2025 CDC Vaccination Guidelines Update
The 2025 CDC vaccination guidelines include significant updates to COVID-19, influenza, meningococcal, pneumococcal, and RSV vaccine recommendations, with influenza vaccines changing from quadrivalent to trivalent formulations and new recommendations for special populations. 1
Key Changes in the 2025 Adult Immunization Schedule
COVID-19 Vaccines
- Adults aged 19-64 years: 1 or more doses of updated 2024-2025 vaccine 1
- Adults aged ≥65 years: 2 or more doses of updated 2024-2025 vaccine 1
- Immunocompromised individuals: Additional dosing recommendations with specific intervals 2
Influenza Vaccines
- All recommended influenza vaccines changed from quadrivalent to trivalent formulation to align with FDA-approved products for 2024-25 season 1
- Adults aged ≥65 years: Preferential recommendation for trivalent high-dose inactivated influenza vaccine (HD-IIV3), trivalent recombinant influenza vaccine (RIV3), or trivalent adjuvanted inactivated influenza vaccine (aIIV3) 1
- Solid organ transplant recipients aged 19-64 years receiving immunosuppressive medications: May now receive HD-IIV3 and aIIV3 (added to previously recommended options) 1
RSV Vaccines
- Adults aged ≥75 years: Universal recommendation if not previously vaccinated 1
- Adults aged 60-74 years: Recommended for those with risk factors for severe RSV disease 1
Other Notable Updates
- Inactivated polio vaccine (IPV) added to the tables 1
- Clarifications in the Notes sections for:
- Hepatitis B vaccine (HepB)
- Mpox vaccine
- Tetanus and diphtheria toxoids, and acellular pertussis vaccine (Tdap) 1
Vaccine Effectiveness Data
Influenza Vaccines
Recent interim estimates show the 2024-2025 seasonal influenza vaccines are effective:
- Adults ≥18 years: 36-54% effective against outpatient influenza visits and 41-55% effective against hospitalizations 3
- These findings support the CDC recommendation for annual influenza vaccination for all eligible persons aged ≥6 months 3
COVID-19 Vaccines
The 2024-2025 COVID-19 vaccines have demonstrated:
- 33% effectiveness against COVID-19-associated ED/UC visits among adults ≥18 years
- 45-46% effectiveness against COVID-19-associated hospitalization among immunocompetent adults ≥65 years
- 40% effectiveness against COVID-19-associated hospitalization among immunocompromised adults ≥65 years 2
Common Pitfalls to Avoid
Delaying vaccination: Providers should not wait until December to administer influenza vaccines; vaccination should begin as soon as vaccines are available and continue throughout the influenza season 4
Overlooking special populations: Different dosing schedules are required for immunocompromised individuals and other special populations 2
Neglecting to report adverse events: Healthcare providers should report adverse events to the Vaccine Adverse Event Reporting System (VAERS), particularly for vaccines under Emergency Use Authorization 2
Assuming natural immunity is sufficient: For COVID-19, vaccination after infection provides more durable and broader protection than infection alone 2
Accessing the Complete Schedule
The complete 2025 adult immunization schedule can be found on the CDC website (https://www.cdc.gov/vaccines/hcp/imz-schedules/index.html) 1. Healthcare providers are strongly encouraged to use all parts of the schedule (cover page, tables, notes, appendix, and addendum) together when making recommendations for individual patients.
The 2025 schedule is recommended by ACIP and approved by CDC, the American College of Physicians, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Nurse-Midwives, the American Academy of Physician Associates, the American Pharmacists Association, and the Society for Healthcare Epidemiology of America 1.