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From the Centers for Disease Control and Prevention
November 23/30, 2005

Recommended Adult Immunization Schedule—United States, October 2005–September 2006

JAMA. 2005;294(20):2569. doi:10.1001/jama.294.20.2569

MMWR. 2005;54:Q1-Q4

The Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule to ensure that the schedule reflects current recommendations for the use of licensed vaccines. In June 2005, ACIP approved the Adult Immunization Schedule for October 2005–September 2006. This schedule has also been approved by the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists.

Changes in the Schedule for October 2005–September 2006

The 2005–2006 schedule differs from the previous schedule as follows:

  • Vaccines listed on the age-based schedule (Figure 1) are displayed so that vaccines recommended for routine use can be differentiated from those recommended for adults with certain risk indicators (similar to the childhood immunization schedule). This is illustrated both by the color scheme and by the broken line.

  • The yellow bars (“For all persons in this group”) and the green bars (“For persons lacking documentation of vaccination or evidence of disease”) from the previous schedule have been merged into one yellow bar, which now reads, “For all persons in this category who meet the age requirements and who lack evidence of immunity (e.g., lack documentation of vaccination or have no evidence of prior infection).”

  • The purple bar has been changed from “For persons at risk (e.g., with medical/exposure indications)” to “Recommended if some other risk factor is present (e.g., on the basis of medical, occupational, lifestyle, or other indications).” The purple bar was added to the 50–64 years and >65 years age-group columns for measles, mumps, rubella (MMR) vaccine.

  • The column, “Diabetes, heart disease, chronic pulmonary disease, or chronic liver disease including chronic alcoholism” has been transposed with the column, “Congenital immunodeficiency, leukemia, lymphoma, generalized malignancy, therapy with alkylating agents, antimetabolites, cerebrospinal fluid leaks, radiation, or large amounts of corticosteroids” on the medical/other indications schedule (Figure 2) so that contraindications for MMR and varicella vaccines are now side-by-side.

  • The row for varicella vaccine has been moved up on both figures (i.e., to immediately after MMR vaccine) because the vaccine is now universally recommended for certain age groups.

  • Meningococcal vaccine has been added to the medical/other indications schedule (Figure 2). The footnote has been revised to incorporate the recently published ACIP recommendations for this vaccine1.

  • The tetanus and diphtheria footnote (#1) has been reworded.

  • The varicella footnote (#3) has been reworded in accordance with ACIP recommendations adopted in June 2005.

  • The influenza footnote (#4) has been revised to add the newest high-risk condition: neuromuscular conditions that compromise respiratory function2.

  • A 10th footnote has been added regarding Haemophilus influenzae type b vaccination for populations at high risk (i.e., persons with asplenia, leukemia, and human immunodeficiency virus [HIV] infection).

The Adult Immunization Schedule is available in English and Spanish at General information about adult immunization, including recommendations concerning vaccination of persons with HIV and other immunosuppressive conditions, is available from state and local health departments and from the National Immunization Program at Vaccine information statements are available at ACIP statements for each recommended vaccine can be viewed, downloaded, and printed from the National Immunization Program website at Instructions for reporting adverse events to the Vaccine Adverse Event Reporting System are available at or by telephone, 800-822-7967.

CDC.  Prevention and control of meningococcal disease: recommendations of the Advisory Committee for Immunization Practices (ACIP).  MMWR. 2005;54:(No. RR-7)  1-21
CDC.  Prevention and control of influenza: recommendations of the Advisory Committee for Immunization Practices (ACIP).  MMWR. 2005;54:(No. RR-8)  1-40