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View the Comparison Chart: Some Vaccines for Adults

The CDC Advisory Committee on Immunization Practices (ACIP) recommends certain vaccines for adults residing in the US. The American Academy of Family Physicians has also recently published an adult immunization schedule. Recommendations for vaccination against COVID-19 and seasonal influenza will be reviewed separately.

The FDA has approved the over-the-counter (OTC) sale of Rextovy (Amphastar), a nasal spray formulation of the opioid antagonist naloxone, for emergency treatment of opioid overdose. Other naloxone nasal sprays (Narcan, and generics; RiVive) are also available OTC (see Table 1).

Initial treatment of allergic rhinitis (AR) depends on the severity of symptoms and whether they are intermittent or persistent (see Table 1).

The FDA has licensed new 2025-2026 formulations of the mRNA COVID-19 vaccines manufactured by Pfizer/BioNTech (Comirnaty) and Moderna (Spikevax, mNEXSPIKE) and the adjuvanted protein subunit COVID-19 vaccine manufactured by Novavax (Nuvaxovid). The new formulations are indicated for use in all adults ≥65 years old and in persons 6 months (Spikevax), 5 years (Comirnaty), or 12 years (mNEXSPIKE, Nuvaxovid) through 64 years old who are at high risk for severe COVID-19 because of an underlying condition. An Emergency Use Authorization allowing administration of the Pfizer vaccine to children 6 months through 4 years old has been withdrawn.

Enlicitide (Lipfendra – Merck), an oral proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitor, has been approved by the FDA to reduce low-density lipoprotein cholesterol (LDL-C) in adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia (HeFH). It is the first oral PCSK9 inhibitor to be approved in the US; the other FDA-approved PCSK9 inhibitors (alirocumab [Praluent], evolocumab [Repatha], and lerodalcibep [Lerochol]) and the PCSK9-directed small interfering RNA inclisiran (Leqvio) are injected subcutaneously. Lipfendra was approved under the Commissioner's National Priority Voucher program, which accelerates the FDA review process for drugs that align with critical national health priorities.

The FDA has approved Idvynso (Merck), a once-daily fixed-dose combination of the non-nucleoside reverse transcriptase inhibitor (NNRTI) doravirine and the first-in- class nucleoside reverse transcriptase translocation inhibitor (NRTTI) islatravir, to replace the current anti-retroviral (ARV) regimen in adults with HIV-1 infection who are virologically suppressed (HIV-1 RNA <50 copies/mL) on a stable ARV regimen with no history of virologic treatment failure and no known substitutions associated with resistance to doravirine. Idvynso is the first two-drug regimen for HIV that does not contain an integrase strand transfer inhibitor (INSTI) or tenofovir. Doravirine is also available alone (Pifeltro) and in combination with lamivudine and tenofovir disoproxil fumarate (Delstrigo).

The FDA has approved olezarsen (Tryngolza – Ionis), a subcutaneously injected apolipoprotein C-III (apoC-III)-directed antisense oligonucleotide, to reduce triglyceride levels and the risk of acute pancreatitis in adults with severe hypertriglyceridemia. Olezarsen and the apoC-III-directed small interfering RNA plozasiran (Redemplo) were approved earlier to reduce triglyceride levels in adults with familial chylomicronemia syndrome (FCS).

Influenza is generally a self-limited illness, but complications including pneumonia, respiratory failure, and death can occur, especially in persons at increased risk (see Table 1).

The FDA has approved ensitrelvir (Xocova – Shionogi), a SARS-CoV-2 main protease inhibitor, for postexposure prophylaxis of COVID-19 in patients ≥12 years old who had contact with an infected individual. Ensitrelvir is the first oral antiviral drug to be approved in the US for this indication. The parenteral monoclonal antibody combinations bamlanivimab and etesevimab and casirivimab and imdevimab (REGEN-COV) are no longer authorized for postexposure prophylaxis of COVID-19 in the US.