Medical - Vaccine Guide 2022 - 24

Notes
y Interrupted schedules: If vaccination schedule is
interrupted, the series does not need to be restarted
y No additional dose recommended when any HPV
vaccine series has been completed using the
recommended dosing intervals.
Shared clinical decision-making
y Some adults age 27-45 years: Based on shared clinical
decision-making, 2- or 3-dose series as above
Special situations
y Age ranges recommended above for routine and catchup
vaccination or shared clinical decision-making also
apply in special situations
- Immunocompromising conditions, including HIV
infection: 3-dose series, even for those who initiate
vaccination at age 9 through 14 years.
- Pregnancy: Pregnancy testing is not needed before
vaccination; HPV vaccination is not recommended until
after pregnancy; no intervention needed if inadvertently
vaccinated while pregnant
Influenza vaccination
Routine vaccination
y Age 19 years or older: 1 dose any influenza vaccine
appropriate for age and health status annually
y For the 2021-2022 season, see www.cdc.gov/mmwr/
volumes/70/rr/rr7005a1.htm
y For the 2022-23 season, see the 2022-23 ACIP influenza
vaccine recommendations.
Special situations
y Egg allergy, hives only: any influenza vaccine appropriate
for age and health status annually
y Egg allergy-any symptom other than hives (e.g.,
angioedema, respiratory distress) or required epinephrine
or another emergency medical intervention: see Appendix
listing contraindications and precautions
y Severe allergic reaction (e.g., anaphylaxis) to a vaccine
component or a previous dose of any influenza vaccine:
see Appendix listing contraindications and precautions
y History of Guillain-Barré syndrome within 6 weeks after
previous dose of influenza vaccine: Generally, should
not be vaccinated unless vaccination benefits outweigh
risks for those at higher risk for severe complications from
influenza
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Recommended Adult Immunization Schedule, United States, 2022
Measles, mumps, and rubella vaccination
Meningococcal vaccination
Routine vaccination
y No evidence of immunity to measles, mumps, or
rubella: 1 dose
- Evidence of immunity: Born before 1957 (health care
personnel, see below), documentation of receipt of MMR
vaccine, laboratory evidence of immunity or disease
(diagnosis of disease without laboratory confirmation is
not evidence of immunity)
Special situations
y Pregnancy with no evidence of immunity to rubella:
MMR contraindicated during pregnancy; after pregnancy
(before discharge from health care facility), 1 dose
y Nonpregnant women of childbearing age with no
evidence of immunity to rubella: 1 dose
y HIV infection with CD4 percentages ≥15% and CD4
count ≥200 cells/mm3
for at least 6 months and no
evidence of immunity to measles, mumps, or rubella:
2-dose series at least 4 weeks apart; MMR contraindicated
for HIV infection with CD4 percentage <15% or CD4 count
<200 cells/mm3
y Severe immunocompromising conditions: MMR
contraindicated
y Students in postsecondary educational institutions,
international travelers, and household or close,
personal contacts of immunocompromised persons
with no evidence of immunity to measles, mumps, or
rubella: 2-dose series at least 4 weeks apart if previously
did not receive any doses of MMR or 1 dose if previously
received 1 dose MMR
y Health care personnel:
- Born before 1957 with no evidence of immunity to
measles, mumps, or rubella: Consider 2-dose series at
least 4 weeks apart for measles or mumps or 1 dose for
rubella
- Born in 1957 or later with no evidence of immunity
to measles, mumps, or rubella: 2-dose series at least 4
weeks apart for measles or mumps or at least 1 dose for
rubella
Special situations for MenACWY
y Anatomical or functional asplenia (including sickle
cell disease), HIV infection, persistent complement
component deficiency, complement inhibitor (e.g.,
eculizumab, ravulizumab) use: 2-dose series MenACWY-D
(Menactra, Menveo, or MenQuadfi) at least 8 weeks apart
and revaccinate every 5 years if risk remains
y Travel in countries with hyperendemic or epidemic
meningococcal disease, or microbiologists routinely
exposed to Neisseria meningitidis: 1 dose MenACWY
(Menactra, Menveo, or MenQuadfi) and revaccinate every 5
years if risk remains
y First-year college students who live in residential
housing (if not previously vaccinated at age 16 years or
older) or military recruits: 1 dose MenACWY (Menactra,
Menveo, or MenQuadfi)
y For MenACWY booster dose recommendations for
groups listed under " Special situations " and in an outbreak
setting (e.g., in community or organizational settings
and among men who have sex with men) and additional
meningococcal vaccination information, see www.cdc.gov/
mmwr/volumes/69/rr/rr6909a1.htm
Shared clinical decision-making for MenB
y Adolescents and young adults age 16-23 years (age
16-18 years preferred) not at increased risk for
meningococcal disease: Based on shared clinical decisionmaking,
2-dose series MenB-4C (Bexsero) at least 1 month
apart or 2-dose series MenB-FHbp (Trumenba) at 0, 6
months (if dose 2 was administered less than 6 months
after dose 1, administer dose 3 at least 4 months after dose
2); MenB-4C and MenB-FHbp are not interchangeable (use
same product for all doses in series)
Special situations for MenB
y Anatomical or functional asplenia (including sickle cell
disease), persistent complement component deficiency,
complement inhibitor (e.g., eculizumab, ravulizumab)
use, or microbiologists routinely exposed to Neisseria
meningitidis:
y 2-dose primary series MenB-4C (Bexsero) at least 1 month
apart or 3-dose primary series MenB-FHbp (Trumenba) at 0,
1-2, 6 months (if dose 2 was administered at least 6 months
after dose 1, dose 3 not needed); MenB-4C and MenB-FHbp
are not interchangeable (use same product for all doses in
series); 1 dose MenB booster 1 year after primary series and
revaccinate every 2-3 years if risk remains
22MS6015
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Medical - Vaccine Guide 2022

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