Summary

2025 CDC/ACIP Adult Immunization Schedule (addendum updated July 2, 2025) for adults aged ≥19 years. Organized by age group (19–26, 27–49, 50–64, ≥65) and by medical condition, covering routine, risk-based, and shared clinical decision-making vaccines including COVID-19, influenza, RSV, Tdap, MMR, varicella, zoster, HPV, pneumococcal, hepatitis A/B, meningococcal, Hib, mpox, and IPV.

Key Recommendations

Administer ≥1 dose of 2024–2025 COVID-19 vaccine to all adults ≥19 years; adults ≥65 should receive ≥2 doses of 2024–2025 vaccine.
Give 1 dose of seasonal influenza vaccine annually to all adults; for adults ≥65, prefer HD-IIV3, RIV3, or aIIV3.
Administer RSV vaccine to all adults ≥75 years, and to adults 50–74 years with risk factors (shared clinical decision-making); give seasonally during pregnancy.
Give 1 dose of Tdap each pregnancy, then Td or Tdap booster every 10 years; use Td/Tdap for wound management.
Administer 2 doses of recombinant zoster vaccine (RZV) to all adults ≥50 years and to immunocompromised adults ≥19 years.
Give HPV vaccination routinely through age 26 (2 or 3 doses depending on age at initiation); for ages 27–45, use shared clinical decision-making.
Vaccinate adults born in 1980 or later with 2 doses of varicella vaccine if lacking evidence of immunity; MMR 1–2 doses if born in 1957 or later.
Provide pneumococcal vaccination (PCV15, PCV20, PCV21, or PPSV23 per ACIP notes) to all adults ≥50 years and to younger adults with risk conditions.
Offer MenB to adults 19–23 years via shared clinical decision-making; give MenACWY and MenB to adults with anatomic/functional asplenia, complement deficiency, or HIV.
Complete a 3-dose IPV series for adults with incomplete or unknown polio vaccination status; self-report of prior doses is acceptable.
Vaccinate adults at risk for mpox with a 2-dose JYNNEOS series.
Vaccinate health care personnel against MMR, varicella, hepatitis B, and influenza regardless of age when evidence of immunity is lacking.

Thresholds & Doses

COVID-19: ≥1 dose of 2024–2025 vaccine for ages 19–64; ≥2 doses for age ≥65.
Influenza: 1 dose annually for all adults ≥19 years; HD-IIV3/RIV3/aIIV3 preferred at ≥65.
RSV: routine for adults ≥75; risk-based for 50–74; seasonal in pregnancy.
Tdap: 1 dose Tdap each pregnancy; Td/Tdap booster every 10 years.
MMR: 1–2 doses for adults born in 1957 or later lacking immunity.
Varicella: 2-dose series for adults born in 1980 or later without immunity.
Zoster (RZV): 2 doses for all adults ≥50 years; 2 doses for immunocompromised adults ≥19 years.
HPV: routine through age 26 (2 doses if initiated <15 yr, 3 doses if ≥15 yr or immunocompromised); shared decision-making 27–45 years.
Pneumococcal: PCV15/PCV20/PCV21/PPSV23 recommended for all adults ≥50 years.
Hepatitis A: 2, 3, or 4 doses depending on product.
Hepatitis B: 2, 3, or 4 doses depending on product or condition.
MenACWY: 1 or 2 doses based on indication, with boosters per ACIP notes.
MenB: 2 or 3 doses; shared clinical decision-making for ages 19–23.
Hib: 1 or 3 doses based on indication (e.g., asplenia, HSCT).
Mpox (JYNNEOS): 2-dose series.
IPV: complete 3-dose series in incompletely vaccinated adults.

Citations

Table 1 — Recommended Adult Immunization Schedule by Age Group, 2025
Notes — COVID-19 vaccination
Notes — Influenza vaccination (preferred products ≥65)
Notes — RSV vaccination (ages 50–74, ≥75, and pregnancy)
Notes — Tdap/Td (pregnancy and decennial booster)
Notes — Zoster recombinant (RZV) ages ≥50 and immunocompromised
Notes — Pneumococcal vaccination (PCV15/20/21, PPSV23)
Addendum (July 2, 2025) — Updated ACIP guidance