What vaccinations are recommended for adults based on age, health status, and other risk factors?

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Last updated: October 31, 2025 • View editorial policy

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Adult Vaccination Recommendations

All adults should receive specific vaccinations based on their age, health status, and risk factors as recommended by the American College of Physicians to prevent vaccine-preventable diseases and reduce morbidity and mortality. 1

Age-Based Recommendations

  • Annual influenza vaccination is recommended for all adults regardless of age or health status 1
  • Tetanus and diphtheria (Td) booster should be administered every 10 years, with one dose of Tdap (tetanus, diphtheria, pertussis) substituting for one Td booster in adulthood 1
  • Human Papillomavirus (HPV) vaccination is recommended as a 3-dose series for women through age 26 years and men through age 21 years 1
  • Zoster (shingles) vaccination is recommended as a single dose for adults aged ≥60 years, regardless of previous history of herpes zoster 1
  • Pneumococcal vaccination is recommended for adults 65 years or older, with PCV13 (based on shared clinical decision-making) followed by PPSV23 at least 1 year later 1

Health Status-Based Recommendations

  • Pneumococcal vaccination is strongly recommended for immunocompromised individuals and adults with chronic conditions including:
    • Chronic pulmonary disease (including asthma)
    • Chronic cardiovascular diseases
    • Diabetes mellitus
    • Chronic liver diseases 1
  • Hepatitis B vaccination is recommended for:
    • Adults with end-stage renal disease, including patients receiving hemodialysis
    • Adults with HIV infection
    • Adults with chronic liver disease 1
    • Adult hemodialysis patients should receive a 4-dose series (0,1,2,6 months) using 40 mcg (2 × 20 mcg) with annual antibody testing to assess need for booster doses 2

Risk Factor-Based Recommendations

  • Hepatitis B vaccination is recommended for:
    • Healthcare personnel and public safety workers exposed to blood
    • Sexually active persons not in long-term monogamous relationships
    • Current or recent injection drug users
    • Men who have sex with men 1
  • Hepatitis A vaccination is recommended for:
    • Persons working with hepatitis A virus in laboratory settings
    • Men who have sex with men
    • Persons who use illegal drugs
    • Persons traveling to countries with high or intermediate endemicity of hepatitis A 1
  • Meningococcal vaccination is recommended for:
    • Microbiologists routinely exposed to Neisseria meningitidis 1
    • Adolescents and adults aged 10 through 55 years at risk, with a single dose of MENVEO 3
    • A booster dose may be administered to individuals aged 15-55 years who remain at risk if at least 4 years have elapsed since prior dose 3

Special Considerations

  • Pregnant women should receive:
    • Tdap during each pregnancy, preferably between 27-36 weeks gestation
    • Influenza vaccination during influenza season 1
  • Asplenic individuals should receive pneumococcal, meningococcal, and Haemophilus influenzae type b vaccines 1

Vaccination Coverage Challenges

  • Despite longstanding recommendations, vaccination coverage among U.S. adults remains low and below Healthy People 2020 targets for most vaccines 4, 5
  • Racial/ethnic disparities persist in vaccination coverage, with generally higher coverage among whites compared to other groups 5
  • Adults without health insurance, those without a usual place for healthcare, and those with fewer physician contacts report lower vaccination rates 5
  • Even among adults with health insurance and frequent physician contacts (≥10 visits/year), 18.2%-85.6% reported not receiving recommended vaccinations 5

Strategies to Improve Vaccination Rates

  • Healthcare providers should assess vaccination status at every clinical encounter 4
  • Providers should routinely recommend and offer needed vaccines to adult patients 5
  • Implementation of reminder-recall systems and standing-order programs can improve vaccination coverage 5
  • Assessment of practice-level vaccination rates with feedback to staff members is recommended 5
  • Special attention should be given to identifying and vaccinating adults without regular providers or insurance 5

References

1
Guideline

Adult Vaccination Recommendations

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

5
Research

Surveillance of Vaccination Coverage among Adult Populations - United States, 2015.

Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002), 2017

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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