Recommended Vaccinations for Adults: Which Vaccines Do You Need?

Why Are Adult Vaccinations Important?

Adult vaccinations protect against serious and potentially life-threatening infectious diseases. Vaccines have dramatically reduced the spread of diseases like measles, tetanus, and polio. Without continued vaccination throughout adulthood, immunity can wane and disease outbreaks can occur, putting both individuals and communities at risk.

Vaccination is one of the most effective public health interventions in history. Vaccines work by stimulating the immune system to recognize and fight specific pathogens without causing the actual disease. This provides immunity that protects you if you're ever exposed to the real infection. The widespread use of vaccines has led to the eradication of smallpox, the near-elimination of polio, and dramatic reductions in diseases like measles, diphtheria, and whooping cough.

Many people assume vaccinations are only for children, but adult immunization is equally crucial. Immunity from childhood vaccines can diminish over time, some vaccines weren't available when older adults were young, and certain vaccines are specifically designed for adults. Additionally, new vaccines are developed as medical science advances, offering protection against diseases that previously had no vaccine.

The concept of herd immunity (or community immunity) is fundamental to vaccination programs. When a sufficient percentage of the population is immune to a disease, its spread is limited, protecting those who cannot be vaccinated due to medical conditions or age. This includes newborns too young for vaccination, immunocompromised individuals, and those with certain allergies. By getting vaccinated, you're not only protecting yourself but also contributing to the health of your community.

Benefits of adult vaccination

Adult vaccination offers numerous benefits beyond personal protection. Vaccines prevent serious illness, hospitalization, and death from infectious diseases. They reduce healthcare costs associated with treating preventable diseases. For employers, vaccinated employees mean fewer sick days and maintained productivity. For families, vaccination prevents the spread of disease between generations, protecting both elderly relatives and young children.

Modern vaccines are remarkably safe. All vaccines undergo rigorous testing through multiple phases of clinical trials before receiving approval from regulatory agencies like the FDA, EMA, and WHO. Post-approval surveillance continues to monitor for any rare side effects. The benefits of vaccination far outweigh the minimal risks of side effects, which are typically mild and short-lived.

What Is the Influenza (Flu) Vaccine?

The influenza vaccine provides protection against seasonal flu viruses. It's recommended annually for all adults, especially those 65 and older, pregnant women, healthcare workers, and people with chronic health conditions. The vaccine composition changes each year to match circulating virus strains.

Influenza, commonly known as the flu, is a highly contagious respiratory illness caused by influenza viruses. While often dismissed as a minor illness, flu can be serious and even fatal, particularly for older adults, young children, and those with underlying health conditions. Each year, seasonal flu causes millions of illnesses, hundreds of thousands of hospitalizations, and tens of thousands of deaths worldwide.

The flu vaccine is unique among vaccines because it must be administered annually. This is due to the remarkable ability of influenza viruses to mutate. Each year, scientists analyze circulating virus strains and predict which will be most prevalent in the upcoming flu season. The vaccine is then formulated to protect against these predicted strains. While the match isn't always perfect, vaccination still provides significant protection and typically reduces the severity of illness even if you do get infected.

Several types of flu vaccines are available. Standard-dose vaccines are appropriate for most adults. High-dose vaccines are specifically designed for adults 65 and older, as aging immune systems may respond less strongly to standard vaccines. Adjuvanted vaccines contain an ingredient that helps create a stronger immune response. Your healthcare provider can recommend the most appropriate vaccine for your age and health status.

Who should get the flu vaccine?

Annual flu vaccination is recommended for all adults, but it's especially important for certain groups who are at higher risk of serious flu complications:

• Adults 65 years and older: Older adults are at significantly higher risk of flu complications
• Pregnant women: Flu can be more severe during pregnancy and vaccination protects the baby after birth
• People with chronic medical conditions: Including heart disease, diabetes, asthma, COPD, and kidney disease
• Immunocompromised individuals: Those with weakened immune systems due to disease or treatment
• Healthcare workers: To protect themselves and their vulnerable patients
• Caregivers: Those caring for infants, elderly, or immunocompromised individuals

The best time to get vaccinated is before flu season begins, typically in autumn. However, vaccination can still be beneficial throughout the flu season. It takes about two weeks after vaccination for the immune system to develop full protection.

What Is the Pneumococcal Vaccine?

