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Recommendations from the Combined Immunization
Schedule Work Group for the 2025 Immunization
Schedules for Children/Adolescents and Adults
Sybil Cineas, MD, FAAP , FACP (ACIP Combined Immunization WG Chair)
Nanda Issa, MD (CDC Co -Lead)
Patricia Wodi, MD (CDC acting Co -Lead)
ACIP Meeting
October 24, 2024National Center for Immunization and Respiratory Diseases
Dr. Patricia Wodi 2025 Update to Adult Immunization Schedule
Age 19 years or older
How to Use the Immunization Schedule
Sections
•Cover Page
•Table 1: Age -based
•Table 2: Medical indication
•Vaccination notes
•Appendix: contraindications
and precautions
•Addendum: updates after
schedule is published
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Proposed Updates to the 2025 Adult Immunization Schedule
Changes to Tables
•Cover Page
•Table 1
•Table 2Changes to Vaccination Notes
•COVID -19
•Hepatitis B
•Influenza
•Meningococcal
•Mpox
•Pneumococcal
•RSV vaccine
•TdapChanges to Appendix
•Pneumococcal
•Hepatitis B
1. Use of COVID -19 Vaccines for Persons Aged ≥6 Months: Recommendations of the Advisory Committee on Immunization Practices — Unite d States, 2024 –2025 | MMWR (cdc.gov)
2. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practic es — United States, 2024 –25 Influenza Season | MMWR (cdc.gov)
3. Use of 21 -Valent Pneumococcal Conjugate Vaccine Among U.S. Adults: Recommendations of the Advisory Committee on Immunization Pra ctices — United States, 2024 | MMWR (cdc.gov)
4. Use of Respiratory Syncytial Virus Vaccines in Adults Aged ≥60 Years: Updated Recommendations of the Advisory Committee on Im mun ization Practices — United States, 2024 | MMWR (cdc.gov)4
Cover page
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Table 1
Immunization schedule by age group
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Table 2
Immunization schedule by medical indication
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Notes
Routine vaccination
Persons NOT moderately or severely
immunocompromised
• Outlines vaccination series by COVID -19
vaccination history.Special situations
Persons who ARE moderately or
severely immunocompromised
•Outlines vaccination series by
COVID -19 vaccination history.
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*Note: Heplisav -B and PreHevbrio are not
recommended in pregnancy due to lack of
safety data in pregnant persons.
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Appendix
Contraindications and precautions
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Pregnancy : Heplisav -B and PreHevbrio
are not recommended due to lack of
safety data in pregnant persons. Use
other hepatitis B vaccines if HepB is
indicated.
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For more information, contact CDC/ATSDR
1-800-CDC-INFO (232 -4636)
TTY: 1 -888-232-6348 www.cdc.gov www.atsdr.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry.
Thank you!
Questions?
Backup slides
Use of Hepatitis B vaccine during pregnancy(1)
•On September 11, 2024, the FDA announced its approval for a labeling change
for Heplisav -B stating that there is now safety data for its use among pregnant
persons.
•CDC has an update regarding this labeling change in clearance for publication
in MMWR.
–Update recommends, Providers can now vaccinate pregnant persons needing HepB
vaccination with Engerix -B, Recombivax HB, Twinrix, or Heplisav -B.
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Use of Hepatitis B vaccine during pregnancy(2)
•Prior to September 2024, neither Heplisav -B nor PreHevbrio had sufficient safety data
among pregnant persons to meet FDA requirements for update to their standardized
package inserts.
–8.1 Pregnancy
Risk Summary
All pregnancies have a risk of birth defect, loss, or other adverse outcomes. In the U.S.
general population, the estimated background risk of major birth defects and miscarriage
in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.
Data
Human Data: Determination that rates of miscarriage and birth defects are not above
background.
Animal Data: Data from developmental toxicity studies if they exist.
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Use of Hepatitis B vaccine during pregnancy(3)
•Recommendations for vaccination of pregnant persons is addressed in the 2018
MMWR: Prevention of Hepatitis B Virus Infection in the United States:
Recommendations of the Advisory Committee on Immunization Practices.
–Guideline lists and describes all vaccines recommended for use in the United States
but makes NO preferential recommendation for use of any particular vaccine.
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