Grades are shown as the source states them. The CDC schedule states recommendations without evidence grades; it distinguishes routine vaccination, vaccination for people with risk factors, and shared clinical decision-making.
Key recommendations
Influenza: one dose every year. From 65, a high-dose (HD-IIV3), recombinant (RIV3) or adjuvanted (aIIV3) vaccine is preferred; if none is available, give any vaccine suitable for age.
Notes: influenza
Pneumococcal: from age 50, anyone who has never had a conjugate vaccine (or whose history is unknown) should have one dose of PCV20 or PCV21, or PCV15 followed by PPSV23 at least a year later.
Notes: pneumococcal
Shingles: from age 50, two doses of recombinant zoster vaccine 2–6 months apart, whether or not the person has had shingles or the old live zoster vaccine.
Notes: zoster
RSV: a single dose for everyone aged 75 or over who has not had one, and for people aged 50–74 at increased risk of severe RSV disease. Further doses are not recommended; giving it in late summer or early autumn, before RSV season, is best.
Notes: respiratory syncytial virus
Tetanus, diphtheria and pertussis: one dose of Tdap if never given in adolescence or adulthood, then Td or Tdap every 10 years.
Notes: Tdap
COVID-19: people aged 65 or over should have two doses of the current (2024–25) vaccine about 6 months apart (minimum 2 months).
Table 1 (by age); Notes: COVID-19
Diagnosis
To decide what is due, check the vaccines recommended by age, then extra vaccines for medical conditions, then the notes on intervals and special situations, the contraindications and precautions, and any addendum.
How to use the schedule
Investigations
Not covered in this summary — see the original guideline.
Treatment
Previous pneumococcal vaccines: after PCV13 only, give PCV20 or PCV21 at least a year later; after PPSV23 only, give PCV15, PCV20 or PCV21 at least a year later; after both PCV13 and PPSV23 (with PPSV23 before 65), give PCV20 or PCV21 at least 5 years after the last dose — or decide together with the person if PPSV23 was given at 65 or over.
Notes: pneumococcal
With an immunocompromising condition, the gap between PCV15 and PPSV23 can be shortened to 8 weeks, and recombinant zoster vaccine is recommended from age 19.
Notes: pneumococcal; zoster
Wounds: give Td or Tdap if more than 10 years have passed since the last tetanus-containing dose for a clean, minor wound, or more than 5 years for any other wound.
Notes: Tdap
Varicella serology is not needed before zoster vaccination.
Notes: zoster
People with an egg allergy can have any influenza vaccine appropriate for their age and health.
Notes: influenza
If vaccination history is incomplete or unknown, give the recommended vaccines; do not restart or add doses to a series because of a long gap between doses.
Administer recommended vaccines
Important geriatric considerations
For people aged 50–74, risk factors for severe RSV include chronic heart disease (not isolated hypertension), chronic lung disease, end-stage kidney disease, diabetes with complications or needing insulin or an SGLT2 inhibitor, neurological conditions that impair airway clearance (such as post-stroke dysphagia), chronic liver disease, severe obesity, immune compromise, living in a nursing home, and other risks such as frailty. People can self-report a risk factor.
Notes: respiratory syncytial virus
Moderately or severely immunocompromised people need more COVID-19 doses than the standard schedule, guided by the CDC's immunocompromise guidance.
Notes: COVID-19
Drug doses
Not covered in this summary — see the original guideline.
When to refer
Not covered in this summary — see the original guideline.
Red flags
Check the contraindications and precautions for each vaccine (in the schedule's appendix) before giving it.
How to use the schedule
Recent updates
A US court order of 16 March 2026 stayed ACIP votes taken in June, September and December 2025; CDC therefore lists the 2 July 2025 adult schedule, amended on 27 April 2026 to add the April 2025 RSV recommendation, as current. Check for later changes before relying on it.
Adult schedule by age: status statement