11 Vaccines Adults Should Ask About

Are your vaccinations current? Experts say many adults are missing important shots, so it may be time to talk with your doctor about a vaccine review.

Key points

• Most U.S. adults are not current on essential vaccines.
• Longer lifespans and medical progress mean more adults remain unprotected against diseases that vaccines can help prevent.
• These are the vaccines experts say you should discuss with your doctor to help protect your health.

When was your last booster? If you have to think about it, you are not alone. CDC data indicate that many U.S. adults have not received vaccinations that are appropriate for their age.

“People often think that if they’ve had all their shots as a kid, that’s it, but that’s not true,” says Susan Besser, MD, MBA, a family physician with Mercy Medical Center in Baltimore.

Childhood vaccine schedules have dramatically cut the burden of infectious disease, but research published in Vaccines highlights why adult immunization matters more than ever:

• People are living longer, and some vaccines lose effectiveness over time.
• As the immune system ages, booster doses are needed to maintain protection.
• Higher rates of chronic illness increase the danger of complications from infectious diseases in unvaccinated people.
• Some vaccine-preventable diseases have returned or become more common again.
• Some adults may have missed vaccines that are now part of the standard schedule.

“Remember what vaccines are for in the first place: to protect our population from a heavy death toll on communicable diseases that we can otherwise prevent,” says Ahmad Garrett-Price, MD, board-certified family medicine physician at GP Health. “No matter how you feel about vaccinations, don’t make your decisions based on myth or message boards. Remember, too, that vaccines aren’t just about protecting you, they’re mainly there to protect the vulnerable: the elderly and children.”

Doctors say these are the booster shots and preventive vaccines worth asking about:

1. Pertussis (whooping cough)

Whooping cough may sound like a disease from the past, but the highly contagious infection still returns in waves. After several quiet years, CDC data show a sharp spike in reported cases, followed by continued elevated levels, with cycle-based ups and downs typical of pertussis. Staying current on vaccination is an important defense, especially for infants, who are at greatest risk of severe illness.

“We used to think that if you were immunized as a child, you’d be fine, but it turns out your immunity wanes as you age,” Dr. Besser explains. She says adults should receive a pertussis booster every 10 years.

If you have never had a whooping cough vaccine, the CDC recommends starting with one dose of Tdap, the combination vaccine that protects against tetanus, diphtheria, and pertussis. After that, a booster is needed every 10 years.

For a healthy adult, the illness may be mostly an irritating cough that lingers, but it can be life-threatening for babies, who cannot begin their own pertussis series until 2 months of age.

Pregnant women can pass short-term protection to their babies, which is why a Tdap booster is recommended during each pregnancy, preferably between 27 and 36 weeks.

2. Tetanus

Tetanus is a bacterial infection that can enter the body through a cut and affect the nervous system. Because it can develop from something as minor as a puncture or animal scratch, the CDC recommends a booster every 10 years.

The Tdap shot also protects against whooping cough, Dr. Besser notes. “People don’t realize it’s not just tetanus in the shot, but you can also get protected from pertussis in the same vaccine,” she says.

3. Flu

In recent flu seasons, the CDC has reported hundreds of pediatric flu-associated deaths, with most occurring in unvaccinated children. “That’s when you can directly see the positive correlation between vaccinations and disease prevention,” says Dr. Garrett-Price.

Flu can be deadly for adults as well. CDC estimates show that a recent season caused up to:

• 24,000 deaths
• 390,000 hospitalizations
• 32 million illness cases

Vaccination also prevented millions of flu illnesses and thousands of deaths in a prior season, despite relatively low coverage among children and adults.

Because so many cases and deaths are preventable, the CDC recommends that everyone age 6 months and older get a flu shot each year. Protection takes about two weeks to develop, and early fall is generally the best time to get vaccinated. Even if that window has passed, doctors say it is still better to get the shot late than skip it altogether.

4. RSV

Like whooping cough, respiratory syncytial virus, or RSV, can seem like a routine cold in healthy adults, but it can lead to serious complications in older adults and infants. Vaccination offers strong protection: a review in JAMA found that among adults 60 and older, vaccination was highly effective at preventing RSV-related hospitalization.

The CDC recommends a single RSV dose for:

• All adults 75 and older who have not previously received one.
• Adults ages 50 to 74 with an increased risk of severe RSV, such as those with chronic health conditions.
• Pregnant women between weeks 32 and 36 of pregnancy, to pass protection to their baby. In pregnancy, Pfizer’s Abrysvo is the only RSV vaccine recommended, and it is typically given during RSV season in most of the continental U.S.

5. Hepatitis

Hepatitis A and B vaccines have long been part of childhood immunization in the U.S., though federal childhood guidance has shifted and become subject to legal challenges. Despite those changes, major pediatric organizations continue to support routine hepatitis A and B vaccination for children.

For adults, recommendations depend mainly on age, vaccination history, and risk factors. The CDC recommends hepatitis B vaccination for:

• All adults ages 19 through 59 who have not completed the series.
• Adults 60 and older who have certain risk factors, such as diabetes, chronic liver disease, or a greater chance of exposure to hepatitis B.

Adults 60 and older without a known risk factor may still choose to be vaccinated. This protection matters because chronic hepatitis B can cause serious liver damage and increase the risk of liver cancer, says Erich M. Sturgis, MD, MPH, a board-certified head and neck surgeon at Baylor College of Medicine.

Hepatitis A vaccination is recommended for adults with certain risk factors, including international travelers, people with chronic liver disease, or those who face increased exposure risk.

