Vaccinations in Adulthood: What Most People Don't Realize They Still Need

Tetanus, diphtheria, and pertussis (whooping cough) vaccines are typically given in childhood, but protection against tetanus and diphtheria wanes over time. Public health guidelines generally recommend a Td (tetanus-diphtheria) booster every ten years for adults. The Tdap version — which adds pertussis coverage — is often recommended at least once in adulthood if you haven't had it, and is especially emphasized for those who are pregnant or in close contact with infants, since whooping cough can be severe in newborns.

Seasonal flu vaccination is one of the most consistently recommended preventive measures for adults of all ages. Because influenza viruses evolve rapidly, the vaccine formulation is updated each year to match circulating strains. Beyond personal protection, annual vaccination can help reduce transmission to those who are more vulnerable — including older adults, young children, and people with compromised immune systems. Flu-related complications, including hospitalization, are not rare in otherwise healthy adults.

Updated COVID-19 vaccine doses are recommended periodically by public health authorities for most adults, with guidance evolving as the virus continues to circulate. The specific recommendations — including which formulation and how often — depend on age, prior vaccination history, and health status. Your provider or public health department can clarify the most current schedule. This is an area where guidance has changed frequently, so it's worth checking even if you received earlier doses.

Shingles is caused by the reactivation of the varicella-zoster virus — the same virus that causes chickenpox. Anyone who has had chickenpox carries the virus and can develop shingles later in life, often with painful consequences including a condition called postherpetic neuralgia, where nerve pain persists long after the rash resolves. A recombinant shingles vaccine is generally recommended for adults starting at age 50, including those who had chickenpox or a previous shingles episode. It's given as a two-dose series.

Pneumococcal disease — which can cause pneumonia, meningitis, and bloodstream infections — is a serious concern particularly for adults 65 and older and for younger adults with certain chronic health conditions such as diabetes, heart disease, or a weakened immune system. There are different types of pneumococcal vaccines, and the recommended schedule has been updated in recent years. Your provider can assess which formulation and timing is appropriate based on your age and medical history.

Hepatitis B vaccination is now recommended for all adults through age 59, and for those 60 and older based on individual assessment. Many adults who were vaccinated in childhood may have adequate protection, but those born before routine vaccination programs were implemented may have never received it. Hepatitis A vaccination is recommended for adults with certain risk factors — including travel to regions where hepatitis A is common, certain medical conditions, or occupational exposure. Both are preventable infections with potentially serious liver complications.

Respiratory syncytial virus (RSV) has long been known as a serious illness for infants, but it also causes significant illness in older adults — particularly those 60 and over. RSV vaccines for older adults have been approved in recent years and are among the newer additions to the adult immunization landscape. As with other vaccines, recommendations about timing and eligibility continue to be refined, making a conversation with your healthcare provider especially useful here.