Adolescent and Adult Vaccine Recommendations

Immunization Schedules

State-Provided Vaccine Usage Policy for Adults

A revised chart is shown below and replaces any previous charts. If you have any questions, please contact your regional program manager.

DSHS Health Service Regions
*Local Health Departments
Other Providers
Hepatitis B
Pneumococcal Polysaccharide (PPSV)

*Agencies contracted by Local health Departments to provide vaccines may immunize adults under the same guidelines as the Local Health Department.

A. All uninsured adults. Exception:  Refugee Health Programs (RHP) receive separate funding for hepatitis B vaccine, and therefore clients of RHPs are excluded.

B. Persons at highest risk of complications from influenza disease as defined by the ACIP.  Excluding those at residential or occupational risk of exposure where the organization, proprietor or employer is required to offer the vaccine by law.

C. Vaccine purchased with LHD funds can be used at the discretion of the LHD.

D. All uninsured adults who met the following criteria:

  • Persons born during or after 1957 should receive at least one dose of MMR unless they have documentation of at least one dose, a history of measles based on healthcare provider diagnosis, or laboratory evidence of immunity.  Women whose rubella vaccination history is unreliable or who lack laboratory evidence of immunity should also receive one dose of MMR.
  • A second dose of MMR is recommended for adults who 1) have been recently exposed to measles or in an outbreak setting; 2) have been previously vaccinated with killed measles vaccine; 3) have been vaccinated with an unknown type of measles vaccine during 1963 – 1967; 4) are students in postsecondary educational institutions; 5) work in a healthcare facility; or 6) plan to travel internationally.

E. Uninsured adults who are at risk.  The following groups are considered at risk:

» Chronic disorders of the pulmonary system

» People who smoke cigarettes

» People with asthma

» Cardiovascular diseases

» Diabetes Mellitus

» Chronic liver diseases, including liver disease as a result of alcohol abuse (e.g., cirrhosis)

» Functional or anatomic asplenia (e.g., sickle cell disease or splenectomy) [If elective splenectomy is planned, vaccinate at least 2 weeks before surgery]

» Immunosuppressive conditions (e.g., congenital immunodeficiency, HIV infection [vaccinate as close to diagnosis as possible when CD4 cell counts are highest], leukemia, lymphoma, multiple myeloma, Hodgkin disease, generalized malignancy, or organ or bone marrow transplantation)

» Chemotherapy with alkylating agents, antimetabolites, or high-dose, long-term corticosteroids

» Cochlear implants

  • Others included: Alaska Natives and certain American Indian Populations
  • Smokers should receive smoking cessation counseling
  • All adults 65 years of age or older, including one-time revaccination of those who have not received vaccine within 5 years and were less than 65 years of age at the time of primary vaccination.  All persons over 65 who have unknown vaccination status should receive one dose of vaccine.
  • Adults 19–64 who are at risk per ACIP recommendations, which includes the following:

F.  All uninsured adults.

G. Any person who was TVFC-eligible AND started the series BEFORE their 19th birthday.

X.  Not eligible for state-supplied vaccine for adults at this site.  Other providers may purchase their own vaccine inventory to vaccinate adults at the client’s expense.