap booster every 10 yearsMeasles, mumps, rubella (MMR) 1 or 2 doses depending on indication (if born in 1957 or later)Varicella (VAR)2 doses(if born in 1980 or later)2 dosesZoster recombinant (RZV)2 doses for immunocompromising conditions (see notes)2 dosesHuman papillomavirus (HPV) 2 or 3 doses depending on age at initial vaccination or condition27 through 45 yearsPneumococcal(PCV15, PCV20, PPSV23)1 dose PCV15 followed by PPSV23OR1 dose PCV20 (see notes)1 dose PCV15 followed by PPSV23OR1 dose PCV20 Hepatitis A (HepA)2 or 3 doses depending on vaccineHepatitis B (HepB)2, 3, or 4 doses depending on vaccine or conditionMeningococcal A, C, W, Y (MenACWY)1 or 2 doses depending on indication, see notes for booster recommendationsMeningococcal B (MenB)Haemophilus influenzae type b (Hib)

7 1 or 3 doses depending on indicationTable 1 Recommended Adult Immunization Schedule by Age Group, United States, 2022oror Recommended vaccination for adults who meet age requirement, lack documentation of vaccination, or lack evidence of past infection Recommended vaccination for adults with an additional risk factor or another indication Recommended vaccination based on shared clinical decision-making No recommendation/Not applicable2 or 3 doses depending on vaccine and indication, see notes for booster recommendations19 through 23 years2, 3, or 4 doses depending on vaccine or conditionVaccinePregnancyImmuno- compromised (excluding HIV infection)HIV infection CD4 percentage and countAsplenia, complement deficienciesEnd-stage renal disease, or on hemodialysisHeart or lung disease.

8 Alcoholism1 Chronic liver diseaseDiabetesHealth care personnel2 Men who have sex with men<15% or <200 mm3 15% and 200 mm3 IIV4 or RIV41 dose annuallyLAIV4 ContraindicatedPrecaution1 dose annuallyTdap or Td1 dose Tdap each pregnancy 1 dose Tdap, then Td or Tdap booster every 10 yearsMMRC ontraindicated*Contraindicated1 or 2 doses depending on indicationVARC ontraindicated*Contraindicated2 dosesRZV2 doses at age 19 years2 doses at age 50 yearsHPVNot Recommended *3 doses through age 26 years2 or 3 doses through age 26 years depending on age at initial vaccination or conditionPneumococcal (PCV15, PCV20, PPSV23)HepAHepB3 doses(see notes)

9 2, 3, or 4 doses depending on vaccine or conditionMenACWYMenBPrecautionHib3 doses HSCT3 recipients only1 dose1 or 2 doses depending on indication, see notes for booster recommendations2 or 3 doses depending on vaccine and indication, see notes for booster recommendations2 or 3 doses depending on vaccineTable 2 Recommended Adult Immunization Schedule by Medical Condition or Other Indication, United States, 2022 Recommended vaccination for adults who meet age requirement, lack documentation of vaccination, or lack evidence of past infection Recommended vaccination for adults with an additional risk factor or another indication Recommended vaccination based on shared clinical decision-making Precaution vaccination might be indicated if benefit of protection outweighs risk of adverse reaction Contraindicated or not Recommended vaccine should not be administered.

10 *Vaccinate after pregnancy. No recommendation/ Not applicableoror1. 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 dose PCV15 followed by PPSV23 OR 1 dose PCV20 (see notes)For vaccine recommendations for persons 18 years of age or younger, see the Recommended Child and Adolescent Immunization VaccinationCOVID-19 vaccines are Recommended within the scope of the Emergency Use Authorization or Biologics License Application for the particular vaccine.