Recommended Vaccines for Adults

4 Vaccines Every Adult Needs (and 4 You May Need)

Children get a lot of vaccinations when they are little, but many parents and adults forget that they need immunizations too. Just because you are an adult doesn’t mean you have already "built up your immunity" and are at less risk of infectious diseases. In some cases, adults may be more at risk than children (as evidenced by the COVID-19 pandemic).

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There are four vaccinations recommended for all adults by the Centers for Disease Control and Prevention (CDC) as well as others that are recommended if you have not been adequately vaccinated or have a health condition. 

If you are unsure if you are up to date with your immunizations, ask your doctor.

For Adults 18 and Over

Some adult vaccinations are limited to specific age groups. Others are not used for primary immunization but rather as a booster to maintain long-term immunity.

Influenza Vaccine

Everyone over two months should receive an annual flu shot, while those between the ages of two and 49 can opt for the flu vaccine nasal spray (FluMist).

The need for influenza vaccination grows greater as you get older, with people 65 and older at increased risk of serious complications including pneumonia and hospitalization.

The flu shot only requires only one dose, delivered by intramuscular injection (into a large muscle). FluMist is sprayed into both nostrils but, as a live vaccine, is avoided in immunocompromised people, including people over 65, people with HIV, or people undergoing chemotherapy.

COVID-19 Vaccine

Currently, all available COVID-19 vaccines are for adults 18 and over only. That may likely change as clinical trials are performed in children and adolescents. It is unknown if boosters will be needed. The vaccines are all delivered by intramuscular injection.

As of March 2021, the U.S. Food and Drug Administration (FDA) issued emergency use authorization (EUA) to the following COVID-19 vaccines:

Human Papillomavirus (HPV) Vaccine

Human papillomavirus (HPV) is a sexually transmitted virus linked to cervical cancer and anal cancer.

The HPV vaccine, called Gardasil-9, is typically given to children between the ages of 11 and 12 but can also be used in anyone through 26 years if they have not been vaccinated. For people 15 to 26, three doses are given by intramuscular injection over the course of six months.

After the age of 26, Gardasil-9 will likely be of minimal benefit as the majority of unvaccinated people will already have been infected. With that said, only a small handful will be at risk of cancer.

Tetanus and Tdap Booster

After receiving the initial series of tetanus shots as a child, adults should receive one dose of the Tdap (tetanus-diphtheria-pertussis) vaccine, followed by a Tdap or Td (tetanus-diphtheria) booster every 10 years.

One of the follow-ups between the ages of 19 and 64 should involve the Tdap vaccine to protect against pertussis (whooping cough). For this same reason, the Tdap vaccine should be administered between 27 and 36 weeks of pregnancy, regardless of when you had your last Tdap or Td vaccination.

The Tdap vaccine is delivered intramuscularly, while the Td can be given either intramuscularly or subcutaneously (beneath the skin).

MMR Vaccine

If you have not had an MMR vaccine and have never had measles, mumps, or rubella (German measles), you may need the vaccine. Adults without evidence of immunity should receive one dose of the MMR vaccine. Being born before 1957 is considered evidence of immunity by the CDC.

The MMR vaccine is delivered by subcutaneous injection.

Varicella (Chickenpox) Vaccine

Varicella (chickenpox) vaccination is recommended for adults 18 to 49 without evidence of immunity. Being born before 1980 is considered evidence of immunity by the CDC.

For adults in need of immunization, two doses of the varicella vaccine are given by subcutaneous injection four to eight weeks apart. Pregnant women should not receive the vaccine.

Vaccines Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

For Adults 50 and Over

There are certain infectious diseases that adults 50 and over are espeically vulnerable to, the risk of which increases with each advancing year.

Pneumococcal Vaccine

All people 65 and older should be vaccinated against pneumococcal disease. This bacterial infection can cause pneumonia, meningitis, and septicemia, potentially severe.

There are two vaccines used for this purpose, both of which can be delivered intramuscularly or subcutaneously:

  • Pneumococcal polysaccharide vaccine (PPSV23), recommended for all adults over 65
  • Pneumococcal conjugate vaccine (PCV13), recommended for immunocompromised people and those with a cochlear implant or a cerebrospinal fluid leak

If you have risk factors that place you at higher risk for pneumococcal disease (such as chronic heart, lung, or kidney disease), you may need to get the PPSV23 vaccine before 65.

Herpes Zoster (Shingles) Vaccine

According to the CDC, one in three Americans will develop shingles (herpes zoster) in a lifetime. Almost all shingles deaths are in people over 65 or those with compromised immune systems.

Due to the high incidence of the disease in older people, as well as the risk of severe neurological and eye complications, shingles vaccination is recommended for all healthy adults 50 and over.

There are two shingles vaccines approved by the FDA, both given in a single dose:

  • Zostavax (zoster vaccine live), administered subcutaneously
  • Shingrix (recombinant zoster vaccine), administered intramuscularly

A Word From Verywell

Before getting a vaccine, check with your doctor about any conditions you have that may contraindicate the vaccine's use. This may include pregnancy, being immunocompromised, or having a pre-existing health condition. Don't simply arrive at a pharmacy or travel clinic asking for a shot that ultimately may not be suited or even safe for you.

You should also avoid getting vaccinated twice, presuming that doing so will "double the protection." In many cases, this will cause more harm than good. If unsure whether you've been vaccinated or not, speak with your doctor.

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Article Sources
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  2. Centers for Disease Control and Prevention. Table 1. Recommended adult immunization schedule for ages 19 years or older, United States, 2021. Updated February 12, 2021.

  3. Centers for Disease Control and Prevention. Influenza (flu). Updated March 21, 2021.

  4. Medimmune. Package insert - FluMist quadrivalent. Updated August 2019.

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  6. U.S. Food and Drug Administration. Emergency use authorization: Coronavirus disease 2019 (COVID-19) EUA information. Updated March 11, 2021.

  7. Luria L, Cardoza-Favarato G. Human papillomavirus. In: StatPearls [Internet]. Updated January 24, 2021.

  8. Centers for Disease Control and Prevention. HPV vaccine schedule and dosing. Updated August 15, 2019.

  9. Bae C, Bourget D. Tetanus. In: StatPearls [Internet]. Updated May 28, 2020.

  10. Centers for Disease Control and Prevention. Who should get diphtheria, tetanus, and whooping cough vaccines?. Updated December 17, 2018.

  11. Centers for Disease Control and Prevention. MMR and MMRV vaccine composition and dosage. Updated January 26, 2021.

  12. Centers for Disease Control and Prevention. Chickenpox (varicella): Administering the vaccine. Updated August 7, 2019.

  13. Centers for Disease Control and Prevention. Shingles burden and trends. August 14, 2019.