The pneumococcal vaccine protects against Streptococcus pneumoniae bacteria, which can cause pneumonia, meningitis, and bloodstream infections. It's recommended for all adults 65 and older and for younger adults with certain risk factors. Unlike the flu vaccine, pneumococcal vaccination provides longer-lasting protection.

Pneumococcal disease is caused by Streptococcus pneumoniae, a bacterium that can cause a range of infections from mild ear infections to life-threatening conditions like pneumonia, meningitis (infection of the brain and spinal cord membranes), and bacteremia (bloodstream infection). The bacteria spread through respiratory droplets when infected people cough or sneeze. While anyone can get pneumococcal disease, it's most dangerous for older adults, young children, and people with weakened immune systems.

Pneumococcal pneumonia is the most common form of pneumococcal disease in adults. Symptoms include high fever, cough, chest pain, and difficulty breathing. Even with treatment, pneumococcal disease can be fatal, particularly in older adults. The mortality rate for pneumococcal bacteremia is about 20% in adults and can be even higher in elderly patients.

There are two types of pneumococcal vaccines available for adults. Pneumococcal conjugate vaccines (PCV13, PCV15, PCV20) protect against the most common and serious strains. Pneumococcal polysaccharide vaccine (PPSV23) protects against 23 strains. Depending on your age and previous vaccination history, your healthcare provider may recommend one or both types. The newer PCV20 vaccine may provide sufficient protection as a single vaccine for many adults.

Who should get pneumococcal vaccination?

Pneumococcal vaccination is recommended for the following groups:

• All adults 65 years and older
• Adults with chronic heart disease (excluding hypertension alone)
• Adults with chronic lung disease including COPD and asthma
• Adults with diabetes
• Adults with chronic liver disease including cirrhosis
• Adults with chronic kidney disease
• Immunocompromised adults including those with HIV, cancer, or on immunosuppressive therapy
• Adults with cochlear implants or cerebrospinal fluid leaks
• Smokers
• Adults who live in long-term care facilities

Unlike the flu vaccine, pneumococcal vaccination provides longer-lasting protection. However, some individuals may need booster doses every 5 years depending on the vaccine type received and their risk factors. Consult your healthcare provider about your specific vaccination schedule.

What Are Tetanus and Diphtheria Boosters?

Tetanus-diphtheria (Td) boosters are recommended every 10-20 years throughout adulthood to maintain protection against these serious bacterial diseases. At least one dose should be the Tdap vaccine, which also includes protection against pertussis (whooping cough), especially important for those in contact with infants.

Tetanus (lockjaw) is a serious bacterial infection caused by Clostridium tetani, which enters the body through wounds. The bacteria produce a toxin that causes painful muscle stiffness and spasms. Tetanus can be fatal even with treatment, with mortality rates of 10-20% in developed countries and higher in areas without access to intensive care. The tetanus bacteria are found in soil, dust, and manure worldwide, making the risk universal.

Diphtheria is a bacterial infection that affects the throat and airways. It can cause a thick coating in the back of the throat that can make it hard to breathe. Diphtheria toxin can also damage the heart and nervous system. While rare in countries with high vaccination rates, diphtheria remains endemic in parts of Asia, Africa, and South America. Outbreaks can occur when vaccination coverage drops.

Pertussis (whooping cough) is a highly contagious respiratory infection characterized by severe coughing fits that can last for weeks. While often considered a childhood disease, pertussis can affect adults and is particularly dangerous when transmitted to unvaccinated infants, for whom it can be fatal. Adults who were vaccinated as children gradually lose immunity, making them susceptible to infection and potential transmission.

Recommended vaccination schedule

The childhood vaccination series provides initial protection against tetanus, diphtheria, and pertussis. However, this protection wanes over time, necessitating booster doses throughout adulthood:

• Td or Tdap booster every 10-20 years: To maintain protection against tetanus and diphtheria
• At least one Tdap dose: All adults should receive at least one dose of Tdap (which includes pertussis protection) if they haven't already
• After wound injury: If you receive a wound that could be contaminated and your last tetanus shot was more than 5 years ago, you may need a booster
• Pregnant women: Tdap is recommended during each pregnancy, ideally between 27-36 weeks, to pass antibodies to the baby

If you're unsure about your vaccination history, your healthcare provider can help determine what vaccines you need. In many cases, it's safer to revaccinate than to risk being unprotected.

What About COVID-19 Vaccination?

