Key 2024 updates: COVID-19: Bivalent mRNA vaccines removed from schedule. New guidance on use of updated (2023-2024 Formula) vaccines. Hep B: Adults ≥60 yo w/ risk factors should be vaccinated, optional for those w/o RFs. Those w/ DM should engage in shared clinical decision-making. Influenza: People w/ egg allergy may receive any influenza vaccine appropriate for age and health status. All seasonal influenza vaccines available in the U.S. for the 2024-2025 season will be trivalent. For adults ≥65 yo, preferred IIVs: high-dose, recombinant, or adjuvanted. Avoid LAIV in close contacts of immunosuppressed pts needing protected environment. Solid organ txp recipients 18-64 yo on immunosuppressive regimens may receive high-dose or adjuvanted IIV3, w/ no preference over other age-appropriate IIV3s or RIV3; LAIV3 should not be used. Meningococcal: New MenACWY-TT/MenB-FHbp vaccine added. Mpox: Guidance on use of Jynneos based on sexual risk factors. Pneumococcal: New PCV-21 vaccine added. Polio: Unvaccinated or incompletely vaccinated adults should complete primary series. Those who are fully vaccinated and at ↑risk of exposure may receive 1 lifetime booster. RSV: New vaccine (Mresvia) added. New recs on use during pregnancy and in adults ≥60 yo, including for jurisdictions w/ RSV seasonality that differs from most of the continental U.S.

High risk includes: pregnancy, DM, immunocompromise (HIV, asplenia, complement deficiency, etc.), chronic heart/lung/kidney/liver dz, CSF leak/cochlear implant.