In the run-up to any recent cold and flu season, you’ve probably encountered many reminders to get your seasonal flu shot and the latest Covid vaccine. When it comes to vaccinations for adults, they’re the two that tend to grab all the attention these days.
But there’s actually a list of recommended immunizations for adults, including some newer vaccines. It can get confusing, and maybe raise questions like, “Do I really need all of these shots?” The best way to answer that question is by talking with your doctor, who will have a record of your past vaccinations (ideally, at least) and know which ones you still need.
In the meantime, here’s a rundown of the five main immunizations that the Centers for Disease Control and Prevention (CDC) recommends for older adults (and sometimes younger ones), in addition to routine flu and Covid shots.
1. Respiratory syncytial virus (RSV) vaccination
RSV is a very common, very contagious virus that often causes nothing more than cold-like misery. But if it makes its way into the lungs, it can lead to pneumonia or worsen existing conditions like asthma, emphysema, or heart disease. That’s why RSV sends up to 160,000 older Americans to the hospital—and kills 6,000 to 10,000—every year.
Up until 2023, we had no vaccine against RSV. Now we have three of them, all approved by the U.S. Food and Drug Administration within the past two years. Vaccination is recommended for:
- Everyone ages 75 and older
- People ages 60 to 74 who have medical conditions that put them at heightened risk of severe RSV. Some of those conditions include chronic lung disease, heart disease, diabetes, and kidney disease. Anyone who lives in a long-term care facility should also be vaccinated.*
At least for now, RSV vaccination is one-and-done. So if you already got the shot, there’s no need for another. Ideally, you should be vaccinated in late summer/early fall (ahead of RSV, cold, and flu season), but you can get the shot at any time of year.
2. Shingles vaccination
If you’ve never had shingles, characterized by a painful rash, consider yourself lucky. Shingles is caused by the chickenpox virus, varicella zoster; once a person has had chickenpox, the virus continues to live in the body in a dormant state. But it commonly reactivates many years later, resulting in shingles, which can then lead to long-term nerve pain called postherpetic neuralgia. The two-dose shingles vaccine (Shingrix) is recommended for:
- Everyone ages 50 and up
- Adults whose immune systems are weakened due to a medical condition or treatment
Shingles vaccination is recommended whether you’ve ever had chickenpox or not—and even if you’ve already suffered a bout of shingles. The vaccine works very well; it’s over 90 percent effective at preventing shingles and postherpetic neuralgia, according to the CDC. Based on studies so far, that protection lasts at least seven years in adults ages 70 or older with healthy immune systems.
3. Pneumococcal vaccination
This vaccine offers protection against the pneumococcal bacterium, a common cause of pneumonia, blood infections, and meningitis (an infection of the tissue covering the brain and spinal cord). This immunization can be confusing because there are several pneumococcal vaccines available, including the latest one, PCV21, approved this past June. The different vaccines target different strains of the bacterium. Pneumococcal vaccination is recommended for:
- All adults ages 50 and older**
- Adults with certain risk factors for pneumococcal infections, including heart or lung disease, diabetes, weakened immunity, and smoking
The choice of which pneumococcal vaccine to get is based on your age, health conditions, and whether you’ve had any pneumococcal vaccine in the past. This is something to figure out with your doctor. (Even if you’ve already been vaccinated, you may need another dose.) As for effectiveness, pneumococcal vaccination isn’t perfect, but it does lower the risk of becoming very ill. The oldest of the vaccines, PCV13, was shown to be 46 percent effective in preventing pneumonia caused by the bacterium the vaccine targets. The newer ones are likely to be more effective.
4. Measles-mumps-rubella (MMR) vaccination
These diseases might sound like relics of the past, but measles and mumps outbreaks have been occurring regularly in recent years, with the vast majority of measles cases striking unvaccinated people. So some adults should receive at least one dose of the MMR vaccine—namely, those who have no documented history of vaccination and were born in 1957 or later. Nearly everyone born before 1957 was infected with measles, mumps, and rubella during childhood and are presumed to have immunity. The MMR vaccine is highly effective against all three diseases.
5. Tetanus, diphtheria, and pertussis (Tdap) vaccination
All adults should receive a Tdap booster every 10 years. Diphtheria and pertussis (whooping cough) are both highly contagious respiratory infections that can have serious complications; diphtheria is now rare in the U.S., but whooping cough outbreaks still happen regularly. Tetanus, meanwhile, is a bacterial infection that attacks the brain and nervous system, with potentially fatal consequences. The Tdap vaccine is very effective at preventing these diseases—for a time. Immunity does wane, and that’s why booster shots are recommended.
Give it a shot
Yes, “vaccine fatigue” is real—there’s plenty of research showing this. And surveys from the past year indicate that many Americans feel they don’t need, or have no plans to get, the recommended flu or Covid shots. This is troubling, because we know those vaccinations can reduce the severity of symptoms and help keep people out of the hospital—and, to a lesser degree, prevent transmission of the virus to others. If the prospect of getting additional vaccinations feels like too much, remember that none of the shots discussed above are yearly, and some may even be one-time.
BOTTOM LINE: In the best-case scenario, you’re already up to date with everything on this list. If not (or you’re not sure), check in with your doctor about getting any vaccinations you’re missing. You can also bring any questions about vaccine safety to your doctor, or turn to reliable sources like the U.S. Department of Health and Human Services and the CDC.