COVID-19 vaccination remains an important part of adult immunization. Recommendations for boosters continue to evolve based on new variants and waning immunity. Adults, especially those 65 and older or with underlying health conditions, should stay up to date with recommended COVID-19 vaccine doses.

COVID-19, caused by the SARS-CoV-2 virus, emerged in late 2019 and led to a global pandemic. The rapid development of COVID-19 vaccines represented an unprecedented scientific achievement. Multiple vaccine types were developed and authorized, including mRNA vaccines (Pfizer-BioNTech, Moderna), viral vector vaccines (Johnson & Johnson, AstraZeneca), and protein subunit vaccines (Novavax).

COVID-19 vaccination significantly reduces the risk of severe illness, hospitalization, and death from the virus. While vaccinated individuals can still become infected (breakthrough infections), they typically experience milder symptoms and shorter illness duration. Vaccination also reduces transmission, though this protection may be less complete against newer variants.

Booster doses have become an important part of COVID-19 vaccination strategy. Immunity from the primary series wanes over time, and booster doses restore and enhance protection. Updated boosters are developed to target currently circulating variants, similar to the annual flu vaccine approach.

Who should get COVID-19 vaccines?

Current recommendations emphasize COVID-19 vaccination for:

• All adults who haven't completed their primary series
• Adults 65 and older: At highest risk of severe COVID-19
• Immunocompromised individuals: May need additional doses
• Adults with chronic health conditions: Heart disease, lung disease, diabetes, obesity
• Pregnant women: COVID-19 vaccines are safe and recommended during pregnancy
• Healthcare workers and essential workers

Recommendations continue to evolve. Check with your healthcare provider or public health authority for the most current guidance on COVID-19 vaccination timing and dosing.

What Is the Shingles Vaccine?

The shingles (herpes zoster) vaccine is a two-dose vaccine recommended for adults 50 years and older. It prevents shingles, a painful rash caused by reactivation of the chickenpox virus, and its most serious complication, postherpetic neuralgia (long-lasting nerve pain).

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After you recover from chickenpox, the virus remains dormant in nerve tissue near your spinal cord and brain. Years or decades later, it can reactivate as shingles, typically appearing as a painful, blistering rash on one side of the body. About one in three people who have had chickenpox will develop shingles in their lifetime.

The risk of shingles increases with age as the immune system naturally weakens. The rash itself is painful, but the most feared complication is postherpetic neuralgia (PHN) – severe nerve pain that can persist for months or even years after the rash heals. PHN affects about 10-18% of shingles patients and is more common and severe in older adults. Other complications can include vision loss if shingles affects the eye, neurological problems, and skin infections.

The recombinant zoster vaccine (Shingrix) is more than 90% effective at preventing shingles and PHN in adults 50 and older. This high efficacy is maintained in adults 70 and older, where the risk of shingles is highest. The vaccine is given as two doses, 2-6 months apart. Both doses are necessary for full protection.

Who should get the shingles vaccine?

Shingles vaccination is recommended for:

• All adults 50 years and older: Regardless of whether they remember having chickenpox (most adults have been exposed)
• Adults who previously had shingles: The vaccine can help prevent future episodes
• Adults who received the older shingles vaccine (Zostavax): Should receive the newer, more effective Shingrix vaccine

The shingles vaccine may be given even if you're uncertain whether you had chickenpox. Blood tests can determine previous exposure, but vaccination is recommended regardless for adults 50 and older due to high background rates of previous infection.

Do Adults Need Measles Vaccination?

Adults born between 1960 and 1980 may have incomplete measles immunity and should verify their vaccination status. Measles is highly contagious and can cause serious complications in adults. Those without documented immunity should receive MMR (measles-mumps-rubella) vaccination.

Measles is one of the most contagious diseases known to humans. The virus spreads through the air when an infected person coughs or sneezes, and can remain infectious in the air for up to two hours. An unvaccinated person has a 90% chance of becoming infected if exposed to the virus. While childhood vaccination programs have dramatically reduced measles cases, outbreaks continue to occur, particularly in communities with lower vaccination rates.

Adults who contract measles can experience severe illness. Symptoms include high fever, cough, runny nose, red eyes, and a characteristic rash. Serious complications include pneumonia (occurring in about 1 in 20 cases), encephalitis (brain inflammation, about 1 in 1,000 cases), and death (1-2 per 1,000 cases in developed countries, higher in developing nations). Measles during pregnancy increases the risk of premature birth and low birth weight.