6. Meningitis

Meningitis can be caused by bacteria, viruses, fungi, or parasites. Not every form is severe, but some types are highly contagious and can be fatal within hours.

“The good news is that there is a vaccine that protects against the bacteria responsible for most cases of meningitis, but the bad news is that because it wasn’t widely available until 1987, most adults haven’t received it,” says Robert Hamilton, MD, a board-certified pediatrician in Santa Monica, California.

Adult vaccination is not routinely recommended for everyone, but it is advised for certain risk groups, including:

• People with immune conditions
• People taking certain medications
• Travelers at risk
• Military recruits
• First-year college students living in residence halls

CDC data also show meningococcal disease has risen sharply in recent years. In one recent year, hundreds of cases were reported, the second-highest total in more than a decade. Meningitis is most often diagnosed in:

• Babies
• Teens and young adults ages 16 to 23
• Adults 65 and older

7. If you are between 27 and 45: Ask about HPV

Human papillomavirus, or HPV, is a common sexually transmitted infection, with roughly 14 million new infections each year, according to the Cleveland Clinic. More than 100 types exist; many are harmless, but some are linked to cervical, vaginal, penile, anal, and other cancers.

That is why routine HPV vaccination is recommended for children, usually at ages 11 to 12, and for anyone through age 26 who was not fully vaccinated earlier. “The HPV vaccine is a whole different way of looking at vaccines because it’s our first cancer-killing vaccine,” says Dr. Besser. “It may pave the way for others in the future.”

The FDA later expanded approval to include adults ages 27 to 45. The American College of Obstetricians & Gynecologists says it is not routinely recommended for everyone in this age group, but advises discussing it with your healthcare provider to see whether you may benefit.

8. If you are 50 or older: Shingles

If you have had chickenpox, the virus can reactivate later in life and cause shingles, a painful rash that can lead to nerve damage and other complications, according to the Cleveland Clinic.

The CDC estimates that one in three people will develop shingles in their lifetime, yet the vaccine is about 90% effective at preventing it. Vaccination rates remain low, however, with only a minority of U.S. adults age 50 and older completing the two-dose Shingrix series.

Because shingles becomes more common with age, the CDC recommends Shingrix for all adults over 50, given in two doses six months apart. It is also recommended for adults 19 and older who are or will be immunocompromised because of a disease or treatment.

This is true even if:

• You have already had shingles.
• You received the earlier shingles vaccine, Zostavax.
• You have been vaccinated against chickenpox.

New research also suggests the shingles vaccine may lower the risk of heart problems.

9. Varicella (chickenpox)

If you were born before 1995 and do not remember having chickenpox as a child, the CDC recommends asking your doctor about the varicella vaccine.

Before widespread vaccination began, nearly everyone got chickenpox during childhood, and recovery usually led to lifelong immunity. Since vaccination started, chickenpox cases have fallen dramatically.

Even so, many people still get chickenpox each year, and the disease can be much more dangerous in adults. The Cleveland Clinic notes that complications can include bacterial infections, encephalitis, pneumonia, dehydration, blood clotting problems, and liver issues.

That is why the CDC recommends the varicella vaccine for adults without evidence of immunity. Evidence of immunity includes:

• Documentation of vaccination
• A confirmed history of chickenpox, verified by a healthcare provider or laboratory testing
• Being U.S.-born before 1980, which is considered presumptive evidence of immunity, though this does not apply to certain groups such as healthcare workers, childcare workers, immunocompromised people, and pregnant women

It is also important to note that the shingles vaccine does not protect against chickenpox. Adults who have never had chickenpox should get the varicella vaccine first, followed later by the shingles vaccine if appropriate.

10. If you are over 50: Pneumonia

The CDC lowered the recommended age for the pneumococcal vaccine to 50, reflecting the higher risk of serious pneumonia complications in this group, Dr. Garrett-Price says.

Younger adults with higher risk, including those with chronic diseases, are also advised to get vaccinated.

The vaccine offers long-lasting protection and helps prevent more than just pneumonia. It can also reduce the risk of other bacterial infections, including ear infections, strep throat, and meningitis, according to the Cleveland Clinic.

11. If you were born after 1957: Measles, possibly

“It was all quiet on the measles front until recently, because we’d previously done a great job vaccinating against it,” says Dr. Garrett-Price, referring to recent large outbreaks. Measles was declared eliminated in the U.S. in 2000 thanks to vaccination, but recent confirmed cases have climbed sharply.

People born before 1957 are generally thought to have natural immunity from earlier exposure. For everyone else, most adults are considered protected with at least one documented dose of MMR, while certain higher-risk groups, including healthcare workers, college students, and international travelers, need two doses.

If you have already received two appropriately spaced doses, you are considered protected for life and do not need a routine measles booster. Anyone unsure of their vaccination history can ask a doctor whether another dose or an immunity test is needed.

About the experts

• Susan Besser, MD, MBA, is a board-certified family physician with Mercy Medical Center in Baltimore. She also holds an MBA in medical management from George Washington University.
• Ahmad Garrett-Price, MD, is a board-certified family medicine physician at GP Health. He was formerly with Kaiser Permanente in California, where he served as local physician education lead and rounding physician for affiliated nursing homes.
• Erich M. Sturgis, MD, MPH, is a board-certified head and neck surgeon specializing in cancer prevention, screening, and treatment. He is a professor and deputy chair at Baylor College of Medicine after 23 years at MD Anderson Cancer Center in Texas.
• Robert Hamilton, MD, is a board-certified pediatrician with more than three decades of experience. He is also the founder and owner of Pacific Ocean Pediatrics in Santa Monica, California.