The Advisory Committee on Immunization Practices (ACIP) recommends use of certain vaccines in adults residing in the US. Routine childhood immunization has reduced the overall incidence of some of these vaccine-preventable diseases, but many adults remain susceptible. Recommendations for vaccination against COVID-19, seasonal influenza, and monkeypox and vaccination of travelers have been reviewed separately.

Persons planning to travel outside the US should be up to date on routine vaccines and, depending on their destination, duration of travel, and planned activities, may also receive certain travel-specific vaccines. Tickborne encephalitis and dengue vaccines, which are not available in the US, are reviewed in a separate article available online. Detailed advice for travel to specific destinations is available from the Centers for Disease Control and Prevention (CDC) at www.cdc.gov/travel/destinations/list. Recommendations for administration of vaccines as part of routine adult immunization are discussed in a separate issue.

The US Advisory Committee on Immunization Practices (ACIP) recommends routine use of the following vaccines in adults residing in the US: influenza, tetanus/diphtheria alone (Td) and in combination with acellular pertussis (Tdap), measles/mumps/rubella (MMR), varicella (VAR), herpes zoster (RZV; ZVL), human papillomavirus (HPV), and pneumococcal conjugate (PCV13) and polysaccharide (PPSV23) vaccines. For adults with certain medical conditions or occupational, behavioral, or other risk factors, hepatitis A (HepA), hepatitis B (HepB), meningococcal (MenACWY; MenB), and Haemophilus influenzae type b (Hib) vaccines are also recommended. Recommendations for vaccination against seasonal influenza and vaccination of travelers are reviewed separately.

Patients planning to travel to other countries should be up to date on routine immunizations and, depending on their destination, duration of travel, and planned activities, may also need to receive certain travel-specific vaccines. Common travel vaccines are listed in Table 2. More detailed advice for travelers is available from the Centers for Disease Control and Prevention (CDC) at www.cdc.gov/travel. Guidelines for routine adult immunization are discussed in a separate issue.

An outbreak of mumps has occurred among students at Fordham University in New York. All of those who developed mumps had been vaccinated against the disease.

Vaccines recommended for routine use in US adults are reviewed here. Vaccines for travel have been reviewed separately.

Live-attenuated vaccines are generally contraindicated during pregnancy; inactivated vaccines can be given if indicated. A more detailed review of routine immunizations for adults will be available in the December issue of Treatment Guidelines from The Medical Letter.

Although immunization programs have produced high vaccination rates in US infants and children, similar successes have not been achieved in adults. Vaccines recommended for routine use in adults are reviewed here. Immunizations for travel were reviewed in a recent issue.

A large mumps outbreak that began in Iowa in December 2005 has spread. About 40% of the cases have been in people 18-25 years old, many of whom are college students and had been vaccinated against the disease.

Patients planning to travel to other countries often ask physicians for information about immunizations and prevention of diarrhea and malaria. More detailed advice for travelers is available from the Centers for Disease Control and Prevention at 877-FYI-TRIP (877-394-8747) or www.cdc.gov/travel.