Table 2. Recommended Adult Immunization Schedule by Medical Condition and Other Indications, United States, 2020

¶ = 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
| = Precaution—vaccination might be indicated if benefit of protection outweighs risk of adverse reaction
^ = Delay vaccination until after pregnancy if vaccine is indicated
± = Not recommended/ contraindicated —vaccine should not be administered
• = No recommendation/ Not applicable

adult conditions vaccine schedule

Vaccine	Pregnancy	Immuno-compromised (excluding HIV infection)	HIV infection CD4 count		Asplenia, complement deficiencies	End-stage renal disease; or on hemodialysis	Heart or lung disease, alcoholism1	Chronic liver disease	Diabetes	Health care personnel2	Men who have sex with men
			<200	≥200
IIV or RIV	1 dose annually¶
LAIV	NOT RECOMMENDED±					PRECAUTION|				1 dose annually¶
Tdap or Td	1 dose Tdap each pregnancy¶	1 dose Tdap, then Td or Tdap booster every 10 yrs¶
MMR	NOT RECOMMENDED±			1 or 2 doses depending on indication¶
VAR	NOT RECOMMENDED±			2 doses¶
RZV (preferred)	DELAY^	•	•	•	2 doses at age ≥50 yrs¶
ZVL	NOT RECOMMENDED±			•	1 dose at age ≥60 yrs¶
HPV	DELAY^	3 doses through age 26 yrs¶			2 or 3 doses through age 26 yrs¶
PCV13	•	1¶					dose§
PPSV23	§	1, 2,or 3 doses depending on age¶								and indication§
HepA	§		¶		§		2 or 3§	doses¶	depending on vaccine§		¶
HepB	§		¶		§	¶	2 or 3§	doses depending on vaccine¶
MenACWY	1 or 2 doses§		depending on indication,¶			see notes for booster recommendations§
MenB	PRECAUTION|	2 or 3 doses§			depending on¶	vaccine and indication, see notes for booster recommendations§
Hib	•	3 doses HSCT3 recipients only¶	§		1¶	dose§

1. Precaution for LAIV does not apply to alcoholism.
2. See notes for influenza; hepatitis B; measles, mumps, and rubella; and varicella vaccinations.
3. Hematopoietic stem cell transplant.