Vaccinations recommended for unvaccinated adults
| Vaccine | Dosing | Contraindications | Precautions |
|---|---|---|---|
| Tetanus, diphtheria, acellular pertussis (TDaP) | 3 doses: 1–2 months between doses 1 and 2 and 6–12 months between doses 2 and 3 Give TD booster every 10 years after initial regimen completed | Prior severe allergic reaction to the vaccine or its components | Moderate or severe acute illness with or without fever For pertussis-containing vaccines only, in patients with progressive or unstable neurologic disorder, uncontrolled seizures, or previous encephalopathy, defer use until a treatment regimen has been established and the condition stabilizes |
| Measles, mumps, rubella (MMR) | Give 1 dose if born in 1957 or later Give 2 doses (no sooner than 4 weeks after initial dose) to high-risk groups:
If pregnant, MMR should be given postpartum | Prior severe allergic reaction to the vaccine or its components Pregnancy or possible pregnancy within 4 weeks Severe immunodeficiency (hematologic and solid tumors, active chemotherapy, congenital immunodeficiency, HIV with severe immunocompromise) | Moderate or severe acute illness with or without fever If blood, plasma, and/or immunoglobulin were given in the last 11 months, follow the ACIP best practices14 History of thrombocytopenia or thrombocytopenic purpura |
| Varicella (chicken-pox) | Give 2 doses: second dose 4–8 weeks after first dose; if delayed, do not start over, just give second dose | Prior severe allergic reaction to the vaccine or its components Pregnancy or possible pregnancy within 4 weeks People who are on long-term immunosuppression or are immunocompromised Vaccine can be considered in patients with CD4 count ≥ 200 cells/mm3 | Moderate or severe acute illness with or without fever If blood, plasma, and/or immunoglobulin were given in last 11 months, follow ACIP best practices14 Recipient of specific antivirals (acyclovir, famciclovir, valacyclovir) 24 hours before vaccination Use of aspirin-containing products as there is an increased risk of Reye syndrome |
ACIP = Advisory Committee on Immunization Practices (part of the US Centers for Disease Control and Prevention); HIV = human immunodeficiency virus Adapted from reference 16.