The CDC Advisory Committee on Immunization Practices routine immunization recommendations for adults are below. Sometimes a person may have a medical condition that makes a particular vaccine the best choice for them, or that even prevents immunization with a certain vaccine, so be sure to follow what your healthcare provider says. Ask for a vaccine record book or card. Take it to every healthcare visit and keep a copy in a safe place. It will be important to hold onto it throughout your life.

Tetanus, Diphtheria & Pertussis Vaccine (Td/Tdap): protects against three bacterial diseases. Respiratory diphtheria initially causes a sore throat, fever and chills. The poison produced by the bacteria can cause serious problems, such as heart failure or paralysis. Tetanus bacteria poisons can cause lockjaw and muscle spasms. Pertussis (whooping cough) causes severe coughing spasms that can last for weeks.

Adults should have completed a three-dose primary series of tetanus- and diphtheria-containing vaccine as a child, and subsequently should get Td every 10 years starting at age 11-12 years. A dose of Tdap should replace one dose of Td, preferably at the 11-12 year old visit.

Even if it has only been 2 years since the last Td shot, a Tdap dose is recommended for women who just had a baby; people in close contact with infants younger than 1 year; and all healthcare personnel with direct patient contact.

Adults who do not have a record of getting three doses of vaccination against tetanus- and diphtheria-containing vaccine should receive two doses of Td and one dose of Tdap over a 6-month period.

Human Papillomavirus Vaccine (HPV): protects against four types of HPV that cause 70 percent of cervical cancers and 90 percent of genital warts. Women 19-26 years of age should receive three doses over a 6-month period. This vaccine is not given during pregnancy.

Measles, Mumps, Rubella Vaccine (MMR): protects against three viruses. Measles cause a rash, fever, cough, runny nose and eye irritation. Mumps cause fever, headache and swollen glands. Rubella (German measles) causes a rash and fever. Rubella infection in the first 3 months of pregnancy can lead to fetal death or serious birth defects.

Adults born before 1957 can generally be considered immune to measles, mumps and rubella. Adults born in 1957 or after should receive one dose of MMR, if they are not already immune or vaccinated. Some adults will need a second dose of MMR vaccine, so consult your healthcare provider.

Women of childbearing age, regardless of when they were born, should have evidence of rubella immunity or vaccination with one dose of rubella. Women who do not have a reliable history of rubella vaccination, or who lack laboratory evidence of immunity, should receive one dose of MMR. This vaccine is not given during pregnancy.

Varicella (Chickenpox) Vaccine: protects against a very contagious virus that causes fever and an itchy rash. Adults born in the U.S. before 1980 (except healthcare personnel and pregnant women) can be considered immune to chickenpox. All other adults who do not have proof of immunity to chickenpox (including healthcare personnel and women of child-bearing age) should receive two doses of varicella vaccine separated by 4-8 weeks. This vaccine is not given during pregnancy.

Flu (Influenza) Vaccine: protects against three influenza viruses that infect the lungs and can cause fever, headache, body aches, fatigue, loss of appetite and a dry cough.  Adults 50 and older and anyone with a chronic health condition (for example, asthma, diabetes, or heart and lung disease) should receive flu vaccine each fall. The vaccine is available to anyone who wants protection against the flu. The vaccine changes each year so get vaccinated annually.

Pneumococcal Polysaccharide Vaccine (PPV23): protects against 23 types of pneumococcus bacteria that can infect the blood (bacteremia), the lungs (pneumonia) and the fluid around the spinal cord and brain (meningitis). Adults 65 or older, and anyone with a chronic health condition (for example, heart or lung disease, sickle cell or immunosuppression) that increases their risk for pneumococcal disease, should be vaccinated.

Hepatitis A Vaccine (Hep A): protects against a virus that causes liver disease. Adults at increased risk for infection (for example, people with chronic liver disease or clotting factor disorder, illegal drug users, men who have sex with men and many international travelers) should receive two doses of hep A vaccine at least 6 months apart.

Hepatitis B Vaccine (Hep B): protects against a virus that causes liver disease, liver scarring or even cancer of the liver. Adults at increased risk for infection (for example, people with chronic liver disease or clotting factor disorder, people who inject illegal drugs, people with kidney disease on dialysis, sexually active persons with more than one partner in 6 months, people with sexually transmitted diseases, household and sex partners of someone infected with hep B, some international travelers, and many healthcare personnel) should receive three doses of hepatitis B vaccine over a 6-month period.

Meningococcal Vaccine (MPSV4 or MCV4): protects against four types of meningococcal bacteria that can infect the blood (septicemia) or the fluid around the spinal cord and brain (meningitis).

Adults at increased risk for meningococcal disease (for example, military recruits, some international travelers and first-year college students who live in a dormitory) should receive one dose of meningococcal vaccine. MCV4 vaccine is preferred for adults 55 and younger. MPSV4 should be used for older adults, or if MCV4 is not available.

Resources
CDC: http://www.cdc.gov/nip/recs/adult-schedule.htm;  http://www.cdc.gov/nip/publications/vis/ and http://www.immunize.org/catg.d/p4030a.pdf

- Donna L. Weaver is nurse educator, National Immunization Program, CDC, Atlanta.