Recommended Immunization Schedule for Adults Aged 19 Years or Older by Medical Conditions and Other Indications, United States, 2017

These recommendations should be read with the footnotes and additional considerations.

* = Recommended for adults who meet the age requirement, lack documentation of vaccination, or lack evidence of past infection

§ = Recommended for adults with additional medical conditions or other indications

• = Contraindicated

⇒ = No recommendation

Vaccine	Pregnancy ^{1-6, 9}	Immuno-compromising (excluding HIV infection)^{3-7, 11}	HIV infection CD4+ count (cells/µL) ^{3-7, 9-11}		Asplenia persistent complement deficiencies ^{7,10, 11}	Kidney failure, end-stage renal disease, on hemodialysis ^{7, 9}	Heart or lung disease, chronic alcoholism ⁷	Chronic liver disease^7-9	Diabetes ^{7, 9}	Healthcare personnel ^{3,4, 9}	Men who have sex with men (MSM)^{6, 8, 9}
Vaccine	Pregnancy ^{1-6, 9}	Immuno-compromising (excluding HIV infection)^{3-7, 11}	< 200	≥ 200	Asplenia persistent complement deficiencies ^{7,10, 11}		Heart or lung disease, chronic alcoholism ⁷	Chronic liver disease^7-9	Diabetes ^{7, 9}	Healthcare personnel ^{3,4, 9}	Men who have sex with men (MSM)^{6, 8, 9}
Influenza¹	1 dose annually*
Td/Tdap²	1 dose Tdap each pregnancy*	Substitute Tdap for Td once, then Td booster every 10 yrs*
MMR³	Contraindicated•			1 or 2 doses depending on indication*
VAR⁴	Contraindicated•			2 doses*
HZV⁵	Contraindicated•			⇒	1 dose*
HPV–Female⁶	⇒	3 doses through age 26 yrs*									⇒
HPV–Male⁶	⇒	3 doses through age 26 yrs*			3 doses through age 21 yrs*						3 doses through age 26 yrs*
PCV13⁷	⇒	1*					dose§
PPSV23⁷	§	1, 2,or 3 doses depending*								on indication§
HepA⁸	2 or 3 doses§							depending*	on vaccine§		*
HepB⁹	§		*		§	*	3§	doses*
MenACWY or MPSV4¹⁰	§		1 or more doses depending*			on indication§
MenB¹⁰	⇒	§			2 or 3 doses*	depending on vaccine§
Hib¹¹	⇒	3 doses post-HSCT recipients only*	§		1*	dose§