Merck Manual

Please confirm that you are not located inside the Russian Federation

Protecting Adults Through Vaccines

Protecting Adults Through Vaccines

Disease*

Who Should Be Vaccinated

People who have been exposed to anthrax

People who may be exposed to anthrax, such as the following:

  • Some military personnel

  • Some laboratory workers

  • Veterinarians

Chickenpox (varicella)

All adults who have not had the vaccine or chickenpox

All adults (usually as a combination vaccine with tetanus as Td or also with pertussis as Tdap) if they have not already been vaccinated

Pregnant women should receive Tdap during each pregnancy

Adults who have not been vaccinated and who are at increased risk, such as the following:

  • People who do not have a functioning spleen

  • People who have a weakened immune system (such as those with AIDS)

  • People who have had chemotherapy for cancer

  • People who have had stem cell transplantation

Adults who have not been vaccinated and who are at increased risk, such as the following:

  • People who travel to or work in areas where the infection is common

  • People who use illegal drugs (such as methamphetamine)

  • Men who have sex with men

  • People who have a chronic liver disorder or high levels of certain liver enzymes in their blood

  • Healthy adults 40 years or under who have recently been exposed to hepatitis A virus

  • People who anticipate close contact with an adopted child during the first 60 days after the child arrives in the United States from an area where hepatitis A is common

  • People who are homeless

  • Pregnant women who are identified to be at risk of getting hepatitis A infection during pregnancy (such as women who are international travelers, who use illicit drugs [injected or not], who may be exposed at work, who anticipate close personal contact with an international adopted child, or who are homeless) or who are at risk of getting very sick or dying of hepatitis A virus infection (such as women who have chronic liver disease or HIV infection)

Adults who have not been vaccinated and who are at increased risk, such as the following:

  • Health care, custodial, or public safety workers

  • Travelers to areas where the infection is common

  • People with a chronic liver disorder or high levels of certain liver enzymes in their blood

  • People with kidney failure, including those who need dialysis

  • People who inject illegal drugs

  • People who have several sex partners

  • People who need to be evaluated or treated for a sexually transmitted disease

  • Men who have sex with men

  • Sex partners and household contacts of people known to be carriers of hepatitis B

  • People with HIV infection

  • People who are under 60 and have diabetes and sometimes people who are age 60 and older who have diabetes

  • People who have spent time (as patients, residents, or employees) in correctional facilities or in facilities that provide services for people at high risk of hepatitis B (such as drug-abuse treatment centers, sites for injection drug use, hemodialysis centers, institutions for developmentally disabled people, and places where people with sexually transmitted diseases or HIV infection are tested and treated)

  • Pregnant women if they are at risk of getting the infection or of getting very sick or dying of hepatitis B infection (such as women who have chronic liver disease or HIV infection)

All males and females who have not been previously vaccinated (typically at age 11 or 12 years) through age 26 years

All adults aged 27 to 45 years should talk with their doctor about whether they should be vaccinated

All people over age 6 months

All adults born in or after 1957 unless they have documentation of vaccination with one or more doses of the measles, mumps, and rubella (MMR) vaccine or laboratory tests detect evidence of measles immunity

Always given as a combination vaccine with mumps and rubella (not available as a single vaccine)

Certain people over age 55

People 16 to 23 years of age who want it

People at increased risk, such as the following:

  • People who do not have a functioning spleen (including sickle cell disease)

  • People with HIV infection

  • People with certain immunodeficiency disorders

  • People who take eculizumab or ravulizumab (drugs that block the complement system)

  • Microbiologists who are routinely exposed to the bacteria

  • Adolescents if they have not already been vaccinated

  • First-year college students who live in dormitories who are 21 years old or younger and who have not been given a dose of the vaccine on or after their 16th birthday

  • Military recruits

  • Travelers to or residents of areas where the infection is common

  • People who have been exposed during a meningitis outbreak

All adults born in or after 1957 unless they have documentation of vaccination with one or more doses of the MMR vaccine or laboratory tests detect evidence of mumps immunity

Always given as a combination vaccine with measles and rubella (not available as a single vaccine)

Pertussis (whooping cough)

All adults (usually given as a combination vaccine with tetanus and diphtheria as Tdap) if they have not already been vaccinated

Pregnant women during each pregnancy

Pneumococcal infections (such as meningitis and pneumonia)

All people aged 65 years and over

Adults at increased risk, such as the following:

  • People with a chronic heart, lung (including asthma and emphysema), kidney, or liver disorder

  • People with diabetes

  • People with a cerebrospinal fluid leak

  • People with a weakened immune system (including those with HIV infection, leukemia, lymphoma, or cancer, those who take drugs that suppress the immune system [immunosuppressants], and those who have had certain organ transplants)

  • People who do not have a functioning spleen (including those with sickle cell disease)

  • People who have a cochlear implant

  • People who have an alcohol use disorder

  • Adults who smoke cigarettes

Adults at increased risk, such as

  • Travelers to areas where polio is common

  • Laboratory workers who work with the polio virus

  • People who treat people who may have polio

People who have been bitten by certain animals

People who may be at increased risk of exposure to infected animals, such as

  • Veterinarians and animal handlers

  • Laboratory workers who handle animals that may be rabid

  • People who explore bat caves

  • People who live or stay more than 30 days in developing countries where rabies in dogs is widespread

Rubella (German measles)

All adults born in or after 1957 unless they have documentation of vaccination with one or more doses of the MMR vaccine or laboratory tests detect evidence of rubella immunity

Women who are planning on becoming pregnant and do not have immunity to rubella

Always given as a combination vaccine with measles and mumps (not available as a single vaccine)

Shingles (herpes zoster)

People aged 50 and over

Not currently recommended except for people at high risk of being exposed to the smallpox virus, such as laboratory workers who directly handle the virus and related materials

All adults every 10 years (usually as a combination vaccine with tetanus and diphtheria as Td or also with pertussis as Tdap) if they have not already been vaccinated

Pregnant women should receive Tdap during each pregnancy

People traveling to areas where the infection is common

People who have close contact with a typhoid carrier

Laboratory workers who work with the bacteria that cause typhoid fever

People traveling to certain parts of Africa and South America, where the infection is common

* Vaccines are available in the United States for these infections.

HIV = human immunodeficiency virus; Td = tetanus-diphtheria; Tdap = tetanus-diphtheria-pertussis.