Vaccine Recommendations for Adults

Shingles Vaccine

The American College of Physicians recommends the shingles vaccine (Shingrix) for all adults aged 50 years and older, regardless of previous vaccination status with older shingles vaccines, with grade 1 evidence (highest quality) supporting its use 1, 2
The Centers for Disease Control and Prevention recommends that even if a person previously received the older shingles vaccine (Zostavax), they should still receive the Shingrix two-dose series 2

The Centers for Disease Control and Prevention recommends a single dose of PCV20 (20-valent pneumococcal conjugate vaccine) for all adults aged 65 years and older who have not previously received a pneumococcal conjugate vaccine 3, 4
For adults ≥65 years who previously received PPSV23 only, the Centers for Disease Control and Prevention recommends administering a single dose of PCV20 after a ≥1 year interval since the last PPSV23 dose 3
The Advisory Committee on Immunization Practices recommends a single dose of PCV20 for adults aged 19-64 years with chronic medical conditions or immunocompromising conditions 3, 5
The Centers for Disease Control and Prevention recommends avoiding administering different pneumococcal vaccines on the same day 4
For patients who have already received both PCV13 and PPSV23, the Centers for Disease Control and Prevention recommends no additional pneumococcal vaccine doses are needed until age 65 5

The American College of Rheumatology recommends that the shingles vaccine should be given before starting biologic therapy or tofacitinib for conditions like rheumatoid arthritis 6
The American College of Rheumatology recommends that live attenuated vaccines (including older shingles vaccines) should not be used in patients currently receiving biologics 6