Immunizations are for everyone!
Adults need vaccines to protect themselves and their
loved ones.
Keep a record! The New York State Immunization Information System (NYSIIS) keeps
track of all immunizations received by persons under 19 years of age. Once you have
turned 19, you can sign a consent form* so that your vaccines continue to be recorded. You
should also use this handy passport to keep your own records up-to-date.
Vaccines are covered! Under the Affordable Care Act, all vaccines recommended by the
Advisory Committee on Immunization Practices (ACIP) are covered when delivered by an
in-network provider.
Apps to track your vaccines:
• THRIVE App
• myFamily App
• ReadyVax
You can also download this handy immunization passport here!
*https://www.health.ny.gov/forms/doh-4439.pdf
CDC Adult Vaccine Recommendations
The specific vaccines you need as an adult are determined by factors such as your age,
LIFETIME IMMUNIZATION RECORD
job, lifestyle, health conditions, locations of travel, and vaccines you’ve received in the past. Always carry this card with you and have your
Throughout your adult life, vaccines are recommended to get and maintain protection against: healthcare professional or clinic keep it up-to-date.
• Seasonal Influenza (flu) (for all adults)
• Pertussis (whooping cough) (for all adults who have not previously received the Tdap
vaccine and for women during each pregnancy)
Last Name First Name MI
• Tetanus and diphtheria (Td) (every 10 years following Tdap vaccine)
• Shingles (Zoster) (for adults 60 years and older)
• Pneumococcal disease (for adults 65 years and older and adults younger than 65 who Birth Date
have specific health conditions such as smoking) Month Day Year
Other vaccinations you may need include those that protect against human papillomavirus
(which can cause certain cancers; cervical cancer in women and anal and throat cancer Medical Notes (e.g., allergies, vaccine reactions):
in men and women), against meningococcal disease, hepatitis B, hepatitis A, chickenpox
(varicella) and measles, mumps and rubella. Recent measles outbreaks are a reminder to
check your vaccination status and get vaccinated.
http://www.cdc.gov/features/adultimmunizations/
Supported by an unrestricted grant from AstraZeneca
 Vaccine Type of Vaccine or titer Date given Date next Vaccine Type of Vaccine or titer Date given Date next Vaccine Type of Vaccine or titer Date given Date next
mo/day/yr dose due mo/day/yr dose due mo/day/yr dose due
Measles, Mumps, Rubella H. Influenzae type b Hepatitis B
(MMR, MMRV) (Hib, Hib-HepB, (HepB, Hib-HepB,
Varicella (chickenpox) DTaP-IPV/Hib, DTap/Hib, DTaP-HepB-IPV,
(VAR, MMRV) MenCY-Hib HepA-HepB)

Hepatitis A Polio Diphtheria, Tetanus,

(HepA, HepA-HepB) (IPV, OPV, Pertussis (whooping cough)
if combo DTaP-HepB-IPV, (DTaP, DTP, DT,
DTaP-IPV/Hib, Td, Tdap,
Meningococcal DTaP-IPV DTaP-HepB-IPV,
(MCV4, MPSV4, DTaP-IPV/Hib,
MenCY-Hib) DTaP-IPV,
Pneumococcal DTaP/Hib)
(PCV7, PCV13,
Human papillomavirus PPSV23)
Influenza
(HPV4{Gardisil},
(TIV, LAIV)
HPV2{Cervanix})
Rotavirus
Zoster (shingles) (RV5 {RotaTea},
Other RV1{Rotarix}
RV{unknown})
Other