About Vaccinations for Adults

Overview

Vaccines help provide protection against many diseases. They help the body to increase protective antibodies that fight off infections. With antibodies, people may not develop illness from the infection or may not develop severe infection. Many vaccines, also referred to as immunizations, are given during childhood. However, there are many vaccines that are also recommended in adulthood. For adults, some vaccines are generally recommended for:

Everyone (all adults)
People of a certain age
People with certain risk factors
As “boosters” for vaccines received earlier in life. Some vaccines provide protection (immunity) for a lifetime; others may need a booster to continue the protection.

Each year, the U.S. Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) reviews and provides updated guidance on vaccine-preventable diseases. The vaccine-preventable diseases include:

COVID-19
Hemophilus Influenza Type B (HiB)
Hepatitis A
Hepatitis B
Human Papillomavirus (HPV)
Influenza (Flu)
Measles, Mumps, and Rubella
Meningococcus
Mpox
Pneumococcus
Poliovirus
Respiratory Syncytial Virus (RSV)
Tetanus
Varicella (Chicken Pox)
Zoster (Shingles)

Here’s a summary of each disease and recommended vaccines. These are general recommendations. The available vaccines listed those included in the June 2024 CDC update. New vaccines may become available, updated or recommended. Check with your healthcare professional regarding the specific vaccines that are available and timing of vaccination for your individual situation.

COVID-19 (Coronavirus Disease 2019)

COVID-19 is a disease caused by the SARS-CoV-2 virus. It is very contagious and can spread rapidly. It causes respiratory symptoms similar to a cold or the flu. For many people, COVID-19 causes mild-to-moderate illness. Some people may develop severe COVID-19 and require hospitalization.
Who should receive COVID-19 vaccine? The CDC recommends that all people age 6 months or older receive an updated COVID-19 vaccine during the upcoming respiratory season (generally September thru January). Vaccination is particularly important for people with multiple health problems, immunocompromised people and those over the age of 64 due to their increased risk for severe complications of COVID-19.
What vaccines are available: There are two types of updated COVID-19 vaccines available for 2024-25
- mRNA vaccines: Pfizer-BioNTech (Comirnaty), Moderna (Spikevax): These vaccines may be used for people age 6 months and older.
- Protein-subunit vaccines: Novavax COVID-19 Vaccine: This vaccine may be used for people age 12 years and older.

Hemophilus Influenza Type B (HiB)

Hemophilus influenza disease is caused by a bacteria called Hemophilus influenza. It can cause many types of illnesses, including bronchitis (chest cold) in adults. It may cause serious infections including pneumonia (lung infection), meningitis (brain and spinal cord lining infection), epiglottitis (throat infection), cellulitis (skin infection), and arthritis (joint infection. The vaccine is available for a specific type of Hemophilus infection, called H. influenza, type B (HiB)
Who should receive the HiB vaccine? HiB vaccine is usually given during childhood. For adults, it is recommended for people with an increased risk of severe complications of hemophilus infection including:
- People with anatomical or functional asplenia (do not have a spleen or functioning spleen), including people with sickle cell disease, if they previously did not receive HiB vaccine
- People who have had a hematopoietic stem cell transplant (HSCT)
- People with HIV disease
- People with immune deficiencies
- People on chemotherapy or radiation therapy for cancer
- People who are awaiting or who have had organ transplants
What vaccines are available?
- ActHIB, Hiberix, PedvaxHIB

Hepatitis A

Hepatitis A is a liver disease caused by infection with hepatitis A virus. It is highly contagious (easily spread) through person-to-person contact or eating contaminated food or drink. It can cause a variety of symptoms, including diarrhea, feeling tired, fever, joint pain, nausea and vomiting, and dark-colored urine or stool.
Who should receive hepatitis vaccination? People who are at high risk for hepatitis A virus infection, including:
- People with chronic liver disease, including hepatitis B, hepatitis C, cirrhosis, fatty liver disease, alcoholic liver disease, autoimmune hepatitis
- HIV infection
- Men who have sex with men
- Injection or noninjection illegal drug use
- Persons experiencing homelessness
- Work exposure to hepatitis A virus (such as in a research laboratory)
- Work exposure to individuals at high risk for HAV infection (group homes, drug rehabilitation facilities)
- Travel to countries with high rates of HAV infection.
- Pregnant women at risk for HAV infection.
What vaccines are available?
- Havrix, Vaqta
- There is also a combination hepatitis a and hepatitis b vaccine: Twinrix