Adults born before 1957 are generally considered immune to measles due to likely natural infection. However, those born between 1960 and 1980 may have incomplete immunity. During this period, vaccination practices varied, and some individuals may have received only one dose of vaccine or a less effective vaccine formulation. Additionally, immunity can occasionally wane over time.

Who needs measles vaccination?

Adults should consider MMR vaccination if they:

• Were born between 1960 and 1980 and lack documentation of vaccination or immunity
• Plan international travel: Measles is common in many parts of the world
• Work in healthcare settings: Two doses of MMR are recommended
• Are students at post-secondary educational institutions
• Have no documented immunity (vaccination records or positive blood test for measles antibodies)

Blood tests can determine measles immunity. If you're uncertain about your vaccination status and cannot locate records, getting vaccinated is safe and ensures protection.

What Vaccines Are Recommended During Pregnancy?

Pregnant women are recommended to receive pertussis (Tdap), influenza, and COVID-19 vaccines. These vaccines protect both the mother, who may be more vulnerable to severe illness during pregnancy, and the newborn baby through transferred maternal antibodies.

Pregnancy causes changes in the immune system that can make certain infections more severe. Additionally, some infections pose specific risks to the developing fetus. Strategic vaccination during pregnancy serves dual purposes: protecting the pregnant person from illness and providing the newborn with passive immunity through antibodies transferred across the placenta.

Pertussis (Tdap) vaccination is particularly important during pregnancy. Whooping cough can be fatal for newborns who are too young to be vaccinated. By receiving Tdap during pregnancy (ideally between 27-36 weeks), the pregnant person produces antibodies that cross the placenta and protect the baby during the vulnerable first months of life. This vaccination is recommended during every pregnancy, regardless of previous Tdap vaccination.

Influenza vaccination during pregnancy protects against flu complications, which can be more severe during pregnancy and increase risks of preterm birth. Flu antibodies also transfer to the baby, providing protection during the first months of life when the infant cannot yet be vaccinated. Any trimester of pregnancy is appropriate for flu vaccination.

COVID-19 vaccination is safe and recommended during pregnancy. Pregnant individuals with COVID-19 are at increased risk of severe illness, ICU admission, and premature birth. Vaccination protects against these outcomes and provides antibodies to the newborn.

Vaccines to avoid during pregnancy

Certain vaccines should not be given during pregnancy:

• Live vaccines: Including MMR (measles-mumps-rubella), varicella (chickenpox), and live attenuated influenza vaccine
• HPV vaccine: Not recommended during pregnancy (can be given while breastfeeding)

Women planning pregnancy should ensure they're up to date on all recommended vaccines, including MMR and varicella, before becoming pregnant. If uncertain about immunity, blood tests can determine whether vaccination is needed.

What Vaccines Do I Need for Travel?

Travel vaccines depend on your destination, trip duration, activities planned, and personal health status. Common travel vaccines include hepatitis A, hepatitis B, typhoid fever, yellow fever, Japanese encephalitis, rabies, and meningitis. Plan vaccination 4-6 weeks before travel.

International travel can expose you to infectious diseases not commonly encountered at home. Different regions of the world have different disease risks based on climate, sanitation infrastructure, and endemic pathogens. Proper pre-travel vaccination is essential for protecting your health and preventing the international spread of infectious diseases.

The specific vaccines needed depend on multiple factors: your destination countries, whether you'll be in urban or rural areas, the duration of your stay, planned activities (such as adventure travel, visiting rural areas, or working with animals), and your personal health status including underlying conditions and current medications.

Planning your travel vaccinations

Start planning travel vaccinations 4-6 weeks before departure to allow time for:

• Multi-dose vaccines: Some vaccines require multiple doses weeks apart
• Immune response development: Most vaccines need 1-2 weeks to provide protection
• Managing side effects: Complete any side effects before travel
• Required documentation: Some countries require proof of vaccination (especially yellow fever)

Consult a travel medicine specialist or your healthcare provider for personalized recommendations based on your specific itinerary and health status. They can also advise on non-vaccine preventive measures like malaria prophylaxis and food/water safety.

What Is RSV Vaccination for Older Adults?

RSV (Respiratory Syncytial Virus) vaccines are now available for adults 60 and older. RSV can cause severe respiratory illness in older adults, similar to flu. Vaccination is particularly recommended for those with underlying health conditions or weakened immune systems.

