• Persons traveling to or working in countries with high rates of HAV.
• Men who have sex with men.
• Persons who use street drugs.
• Persons with chronic liver disease.
• Persons who work with HAV-infected primates or with HAV in a research setting.
• Persons with clotting factor disorders.

 Adults should receive a single dose, followed by a booster dose >6 months later.

• Persons who are exposed to blood or blood products in their work.
• Clients and staff of institutions for the developmentally disabled hemodialysis patients.
• Recipients of factor VIII or IX concentrates.
• Household or sexual contacts of persons identified as HBsAg-positive.
• Persons who plan to travel or live in parts of the world where HBV infections are common.
• Injecting drug users.
• Sexually active homosexual or bisexual males.
• Sexually active heterosexual persons with multiple partners or a recent episode  of a sexually transmitted disease (STD).
• Inmates of long-term correctional facilities.
• Persons of Pacific Islander ethnicity or first generation immigrants/refugees from countries where HBV infection is of high/intermediate endemicity. 
  
  A 3-dose series should be given on a schedule of 0, 1, and 6 months.

• All adults >50 years of age.
• Residents of nursing homes and other long-term care facilities.
• Younger adults with chronic cardiopulmonary disorders, chronic metabolic diseases (including diabetes), renal dysfunction, hemoglobinopathies, or immunosuppression.
• Household members, caregivers, and health care workers, to the above.
• Other adults who wish to reduce their likelihood of becoming ill with influenza may also be vaccinated.

• All adults >65 years and those <65 years with chronic cardiovascular disease, chronic pulmonary disease, diabetes mellitus, alcoholism, cirrhosis, CSF leaks, functional or anatomic asplenia, HIV infection, leukemia, lymphoma, Hodgkin's disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome, or if receiving immunosuppressive chemotherapy. 
• Routine revaccination of immunocompetent persons previously vaccinated with 23-valent polysaccharide vaccine is not recommended.
• However, revaccination is recommended if the person was vaccinated >5 years previously and either (1) was <65 when first vaccinated and is now >65 years or (2) is at highest risk for serious pneumococcal infection, as defined by ACIP, or (3) is likely to have a rapid decline in pneumococcal antibody levels.

• Administer varicella vaccine to susceptible persons who will have close contact with persons at high risk for serious complications (e.g., health care workers and family contacts of immunocompromised persons). 
• Consider giving to susceptible persons who are at high risk of exposure, such as those with occupational risk (i.e., teachers of young children, day care workers, and residents and staff in institutional settings).
• College students.
• Inmates and staff of correctional institutions; military personnel.
• Non-pregnant women of childbearing age.
• And international travelers
  
  Vaccination for adults consists of 2 doses given 4-8 weeks apart.

SPECIAL NOTES 
Assessing adult vaccination status: All adults should be assessed at age 50 years to determine current vaccination status, receive Td toxoid as indicated, and be evaluated for risk factors for other vaccine-preventable diseases (e.g., influenza and pneumococcal disease).

Reporting adverse reactions: Report vaccine reactions through the federal Vaccine Adverse Event Reporting System. For information on reporting reactions following vaccines administered by private physicians, call the 24 hour national toll-free information line (800) 822-7967.

Click here for printable versions of Adult Immunization Schedule.