Hepatitis B

Hepatitis B is a disease caused by the hepatis B virus (HBV). HBV is spread by sexual intercourse or injection drug use. HBV attacks the liver and may lead to cirrhosis (scarring of the liver), liver cancer, and liver failure. HBV is a lifelong infection.
Who should receive the hepatitis B vaccine?
- People age 19 through 59 years
- People 60 years or older at high risk for HBV invection.
- Risk factors for HBV infection include:
  - Chronic liver disease, including hepatitis C, cirrhosis, fatty liver disease, alcoholic liver disease, autoimmune hepatitis.
  - HIV infection.
  - Sexual exposure risk, including sex partners of hepatitis B surface antigen (HBsAg)-positive persons; sexually active persons not in mutually monogamous relationships; persons seeking evaluation or treatment for a sexually transmitted infection; men who have sex with men.
  - Current or recent injection drug use.
  - Risk of exposure to blood, including household contacts of people who have HBV, dialysis patients, or health care personnel.
  - Incarceration.
  - Travel to countries with high or intermediate numbers of people with hepatitis B.
What vaccines are available?
- Engerix-B, Heplisav-B, PreHevbrio, Recombivax HB
- There is also a combination hepatitis A and hepatitis B vaccine: Twinrix

Human Papillomavirus (HPV)

HPV infection is very common viral infection that may cause anal and genital warts as well as oral and anogenital cancers later in life. HPV is spread through intimate skin-to-skin contact, including vaginal, anal or oral sex with someone who is infected but may not know they are infected. Many people may not know they are infected.
Who should receive the HPV vaccine? The HPV vaccine is usually given during adolescence. Adults age 27-45 years who did not complete the full series of HPV vaccinations may consider receiving HPV vaccine to complete the series, but routine vaccination is not usually recommended.
What vaccines are available? Gardasil 9

Influenza (Flu)

Influenza is a contagious respiratory illness caused by infection with influenza viruses, including influenza type a and influenza type B. These viruses cause the flu each year during “flu season”, generally October through May. The viruses may change each year, so new flu vaccines are created each year to be available starting around September.
Who should receive vaccine? All people 6 months old or older should receive the annual influenza vaccine each year, unless contraindicated (such as for allergic reaction to the flu shot).
What vaccines are available? There are many brands of flu shot available each year. Check with the doctor or pharmacist regarding whether a specific flu shot is recommended for your individual situation.

Measles, Mumps, and Rubella (MMR)

Measles, mumps and rubella are very contagious (easily spread) diseases caused by viruses. Each condition causes a variety of symptoms and may lead to serious complications.
Who should receive the MMR vaccine? MMR vaccine is usually given during childhood. Adults who may need MMR vaccination include healthcare workers, college students, international travelers and people with HIV disease who do not have evidence of immunity to measles, mumps, or rubella. Evidence of immunity for measles, mumps or rubella include being born before 1957, documentation of receiving MMR vaccine, or blood tests that show evidence of immunity.
What vaccines are available?
- M-M-R II, Priorix

Meningococcus

Meningococcal disease is relatively rare condition caused by the bacteria Neisseria meningitidis. Infection can cause meningitis and bloodstream infections that cause serious illness and could be deadly within hours. Meningococcal bacteria are spread through close or lengthy contact with infected people. People at increased risk for infection include children younger than 1 year old, teens and young adults (ages 16 through 23 years old), and adults 65 years and older.
Who should receive the meningococcal vaccine? Meningococcus vaccines are usually given during the teen years. Adults who may need to consider getting meningococcus vaccine include:
- People with anatomical or functional splenia (no spleen or spleen function), including people with sickle cell disease.
- People with HIV disease .
- People with immune deficiencies.
- Travel to countries where exposure to Neisseria meningitidis bacteria may be high.
- First year college students living in dorms (if not previously vaccinated).
- Miliary recruits.
What vaccines are available? It is important to check with a healthcare professional regarding whether a specific meningococcus vaccine is recommended for your individual situation.
- Meningococcal conjugate (Men ACWY): Menvio, MenQuadri
- Serogroup B meningococcal (Men B): Bexsero, Trumemba
- Pentavalent meningococcal (Men ABCWY): Penbraya

