2024 ACIP Adult Immunization Schedule for Ages 19 Years and Older
The 2024 ACIP adult immunization schedule, approved in October 2023, provides comprehensive vaccination recommendations for all adults aged ≥19 years and is endorsed by CDC and eight major medical professional organizations. 1
Key Structural Components
Healthcare providers must use all components together when determining vaccination recommendations for individual patients 1:
- Cover page with implementation guidance
- Table 1 (age-based routine immunization schedule)
- Table 2 (indication-based immunization schedule)
- Notes sections with detailed vaccine-specific guidance
- Appendix with additional information
- New addendum section that summarizes recommendations occurring between annual updates 1
Major Vaccine Updates in 2024
The 2024 schedule includes significant changes across multiple vaccines 1:
Respiratory Syncytial Virus (RSV)
- New addition to the schedule with age-stratified recommendations 1
- Adults aged ≥60 years: Shared clinical decision-making approach for vaccination with either Abrysvo or Arexvy 1
- Pregnant individuals (32-36 weeks' gestation): Seasonal administration of Abrysvo 1
COVID-19 Vaccines
- Updated to reflect monovalent XBB.1.5-derived vaccine (2023-2024 formula) 1
- Recommendation for "1 or more doses of updated vaccine" for all adults aged ≥19 years 1
- Bivalent mRNA COVID-19 vaccines removed from the schedule as they are no longer recommended 1
Influenza Vaccines
- Updated recommendations with continued annual vaccination for all adults 1
Other Vaccine Changes
- Mpox vaccine (Jynneos): Updated recommendations 1
- Inactivated poliovirus vaccine (IPV): New guidance 1
- Pentavalent meningococcal vaccine (MenACWY-TT/MenB-FHbp [Penbraya]): Added to schedule 1
- MenACWY-D (Menactra): Removed entirely as product is no longer distributed in the United States 1
Clarifications for Existing Vaccines
Updated guidance provided for 1:
- Hepatitis A vaccine (HepA)
- Hepatitis B vaccine (HepB)
- Human papillomavirus vaccine (HPV)
- Measles, mumps, and rubella vaccine (MMR)
- Pneumococcal vaccines
- Tetanus, diphtheria, and pertussis vaccine (Tdap)
Evidence-Based Development Process
ACIP recommendations are developed through rigorous evaluation of multiple factors 1:
- Disease epidemiology and societal impacts
- Vaccine efficacy and effectiveness data
- Vaccine safety profiles
- Quality of evidence
- Feasibility of program implementation
- Impact on health equity
- Economic analyses of immunization policy
Critical Implementation Points
Dynamic Nature of Recommendations
Healthcare providers must recognize that vaccine recommendations change between annual schedule updates 1. The new addendum section addresses this by summarizing interim changes, but providers should regularly consult ACIP recommendations directly for the most current guidance 1.
Multi-Organization Endorsement
The schedule carries approval from eight major professional organizations beyond CDC and ACIP 1:
- American College of Physicians
- American Academy of Family Physicians
- American College of Obstetricians and Gynecologists
- American College of Nurse-Midwives
- American Academy of Physician Associates
- American Pharmacists Association
- Society for Healthcare Epidemiology of America
Access and Implementation
- Online version and mobile app available at CDC's immunization schedule website 1
- Content syndication recommended over copying schedules to ensure organizations display the most current version 1
Common Pitfalls to Avoid
Do not rely solely on Table 1 or Table 2 - the complete schedule requires integration of all components (cover page, tables, notes, appendix, and addendum) for accurate patient-specific recommendations 1.
Do not assume vaccine trade names imply endorsement - these are used for identification purposes only 1.
Do not overlook the addendum section - this new feature captures important interim updates that occur between annual publications 1.