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 may be exposed to anthrax, such as the following:

  • Some military personnel

  • Some laboratory workers

Chickenpox (varicella)

All adults who have not had the vaccine or the disease

All adults

  • As a combination vaccine with tetanus and pertussis (as Tdap) if they have never received the combination

  • As a combination booster vaccine with tetanus every 10 years

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:

  • Travelers to areas where the disease is common

  • People who inject illegal drugs

  • Men who have sex with men

  • People who have a chronic liver disorder or a blood clotting disorder

  • Healthy adults 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

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

  • Health care workers

  • Travelers to areas where the disease is common

  • People with a chronic liver disorder or a blood clotting disorder

  • 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

  • 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 those that treat people with sexually transmitted diseases or HIV infection)

All males and females at age 11 or 12 years (can start at age 9 years) and people who have not been previously vaccinated through age 26 years

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

All males aged 22–26 years who have not been previously vaccinated and have one of the following:

  • Sex with men

  • HIV infection

  • Another condition that weakens the immune system

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

Health care workers if laboratory tests do not detect evidence of measles immunity

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

People at increased risk, such as the following:

  • People who do not have a functioning spleen

  • People with HIV infection

  • People with certain immunodeficiency disorders

  • People who take eculizumab (a drug that blocks 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

  • Military recruits

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

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

Health care workers if laboratory tests do not 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)

Adults at increased risk, such as the following:

  • People aged 65 and over

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

  • People with diabetes

  • People with a cerebrospinal fluid leak

  • People with a weakened immune system

  • People who do not have a functioning spleen

  • People who have a cochlear implant

  • Alcoholics

  • Adults who smoke cigarettes

Adults at increased risk, such as travelers to areas where polio is common and laboratory workers who work with the polio virus

People who have been bitten by certain animals

People who may be exposed to infected animals (such as veterinarians)

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

Health care workers if laboratory test do not 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 (boosters every 10 years after the primary series, which is usually given during childhood as a combination vaccine with diphtheria and pertussis)

People traveling to areas where the disease 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 disease is common

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

HIV = human immunodeficiency virus.