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Note that the dosing frequency and interval for the other Men B, Men B-4C (Bexsero, Glaxo Smith Kline), have not changed; Men B-4C remains a 2-dose series administered at least 1 month apart. The change in ACIP recommendations on the use of Men B-FHbp does not imply a preference for one Men B over the other.

These updates in meningococcal vaccination are reflected in the 2017 adult immunization schedule as:• Adults with anatomical or functional asplenia or persistent complement component deficiencies should receive a 2-dose primary series of Men ACWY at least 2 months apart and revaccinate every 5 years.

The footnote on “additional information,” contained in previous iterations of the adult immunization schedule, has been moved to the cover page.

In addition, the table of contraindications and precautions for vaccines routinely recommended for adults that was formerly a standalone document has been incorporated into the adult immunization schedule.

Changes in the 2017 adult immunization schedule from the previous year's schedule include new or revised ACIP recommendations on influenza, human papillomavirus, hepatitis B, and meningococcal vaccinations. Changes are related to concerns regarding low effectiveness of the live attenuated influenza vaccine (LAIV) (Flu Mist, Med Immune) against influenza A(H1N1)pdm09 in the United States during the 2013–20–2016 influenza seasons and revised recommendations on the use of the influenza vaccine among patients with egg allergy.

These documents can also be found at gov/vaccines/schedules.

The full ACIP recommendations for each vaccine can be found at gov/vaccines/hcp/acip-recs/

These changes are described in the 2017 adult immunization schedule as:• Women through age 26 years and men through age 21 years who have not received any HPV should receive a 3-dose series of HPV at 0, 1-2, and 6 months.

Men aged 22 through 26 years may be vaccinated with a 3-dose series of HPV at 0, 1-2, and 6 months.• Women through age 26 years and men through age 21 years (and men aged 22 through 26 years who may receive HPV) who initiated HPV series before age 15 years and received 2 doses at least 5 months apart are considered adequately vaccinated and do not need an additional dose of HPV.• Women through age 26 years and adult males through age 21 years (and men aged 22 through 26 years who may receive HPV) who initiated HPV series before age 15 years and received only 1 dose, or 2 doses less than 5 months apart, are not considered adequately vaccinated and should receive 1 additional dose of HPV.• Adults with chronic liver disease, including, but not limited to, hepatitis C virus infection, cirrhosis, fatty liver disease, alcoholic liver disease, autoimmune hepatitis, and an alanine aminotransferase (ALT) or aspartate aminotransferase (AST) level greater than twice the upper limit of normal, should receive a Hep B series. There are 2 changes in meningococcal vaccination recommendations for 2017.

Adults with HIV infection are not routinely recommended to receive Men B because meningococcal disease in this population is caused primarily by serogroups C, W, and Y.

should receive 1 dose of Men ACWY and revaccinate every 5 years if the risk for infection remains, and either a 2-dose series of Men B-4C at least 1 month apart or a 3-dose series of Men B-FHbp at 0, 1-2, and 6 months.• Adults at risk because of a meningococcal disease outbreak should receive 1 dose of Men ACWY if the outbreak is attributable to serogroup A, C, W, or Y, or either a 2-dose series of Men B-4C at least 1 month apart or a 3-dose series of Men B-FHbp at 0, 1-2, and 6 months if the outbreak is attributable to serogroup B.• Young adults aged 16 through 23 years (preferred age range is 16 through 18 years) who are healthy and not at increased risk for serogroup B meningococcal disease may receive either a 2-dose series of Men B-4C at least 1 month apart or a 2-dose series of Men B-FHbp at 0 and 6 months for short-term protection against most strains of serogroup B meningococcal disease.• In Figures 1 and 2, standardized acronyms for vaccines are used to promote simplicity and consistency, and their listing has been reordered.

These figures must be read with the footnotes that contain important information for each vaccine and considerations for special populations.• In Figure 2, the columns for medical condition and other indications have been reordered to keep medical conditions together and special populations together.

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