Table 2. Recommended Adult Immunization Schedule by Medical Condition and Other Indications, United States, 2021

¶ = 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
			<2003	≥2003
IIV or RIV4	1 dose annually¶
LAIV4	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*±	NOT RECOMMENDED±		1 or 2 doses depending on indication¶
VAR	NOT RECOMMENDED*±	NOT RECOMMENDED±		^	2 doses¶
RZV	•				2 doses at age ≥50 yrs¶
HPV	NOT RECOMMENDED*±	3 doses through age 26 yrs¶			2 or 3 doses through age 26 years depending on age at initial vaccination or condition¶
PCV13	•	1¶					dose§
PPSV23	§	1, 2,or 3 doses depending on age¶								and indication§
HepA	§		¶		2 or 3§			doses¶	depending on vaccine§		¶
HepB	§		¶		2, 3, or 4§	doses depending on¶	vaccine or§	condition¶	<60 years¶	¶
									≥60 years^
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.