---
title: Adult Immunization Schedule
description: A comprehensive guide to recommended adult immunizations, including indications, schedules, and considerations.
keywords: [adult immunization, vaccination, preventive care, public health, disease prevention]
category: clinical
---

## Introduction

Immunization is a critical component of preventive healthcare for adults. The adult immunization schedule, as recommended by the Centers for Disease Control and Prevention (CDC) and other leading medical organizations, outlines the appropriate vaccinations for individuals aged 19 years and older. This clinical reference document provides an overview of the key adult immunizations, including their indications, schedules, and important considerations for healthcare providers.

## Routine Vaccinations

### Influenza Vaccine
The influenza (flu) vaccine is recommended annually for all adults. The inactivated influenza vaccine (IIV) or the recombinant influenza vaccine (RIV) should be administered by intramuscular injection, typically in the deltoid muscle. For the 2022-2023 season, the quadrivalent formulation, which protects against four influenza virus strains, is preferred. Individuals with egg allergies can receive the egg-free recombinant vaccine.

### Pneumococcal Vaccines
Two pneumococcal vaccines are recommended for adults: the pneumococcal conjugate vaccine (PCV13) and the pneumococcal polysaccharide vaccine (PPSV23). PCV13 is recommended for all adults aged 65 years and older, as well as adults aged 19-64 years with certain underlying medical conditions, such as immunocompromising conditions, chronic heart or lung disease, or diabetes. PPSV23 is recommended for all adults aged 65 years and older and adults aged 19-64 years with risk factors. The vaccines should be administered sequentially, with PCV13 followed by PPSV23 at least one year later.

### Tetanus, Diphtheria, and Pertussis (Tdap) Vaccine
The Tdap vaccine is recommended for all adults, including those who have previously received the tetanus and diphtheria (Td) vaccine. A single dose of Tdap should be administered, followed by a Td booster every 10 years. Pregnant individuals should receive a dose of Tdap during each pregnancy, preferably between 27 and 36 weeks of gestation.

## Recommended Vaccinations for High-Risk Groups

### Hepatitis B Vaccine
The hepatitis B vaccine is recommended for adults with certain risk factors, including those with end-stage renal disease, HIV infection, chronic liver disease, or who are healthcare workers. The vaccine is administered as a series of three doses, with the second and third doses given one and six months after the first dose, respectively.

### Hepatitis A Vaccine
The hepatitis A vaccine is recommended for adults with certain risk factors, such as those with chronic liver disease, men who have sex with men, and those who use illicit drugs. The vaccine is administered as a series of two doses, with the second dose given 6-12 months after the first.

### Zoster Vaccine
The recombinant zoster vaccine (RZV) is recommended for all adults aged 50 years and older, regardless of prior history of herpes zoster (shingles). The vaccine is administered as a series of two doses, with the second dose given 2-6 months after the first.

## Travel-Related Vaccinations

### Yellow Fever Vaccine
The yellow fever vaccine is recommended for adults traveling to or living in areas with risk of yellow fever virus transmission. The vaccine is administered as a single dose, with revaccination required every 10 years for continued risk of exposure.

### Typhoid Vaccine
The typhoid vaccine is recommended for adults traveling to areas with increased risk of typhoid fever, such as developing countries. The vaccine is available in both injectable and oral formulations, with the schedule depending on the specific vaccine used.

## Contraindications and Precautions

Certain medical conditions or circumstances may contraindicate or require precautions for specific adult immunizations. Healthcare providers should carefully review each patient's medical history and consider the following:

- Severe allergic reaction (e.g., anaphylaxis) to a previous dose of a vaccine or vaccine component
- Moderate or severe acute illness, with or without fever
- Immunocompromising conditions, such as HIV/AIDS, cancer, or organ transplantation
- Pregnancy (with the exception of the Tdap vaccine)

## Monitoring and Follow-up

After administering adult immunizations, healthcare providers should monitor patients for any immediate adverse reactions, such as syncope, allergic reactions, or pain at the injection site. Patients should be advised to report any delayed side effects, such as fever, muscle aches, or redness at the injection site.

Healthcare providers should also document the administration of vaccines in the patient's medical record, including the vaccine name, dose, route, date, and the name of the vaccine administrator. This information should be reported to immunization information systems (IIS) or registries, as required by local or state regulations.

## Conclusion

The adult immunization schedule is a crucial component of preventive healthcare, helping to protect individuals from a variety of infectious diseases. By staying up-to-date with recommended vaccinations, adults can reduce their risk of serious illness, hospitalization, and complications. Healthcare providers play a vital role in educating patients about the importance of adult immunizations and ensuring timely administration of the appropriate vaccines.