Medical - Vaccine Guide 2022 - 23

Notes
Recommended Adult Immunization Schedule for ages 19 years or older, United States, 2022
For vaccine recommendations for persons 18 years
of age or younger, see the Recommended Child
and Adolescent Immunization Schedule.
COVID-19 Vaccination
COVID-19 vaccines are recommended within the
scope of the Emergency Use Authorization or
Biologics License Application for the particular
vaccine. ACIP recommendations for the use of
COVID-19 vaccines can be found at www.cdc.gov/
vaccines/hcp/acip-recs/vacc-specific/covid-19.html.
CDC's interim clinical considerations for use of
COVID-19 vaccines can be found at www.cdc.gov/
vaccines/covid-19/clinical-considerations/covid-19vaccines-us.html.
Haemophilus
influenzae type b vaccination
Special situations
y Anatomical or functional asplenia (including sickle cell
disease): 1 dose if previously did not receive Hib; if elective
splenectomy, 1 dose, preferably at least 14 days before
splenectomy
y Hematopoietic stem cell transplant (HSCT): 3-dose
series 4 weeks apart starting 6-12 months after successful
transplant, regardless of Hib vaccination history
Hepatitis A vaccination
Routine vaccination
y Not at risk but want protection from hepatitis A
(identification of risk factor not required): 2-dose series
HepA (Havrix 6-12 months apart or Vaqta 6-18 months
apart [minimum interval: 6 months]) or 3-dose series HepAHepB
(Twinrix at 0, 1, 6 months [minimum intervals: dose 1
to dose 2: 4 weeks / dose 2 to dose 3: 5 months])
Special situations
y At risk for hepatitis A virus infection: 2-dose series HepA
or 3-dose series HepA-HepB as above
- Chronic liver disease (e.g., persons with hepatitis B,
hepatitis C, cirrhosis, fatty liver disease, alcoholic liver
disease, autoimmune hepatitis, alanine aminotransferase
[ALT] or aspartate aminotransferase [AST] level greater
than twice the upper limit of normal)
22MS6015
- HIV infection
- Men who have sex with men
- Injection or noninjection drug use
- Persons experiencing homelessness
-Work with hepatitis A virus in research laboratory or
with nonhuman primates with hepatitis A virus infection
- Travel in countries with high or intermediate endemic
hepatitis A (HepA-HepB [Twinrix] may be administered
on an accelerated schedule of 3 doses at 0, 7, and 21-30
days, followed by a booster dose at 12 months)
- Close, personal contact with international adoptee
(e.g., household or regular babysitting) in first 60 days
after arrival from country with high or intermediate
endemic hepatitis A (administer dose 1 as soon as
adoption is planned, at least 2 weeks before adoptee's
arrival)
- Pregnancy if at risk for infection or severe outcome from
infection during pregnancy
- Settings for exposure, including health care settings
targeting services to injection or noninjection drug users
or group homes and nonresidential day care facilities for
developmentally disabled persons (individual risk factor
screening not required)
Hepatitis B vaccination
Routine vaccination
y Age 19 through 59 years: complete a 2- or 3-, or 4-dose
series
- 2-dose series only applies when 2 doses of Heplisav-B* are
used at least 4 weeks apart
- 3-dose series Engerix-B or Recombivax HB at 0, 1, 6 months
[minimum intervals: dose 1 to dose 2: 4 weeks / dose 2 to
dose 3: 8 weeks / dose 1 to dose 3: 16 weeks])
- 3-dose series HepA-HepB (Twinrix at 0, 1, 6 months
[minimum intervals: dose 1 to dose 2: 4 weeks / dose 2 to
dose 3: 5 months])
- 4-dose series HepA-HepB (Twinrix) accelerated schedule
of 3 doses at 0, 7, and 21-30 days, followed by a booster
dose at 12 months
- 4-dose series Engerix-B at 0, 1, 2, and 6 months for persons
on adult hemodialysis (note: each dosage is double that of
normal adult dose, i.e., 2 mL instead of 1 mL)
*Note: Heplisav-B not recommended in pregnancy due to
lack of safety data in pregnant women
Special situations
y Age 60 years or older* and at risk for hepatitis B virus
infection: 2-dose (Heplisav-B) or 3-dose (Engerix-B,
Recombivax HB) series or 3-dose series HepA-HepB
(Twinrix) as above
- Chronic liver disease (e.g., persons with hepatitis
C, cirrhosis, fatty liver disease, alcoholic liver disease,
autoimmune hepatitis, alanine aminotransferase [ALT] or
aspartate aminotransferase [AST] level greater than twice
upper limit of normal)
- HIV infection
- Sexual exposure risk (e.g., 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
- Percutaneous or mucosal risk for exposure to blood
(e.g., household contacts of HBsAg-positive persons;
residents and staff of facilities for developmentally
disabled persons; health care and public safety personnel
with reasonably anticipated risk for exposure to blood or
blood-contaminated body fluids; hemodialysis, peritoneal
dialysis, home dialysis, and predialysis patients; patients
with diabetes)
- Incarcerated persons
- Travel in countries with high or intermediate endemic
hepatitis B
*Note: Anyone age 60 years or older who does not meet
risk-based recommendations may still receive Hepatitis B
vaccination.
Human papillomavirus vaccination
Routine vaccination
y HPV vaccination recommended for all persons through
age 26 years: 2- or 3-dose series depending on age at initial
vaccination or condition:
- Age 15 years or older at initial vaccination: 3-dose series
at 0, 1-2 months, 6 months (minimum intervals: dose 1 to
dose 2: 4 weeks / dose 2 to dose 3: 12 weeks / dose 1 to
dose 3: 5 months; repeat dose if administered too soon)
- Age 9-14 years at initial vaccination and received 1
dose or 2 doses less than 5 months apart: 1 additional
dose
- Age 9-14 years at initial vaccination and received 2
doses at least 5 months apart: HPV vaccination series
complete, no additional dose needed
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Medical - Vaccine Guide 2022

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