Mpox

Mpox (formerly called monkeypox) is a disease caused by infection with the monkeypox virus. It often causes symptoms such as flu-like symptoms, rash, pain that makes it hard to eat or drink or use the bathroom, and scabbing. In some people, it can cause severe illness
Who should receive the Mpox vaccine? Mpox vaccine may be considered for people at high risk of infection from the monkeypox virus, including:
- Men who have sex with men or their partners who in the past 6 months have had
  - A new diagnosis of at least one sexually-transmitted infection (STI)
  - More than 1 sex partner
  - Sex at a commercial sex venue
  - Sex in association with a large public event in a geographic area where Mpox transmission is occurring.
- People with immune deficiencies.
- People who plan to travel to a country where there is an outbreak and anticipate sex with a new or multiple partners.
What vaccines are available?
- Jynneos

Pneumococcus

Pneumococcal disease is caused by infection with the bacteria Streptococcus pneumoniae. Streptococcus pneumonia infection is spread through direct contact with respiratory secretions, like saliva and mucus. Pneumococcus can cause illness including:
- Pneumonia (lung infection)
- Meningitis (brain and spinal cord lining infection)
- Bacteremia (bloodstream infection)
- Otitis media (middle ear infection), and sinusitis (sinus infection).
Who should receive the pneumococcal vaccine (PCV)? It is advised to consult with a healthcare professional regarding recommendations for pneumococcal vaccine for your specific situation. In general, for adults, CDC recommends pneumococcal vaccines for:
- People over 50 years old who never received the PCV vaccine.
- People 19 through 49 years old with risk factors or conditions, including:
  - Alcohol use disorder
  - Cerebrospinal fluid (CSF) leak
  - Chronic heart disease
  - Chronic liver disease
  - Chronic lung disease
  - Cigarette smoking
  - Cochlear implant (surgically implanted hearing device)
  - Diabetes
  - Weakened immune system from conditions (“immunocompromising conditions”)
    - Nonfunctional spleen or no spleen
    - HIV infection
    - Kidney failure requiring dialysis
    - Nephrotic syndrome (a type of kidney disease)
    - Sickle cell disease
    - Cancer (including leukemia, lymphoma, Hodgkin Disease, and multiple myeloma)
    - Solid organ transplant (for example, kidney, liver, lung, or heart)
- Adults who previously received certain older pneumococcus vaccines such as PCV13
What vaccines are available?
- Pneumococcal conjugate vaccine (PCV):
  - PCV 15 (Vaxneuvance): This vaccine is approved for use in people 6 months of age and older.
  - PCV20 (Prevnar 20): This vaccine is approved for use in people 6 months of age and older.
  - PCV21 (Capvaxive): This vaccine is approved for use in people 18 years and older.
- Pneumococcal polysaccharide vaccine (PPSV): Pneumovax 23. The PPSV23 vaccine is approved for use in adults 50 years old and older, and for people 2 years old and older who are at increased risk for pneumococcal disease.

Poliovirus

Poliovirus has been eliminated in most parts of the world because of widespread vaccination during childhood. The virus may cause symptoms such as sore throat, fever, fatigue, nausea or headache. In most cases the symptoms go away on their own after a few days. In rare cases the virus can cause an infection of the covering of the brain and spinal cord called meningitis, or paralysis of the arms and legs that can be permanent. In the worst cases, poliovirus can cause death. The virus is very contagious and can be spread by infected people even if they don’t know they are sick. The virus enters the body through the mouth, either by coming in contact with contaminated food, toys or other objects, close contact with an infected person or eating or drinking food that are contaminated with the feces (poop) of an infected person. The best way to protect against infection by the poliovirus is vaccination.
Who should receive the inactivated polio vaccine (IPV)? Adults who have not received full vaccination against polio are at risk. Travel to certain countries or occupational exposure can also place people at risk, and booster vaccines may be recommended.
What vaccines are available?
- Inactivated polio vaccine (IPV): This is the only vaccine available in the United States.

Respiratory Syncytial Virus (RSV)

Infection with RSV, a common respiratory virus, often causes mild, cold-like symptoms. Infants and older adults are more likely to develop severe RSV illness and require hospitalization. RSV infections often occur during the fall and winter months, or “flu season”. This may make it difficult to determine whether a person has a cold, flu, COVID, or RSV. RSV vaccination helps prevent RSV illness. CDC recommends the best time to get vaccinated in in late summer and early fall, just before RSV usually starts to spread.
Who should receive the RSV vaccine? For adults, CDC recommends one dose of RSV vaccine for:
- People age 75 years and older
- People age 60 – 74 years old with increased risk of severe RSV. Risk factors for severe RSV include:
  - Chronic heart disease
  - Chronic lung disease
  - Kidney disease
  - Liver disease
  - Diabetes
  - Immune deficiencies
  - Residents of nursing homes or long-term care facilities.
- People who are 32 to 36 weeks pregnant during September thru January. This timing helps pass maternal RSV antibodies to an infant at birth to help protect the infant from RSV.
What vaccines are available?
- Arexvy: This vaccine can be used in older adults
- Abrysvo: This vaccine can be used in older adults and women who are 32-36 weeks pregnant during September thru January
- mResvia: This vaccine can be used in older adults.

