Summary

2025 ACIP Adult Immunization Schedule (addendum updated July 2, 2025) provides age-based vaccine recommendations for adults ≥19 years in the United States. Schedule is organized by age band (19–26, 27–49, 50–64, ≥65) and is paired with separate tables by medical condition, notes, appendix, and addendum for updated ACIP guidance. Notable 2025 features include the ≥65 recommendation for ≥2 doses of 2024–2025 COVID-19 vaccine, RSV vaccination at age ≥75 (and 50–74 with risk factors), and seasonal RSV in pregnancy.

Key Recommendations

Give 1 dose of inactivated or recombinant influenza vaccine annually to all adults ≥19 years; for adults ≥65, prefer HD-IIV3, RIV3, or aIIV3.
Recommend ≥2 doses of 2024–2025 COVID-19 vaccine for adults ≥65 years; ≥1 dose for adults 19–64.
Routinely give RSV vaccine to adults ≥75 years; offer to adults 50–74 with risk factors, and give seasonally during pregnancy.
Give 1 dose Tdap (any adult who has not received it), then Td or Tdap booster every 10 years; give Tdap each pregnancy and for wound management.
Vaccinate adults born in 1957 or later with 1–2 doses MMR depending on indication; ensure 2-dose MMR for healthcare personnel.
Give 2 doses varicella vaccine to adults without evidence of immunity (especially if born in 1980 or later).
Give 2 doses recombinant zoster vaccine (RZV) to all adults ≥50 years, and to immunocompromised adults ≥19 years.
Offer HPV vaccination routinely through age 26; use shared clinical decision-making for ages 27–45.
Use age-appropriate pneumococcal vaccination (PCV15, PCV20, PCV21, or PPSV23) for adults ≥65 and for younger adults with risk conditions, per Notes.
Give MenACWY (1–2 doses) and MenB (2–3 doses, ages 19–23 by shared clinical decision-making) based on indication and risk factors.
Complete a 3-dose IPV series in adults who are incompletely vaccinated; self-report of prior doses is acceptable.
Give 2-dose Mpox (JYNNEOS) vaccine to adults at risk for mpox exposure.

Thresholds & Doses

Age ≥65 years: ≥2 doses of 2024–2025 COVID-19 vaccine; age 19–64: ≥1 dose.
Age ≥75 years: routine RSV vaccination; age 50–74: RSV with risk factors.
Influenza: 1 dose annually for all adults ≥19; HD-IIV3, RIV3, or aIIV3 preferred at ≥65 years.
Tdap: 1 dose, then Td/Tdap booster every 10 years; 1 dose Tdap each pregnancy.
MMR: routine for adults born in 1957 or later; 2 doses for healthcare personnel.
Varicella: 2 doses if born in 1980 or later without evidence of immunity.
RZV (zoster): 2 doses at age ≥50; 2 doses at age ≥19 if immunocompromised.
HPV: routine through age 26; shared clinical decision-making ages 27–45; 2 or 3 doses depending on age at initiation.
MenB: shared clinical decision-making for ages 19–23 without risk factors.
IPV: complete 3-dose series if incompletely vaccinated.
Mpox: 2-dose series for at-risk adults.
Hepatitis A: 2, 3, or 4 doses depending on product; Hepatitis B: 2, 3, or 4 doses depending on product/condition.

Citations

Table 1 — Recommended Adult Immunization Schedule by Age, 2025 (ages 19–26, 27–49, 50–64, ≥65)
Adult Schedule Notes — COVID-19, influenza, RSV, Tdap, MMR, varicella, zoster, HPV, pneumococcal, hepatitis A/B, meningococcal, Hib, mpox, polio
Addendum (updated July 2, 2025) — new or updated ACIP guidance
Table 2 — Recommended Adult Immunization Schedule by Medical Condition and Other Indications
Appendix — Contraindications and Precautions for Vaccines Routinely Recommended for Adults
ACIP Shared Clinical Decision-Making Recommendations (HPV 27–45, MenB 19–23)