Respiratory Syncytial Virus (RSV) is a common respiratory virus that usually causes mild, cold-like symptoms in healthy adults. However, in older adults, particularly those with chronic heart or lung conditions or weakened immune systems, RSV can cause severe illness including pneumonia and bronchiolitis. RSV is responsible for tens of thousands of hospitalizations and thousands of deaths among adults 65 and older each year.

RSV vaccines for adults were approved in 2023, representing a significant advancement in adult immunization. These vaccines have shown high efficacy in preventing RSV-related lower respiratory tract disease, hospitalization, and death in older adults. The vaccines work by stimulating the immune system to produce antibodies against the RSV fusion protein.

RSV vaccination is recommended for adults 60 years and older, with shared clinical decision-making between the patient and healthcare provider. Factors to consider include age, underlying health conditions, frailty, and living situation (such as residence in a long-term care facility). Adults with chronic heart or lung disease, diabetes, immunocompromising conditions, or who live in congregate settings may benefit most from vaccination.

Can Adults Get the HPV Vaccine?

HPV (Human Papillomavirus) vaccination is approved for adults up to age 45 who weren't adequately vaccinated earlier. While most beneficial when given before sexual activity begins, vaccination can still provide protection against HPV strains not yet encountered.

Human Papillomavirus (HPV) is the most common sexually transmitted infection. Most HPV infections clear on their own, but persistent infection with certain HPV types can cause cervical cancer, other genital cancers, oropharyngeal (throat) cancer, and genital warts. HPV vaccination prevents infection with the HPV types most likely to cause cancer and genital warts.

The HPV vaccine is most effective when administered before sexual activity begins, which is why routine vaccination is recommended for adolescents. However, adults who weren't vaccinated as teenagers can still benefit. The vaccine is approved for adults up to age 45 and can protect against HPV types you haven't yet been exposed to.

HPV vaccination for adults aged 27-45 should involve shared clinical decision-making with a healthcare provider. Factors to consider include previous HPV exposure (related to number of sexual partners), current relationship status, and likelihood of exposure to new HPV types. The vaccine won't treat existing HPV infections but can prevent new infections with different HPV strains.

Where Can Adults Get Vaccinated?

Adults can receive vaccinations at various locations including doctor's offices, pharmacies, community health centers, workplace clinics, and public health departments. Many pharmacies offer walk-in vaccination services for common vaccines like flu and COVID-19.

Getting vaccinated as an adult has become increasingly convenient with multiple options available:

• Primary care provider: Your regular doctor can administer most vaccines and help you track your vaccination history
• Pharmacies: Many pharmacies offer walk-in vaccination services, particularly for flu, COVID-19, shingles, and pneumococcal vaccines
• Community health centers: Federally qualified health centers provide vaccinations regardless of insurance status
• Workplace vaccination programs: Many employers offer on-site flu vaccination clinics
• Public health departments: Local health departments often provide vaccinations at reduced cost
• Travel clinics: Specialized clinics for travel-related vaccinations and advice
• Urgent care centers: Many urgent care facilities offer vaccination services

When getting vaccinated, bring any available vaccination records. After vaccination, request documentation and keep records of all vaccines received, including the vaccine name, date, and lot number. This information is important for future healthcare visits and may be required for certain travel or employment.

What Are Common Vaccine Side Effects?

Common vaccine side effects include soreness at the injection site, mild fever, fatigue, and muscle aches lasting 1-2 days. Serious side effects are extremely rare. The benefits of vaccination far outweigh the minimal risks. Allergic reactions, while very rare, require immediate medical attention.

Vaccines, like all medical interventions, can cause side effects. However, the vast majority of side effects are mild, temporary, and far outweighed by the protection vaccines provide against serious diseases. Understanding what to expect after vaccination can help you distinguish normal reactions from those requiring medical attention.

Common, mild side effects that may occur after vaccination include:

• Pain, redness, or swelling at the injection site: This is the most common reaction and typically resolves within a few days
• Low-grade fever: A slight increase in temperature indicates your immune system is responding to the vaccine
• Fatigue and muscle aches: Feeling tired or achy for a day or two is normal
• Headache: Usually mild and resolves with over-the-counter pain relievers
• Nausea: Occasionally occurs and is typically brief

These side effects typically appear within 24-48 hours of vaccination and resolve within 1-3 days. They indicate that your immune system is responding to the vaccine and building protection. Over-the-counter pain relievers can help manage discomfort, and applying a cool compress to the injection site can reduce local swelling.