Adult immunization schedule by age - Recommendations for ages 19 years or older, United States, 2024
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 CDC.
NOTES
For vaccine recommendations for persons 18 years of age or younger, refer to the Recommended Child and Adolescent Immunization Schedule.
- For calculating intervals between doses, 4 weeks = 28 Intervals of ≥4 months are determined by calendar months.
- Within a number range (eg, 12-18), a dash (–) should be read as "through."
- Vaccine doses administered ≤4 days before the minimum age or interval are considered valid. Doses of any vaccine administered ≥5 days earlier than the minimum age or minimum interval should not be counted as valid and should be repeated. The repeat dose should be spaced after the invalid dose by the recommended minimum interval. For further details, refer to Table 3-2, Recommended and minimum ages and intervals between vaccine doses, in General Best Practice Guidelines for Immunization.
- Information on travel vaccination requirements and recommendations is available at cdc.gov/travel/.
- For vaccination of persons with immunodeficiencies, refer to Table 8-1, Vaccination of persons with primary and secondary immunodeficiencies, in General Best Practice Guidelines for Immunization.
- For information about vaccination in the setting of a vaccine-preventable disease outbreak, contact your state or local health department.
- The National Vaccine Injury Compensation Program (VICP) is a no-fault alternative to the traditional legal system for resolving vaccine injury claims. All vaccines included in the adult immunization schedule except PPSV23, RSV, RZV, Mpox, and COVID-19 vaccines are covered by the National Vaccine Injury Compensation Program (VICP). Mpox and COVID-19 vaccines are covered by the Countermeasures Injury Compensation Program (CICP). For more information, refer to www.hrsa.gov/vaccinecompensation or www.hrsa.gov/cicp.
- Routine vaccination:
- Adults known or suspected to be unvaccinated or incompletely vaccinated: Administer remaining doses (1, 2, or 3 IPV doses) to complete a 3-dose primary series (NOTE: Complete primary series consists of at least 3 doses of IPV or trivalent oral poliovirus vaccine [tOPV] in any combination). Unless there are specific reasons to believe they were not vaccinated, most adults who were born and raised in the United States can assume they were vaccinated against polio as children.
- Special situations:
- Adults at increased risk of exposure to poliovirus who completed primary series (NOTE: Complete primary series consists of at least 3 doses of IPV or trivalent oral poliovirus vaccine [tOPV] in any combination): May administer one lifetime IPV booster.
- For detailed information, refer to www.cdc.gov/vaccines/vpd/polio/hcp/recommendations.html.
- Contraindications and precautions:
- For contraindications and precautions to Poliovirus vaccine, inactivated (IPV), refer to Poliovirus Appendix.
- Routine vaccination:
- Age 19 years or older.
- Unvaccinated:
- 1 dose of updated (2023-2024 Formula) Moderna or Pfizer-BioNTech vaccine.
- 2-dose series of updated (2023-2024 Formula) Novavax at 0, 3-8 weeks.
- Previously vaccinated‡‡ with 1 or more doses of any COVID-19 vaccine: 1 dose of any updated (2023-2024 Formula) COVID-19 vaccine administered at least 8 weeks after the most recent COVID-19 vaccine dose.
- Special situations
- Persons who are moderately or severely immunocompromised.††
- Unvaccinated:
- 3-dose series of updated (2023-2024 Formula) Moderna at 0, 4, 8 weeks.
- 3-dose series of updated (2023-2024 Formula) Pfizer- BioNTech at 0, 3, 7 weeks.
- 2-dose series of updated (2023-2024 Formula) Novavax at 0, 3 weeks.
- Previously vaccinated‡‡ with 1 dose of any Moderna: 2-dose series of updated (2023-2024 Formula) Moderna at 0, 4 weeks (minimum interval between previous Moderna dose and dose 1: 4 weeks).
- Previously vaccinated‡‡ with 2 doses of any Moderna: 1 dose of updated (2023-2024 Formula) Moderna at least 4 weeks after most recent dose.
- Previously vaccinated‡‡ with 1 dose of any Pfizer- BioNTech: 2-dose series of updated (2023-2024 Formula) Pfizer-BioNTech at 0, 4 weeks (minimum interval between previous Pfizer-BioNTech dose and dose 1: 3 weeks).
- Previously vaccinated‡‡ with 2 doses of any Pfizer- BioNTech: 1 dose of updated (2023-2024 Formula) Pfizer-BioNTech at least 4 weeks after most recent dose.
- Previously vaccinated‡‡ with 3 or more doses of any Moderna or Pfizer-BioNTech: 1 dose of any updated (2023-2024 Formula) COVID-19 vaccine at least 8 weeks after the most recent dose.
- Previously vaccinated‡‡ with 1 or more doses of Janssen or Novavax with or without dose(s) of any Original monovalent or bivalent COVID-19 vaccine: 1 dose of any updated (2023-2024 Formula) of COVID-19 vaccine at least 8 weeks after the most recent dose.
- There is no preferential recommendation for the use of one COVID-19 vaccine over another when more than one recommended age-appropriate vaccine is available.
- Current COVID-19 vaccine information available at www.cdc.gov/covidschedule. For information on Emergency Use Authorization (EUA) indications for COVID-19 vaccines, refer to www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines.
- ‡‡ Previously vaccinated is defined as having received any Original monovalent or bivalent COVID-19 vaccine (Janssen, Moderna, Novavax, Pfizer-BioNTech) prior to the updated 2023-2024 formulation.
- †† Persons who are moderately or severely immunocompromised have the option to receive one additional dose of updated (2023-2024 Formula) COVID-19 vaccine at least 2 months following the last recommended updated (2023-2024 Formula) COVID-19 vaccine dose. Further additional updated (2023-2024 Formula) COVID-19 vaccine dose(s) may be administered, informed by the clinical judgement of a health care provider and personal preference and circumstances. Any further additional doses should be administered at least 2 months after the last updated (2023-2024 Formula) COVID-19 vaccine dose.
- Contraindications and precautions:
- For contraindications and precautions to COVID-19 vaccination, refer to COVID-19 Appendix.
- Routine vaccination:
- Age 19 years or older: 1 dose any influenza vaccine appropriate for age and health status annually.
- Age 65 years or older: Any one of quadrivalent high-dose inactivated influenza vaccine (HD-IIV4), quadrivalent recombinant influenza vaccine (RIV4), or quadrivalent adjuvanted inactivated influenza vaccine (aIIV4) is preferred. If none of these three vaccines is available, then any other age-appropriate influenza vaccine should be used.
- For the 2023-2024 season, refer to www.cdc.gov/mmwr/volumes/72/rr/rr7202a1.htm.
- For the 2023-2024 season, refer to the 2024-2025 ACIP influenza vaccine recommendations.
- Special situations:
- Close contacts (eg, caregivers, health care workers) of severely immunosuppressed persons who require a protected environment: Should not receive LAIV4. If LAIV4 is given, they should avoid contact with/caring for such immunosuppressed persons for 7 days after vaccination.is given, they should avoid contact with/caring for such immunosuppressed persons for 7 days after vaccination.
- NOTE: Persons with an egg allergy can receive any influenza vaccine (egg-based and non-egg based) appropriate for age and health status.
- Contraindications and precautions:
Reproduced from: Advisory Committee on Immunization Practices. Adult Immunization Schedule by Age, Recommendations for Ages 19 Years or Older, United States, 2024. Centers for Disease Control and Prevention. Available at:
https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html (Accessed on January 18, 2024).