Tetanus

Tetanus is a disease caused by infection with the bacteria Clostridium tetani. Tetanus is a serious disease that causes lockjaw and can progress to seizures, difficult swallowing, involuntary muscle spasms, seizures, and difficulty breathing.
Who should receive tetanus vaccine? Tetanus vaccine is usually given during childhood. It is usually given in combination with diptheria and pertussis vaccines. Adults who may need tetanus vaccine include:
- People who never have received tetanus vaccine
- People who received a tetanus vaccine more than 10 years ago
- People who are pregnant
- People with wounds and unknown tetanus vaccine history or more than 5-10 years since the last tetanus vaccine.
What vaccines are available?
- Tetanus and diptheria toxoids (Td): Tenivac, Tdvax
- Tetanus, diptheria, and acellular pertussis (Tdap): Adacel, Boostrix
- Diptheria, Tetanus, and acellular pertussis (DTaP): Daptacel, Infanrix

Varicella (Chicken Pox)

Chicken pox is a very contagious (easily spread) disease caused by the varicella-zoster virus (VZV). It causes blister-like rash, itching, and fever. It usually causes mild illness. However, it can cause serious illness in infants and people who are pregnant or have weekended immune systems. Serious illness may require hospitalization.
Who should receive the varicella vaccine? The varicella vaccine is usually given during childhood. For adults, 2 doses of varicella vaccine are recommended for people at high risk of exposure or severe disease including but not limited to:
- Health care workers
- Household contacts of people with immune system deficiencies
- Teachers of young children
- Childcare providers
- Staff and residents of institutions such as correctional facilities
- College Students
- Military personnel
- People who do not have evidence of immunity. Evidence of immunity for adults includes documentation of varicella vaccination, blood test evidence of immunity, birth in the United States before 1980, or healthcare provider verification of history of varicella or herpes zoster illness.
What vaccines are available?
- Varivax

Whooping Cough (Pertussis)

Whooping cough, also called pertussis, is a very contagious respiratory illness caused by the Bordatella pertussis bacteria. It causes symptoms of a cold (runny nose, low-grade fever, and mild cough). The cough can progress to uncontrollable coughing fits. People with pertussis may make a high-pitched whoop sound when they inhale during these coughing fits. This may cause breathing problems. Contact a doctor immediately if struggling to breathe.
Who should receive the pertussis vaccine? The pertussis vaccine may not entirely prevent the disease, but it can help decrease the severity of the illness. The pertussis vaccine is recommended for:
- Pregnant people during the 27^th-36^th week of each pregnancy, given as the Tdap vaccine.
- Adults who have never received the pertussis vaccine, given as the Tdap vaccine.
What vaccines are available? Pertussis is available in combination vaccines:
- DTaP (Daptacel, Infanrix): This combination vaccine protects against diphtheria, tetanus, and pertussis (whooping cough). It is given to children between the ages of 2 months and 6 years. It may also be combined with additional vaccines for polio, hepatitis B, and invasive Hib disease.
- Tdap (Adacel, Boostrix): This combination vaccine protects against tetanus, diphtheria, and pertussis (whooping cough). It is given to people 7 years old and older.

Zoster (Shingles)

Shingles is a painful rash illness that occurs when varicella zoster virus (VZV) that causes chicken pox reactivates in people. VZV stays in the body after chicken pox resolves, then reactivates to cause shingles (also called zoster). Shingles can be treated with antiviral medicine; however, it may lead to a long-term complication called post-herpetic neuralgia (PHN). PHN causes nerve pain. The zoster vaccine can prevent the development of shingles.
Who should receive the zoster vaccine? The zoster vaccine is recommended for:
- People 50 years old and older. It is given as a 2-dose series, with doses given 2-6 months apart.
- The zoster vaccine is also recommended for people 19 years of age and older with immune system deficiencies such as impaired spleen function, chemotherapy and chronic steroid use.
What vaccines are available?
- Shigrix