Immunizing Adult Patients: 

Standards for Practice

Your patients trust you to give them the best advice on how to protect their health. Vaccinepreventable diseases can result in serious illness, hospitalization, and even death.

Make adult vaccination a standard of care in your practice.

Your patients have probably not 

received all the vaccines they need.

Even though most insurance plans cover the cost of 

recommended vaccines, adult vaccination rates in the U.S. are 

extremely low. Each year, tens of thousands of 

adults needlessly suffer, are hospitalized, 

and even die as a result of diseases that 

could be prevented by vaccines. 

Your patients may 

not even realize that 

they need vaccines.

Many adults don’t know which vaccines 

are recommended for them throughout 

their lives. Many also report not 

receiving vaccine recommendations 

from their healthcare professional. 

You can make 

a difference.

Clinicians are the most 

valued and trusted source 

of health information for 

adults. Research shows 

that most adults believe 

vaccines are important and that 

a recommendation from their 

healthcare professional is a key 

predictor of patients getting 

needed vaccines. 

Make Immunization a Standard of 

Patient Care In Your Practice:

1. ASSESS the immunization status of all your patients

at every clinical encounter.

• Stay informed about the latest CDC recommendations

for immunization of adults.

• Implement protocols in your office to ensure that

patients’ vaccine needs are routinely reviewed and

patients get reminders about vaccines they need.

2. Strongly RECOMMEND vaccines that your

patients need.

• Address patient questions and concerns in clear and

understandable language.

• Highlight your positive experiences with vaccination

(personal or in your practice).

3. ADMINISTER needed vaccines or REFER your

patients to a vaccination provider.

• For vaccines that you stock, make vaccination services

as convenient as possible for your patients.

• For vaccines that you don’t stock, refer patients to

providers in the area that offer vaccination services.

4. DOCUMENT vaccines received by your patients.

• Participate in your state’s immunization registry to

help your office, your patients, and your patients’ other

providers know which vaccines your patients have had.

• Follow up to confirm that patients received

recommended vaccines that you referred them to get

from other immunization providers.

Standards for Adult Immunization Practice emphasize the role of ALL healthcare 

professionals—whether they provide immunization services or not—in ensuring 

that adult patients are fully immunized. These standards are published by the 

National Vaccine Advisory Committee and supported by the Centers for Disease 

Control and Prevention as well as a number of national medical associations. 

DON’T WAIT.

VACCINATE!

U.S. Department of 

Health and Human Services 

Centers for Disease 

Control and Prevention 
Overview of Recommended Vaccines for Adults*

VACCINE WHO NEEDS IT NUMBER OF DOSES

Seasonal 

Influenza

ALL Adults 1 dose every year

Tdap ALL Adults who have not received a dose since age 11 or older

Women should receive during every pregnancy

1 dose (All)

1 dose each pregnancy

Td ALL Adults 1 dose every 10 years

Zoster† Adults 50 years or older 2 doses

Pneumococcal 

Conjugate

Adult 65 years or older

Adults 64 or younger with certain medical conditions (HIV, asplenia, sickle cell disease, 

cerebrospinal fluid leaks, cochlear implants, or conditions that cause weakening of the 

immune system)

1 dose (if not 

previously received)

1 dose (if not 

previously received)

Pneumococcal 

Polysaccharide

Adults 65 years or older

Adults 64 years or younger with certain medical conditions and who are at higher risk 

of infection

1 dose

1 or 2 doses

HPV Adults 26 years or younger who have not started or finished the vaccine series

Meningococcal Adults who have not had the vaccine and are at risk for exposure or have 

damaged spleen 1 or more doses

MMR Adults born during or after 1957 who have not had the vaccine or do not have 

documented evidence of immunity

1 or 2 doses

Varicella Adults who have not had chickenpox or do not have documented evidence of immunity 2 doses

Hep A Adults who are at risk and have not had the vaccine series 2 doses

Hep B Adults who have not had the vaccine series and who are at risk, including adults with 

diabetes, end-stage kidney disease, chronic liver disease, or behaviors that increase risk

3 doses

Hib Adults with special health conditions (sickle cell disease, HIV/AIDS, removal of 

the spleen, bone marrow transplant, or cancer treatment with drugs) who have 

not already had the vaccine

1 dose

*Visit www.cdc.gov/vaccines/schedules/ for a detailed schedule of recommended vaccines and guidelines for administration.

Coverage of Adult Vaccines

Most private health insurance plans cover the cost of recommended vaccines. If your patients 

do not currently have health insurance, refer them to www.HealthCare.gov to learn more about 

health coverage options. 

For patients 65 years or older enrolled in Medicare, Medicare Part B covers the cost of influenza 

and pneumococcal vaccines as well as Hep B vaccine for persons at increased risk of hepatitis. 

Those with a Medicare Prescription Drug Plan (Part D) or enrolled in a Medicare Advantage Plan 

(Part C) that offers Medicare prescription drug coverage may also have coverage for additional 

vaccines like zoster, MMR, and Tdap. Visit www.Medicare.gov for more information.

Vaccine coverage for Medicaid beneficiaries varies by state. Contact your State Medicaid Agency 

for more information.

In 2014:

• Only 20% of adults 

19 years or older had 

received Tdap vaccine.

• Only 28% of adults 

60 years or older had 

received zoster vaccine. 

• Only 20% of adults 

19 to 64 years at high 

risk had received 

pneumococcal vaccine.

Source: National Health 

Interview Survey, 2014.

For additional information on adult

immunization and resources for patient education, 

visit: www.cdc.gov/vaccines/hcp/adults. Last Updated March 2020

†Zostavax may still be used to prevent shingles in healthy adults 60 years and older. For example, you could use Zostavax 

if a person is allergic to Shingrix, prefers Zostavax, or requests immediate vaccination and Shingrix is unavailable. 

See: https://www.cdc.gov/vaccines/vpd/shingles/public/zostavax/index.html

2 or 3 doses, depending 

on age at first dose