Vaccination in Adulthood: The Shots Many People Forget After Childhood

Most adults received a childhood series of DTaP vaccines, but protection against tetanus and diphtheria fades over time. The CDC recommends that adults receive a Td (tetanus-diphtheria) booster every 10 years. Adults who never received the Tdap formulation — which adds pertussis (whooping cough) coverage — should get one dose of Tdap in place of a single Td booster.

Pertussis is particularly relevant for adults who spend time around infants, who are most vulnerable to severe complications. Pregnant people are generally advised to receive Tdap during each pregnancy, typically during the third trimester, to help protect newborns before they can be vaccinated themselves. Consult your provider for guidance specific to your situation.

Influenza vaccines are reformulated each year to match circulating strains, which is why annual vaccination is recommended by major health organizations including the CDC and the Advisory Committee on Immunization Practices (ACIP). Flu can cause serious complications — including hospitalization and death — particularly among adults 65 and older, those with chronic health conditions, and pregnant individuals.

Adults 65 and older may be offered higher-dose or adjuvanted flu vaccines, which are designed to produce a stronger immune response in older immune systems. The optimal time to get vaccinated is generally before flu season peaks, though vaccination at any point during the season provides benefit.

Shingles is caused by the reactivation of the varicella-zoster virus — the same virus responsible for chickenpox. After a chickenpox infection, the virus lies dormant in nerve tissue and can reactivate decades later, causing a painful rash that can lead to long-lasting nerve pain known as postherpetic neuralgia.

The recombinant zoster vaccine (RZV), currently the preferred option in the U.S., is recommended for adults 50 and older regardless of prior shingles history. It is given as a two-dose series. Adults with weakened immune systems may have different recommendations, so a healthcare provider should be consulted for individualized guidance.

Pneumococcal disease, caused by the bacterium Streptococcus pneumoniae, can lead to pneumonia, meningitis, and bloodstream infections. Adults 65 and older, as well as younger adults with certain chronic health conditions or weakened immune systems, are generally recommended to receive pneumococcal vaccination.

Multiple pneumococcal vaccine types are available, and recommendations around which formulations to use and in what sequence have evolved as newer vaccines have been approved. This is an area where guidance from a healthcare provider is particularly valuable, as the optimal approach can depend on prior vaccination history and individual risk factors.

COVID-19 vaccine recommendations for adults have evolved as new variants emerged and updated formulations were developed. Health authorities including the CDC have recommended updated COVID-19 vaccines to maintain protection, particularly for older adults and those with underlying health conditions who face higher risk of severe illness.

Because guidance in this area continues to be refined, it is important to consult the CDC's current recommendations or speak with a healthcare provider to understand which formulation and timing are appropriate given your age, health status, and prior vaccination history.

Hepatitis B vaccination became part of the routine childhood schedule in the early 1990s, meaning many adults born before that time may never have been vaccinated. The CDC now recommends hepatitis B vaccination for all adults up to age 59, and for adults 60 and older based on individual circumstances and provider discussion.

Hepatitis A vaccination is recommended for adults at increased risk — including international travelers to certain regions, people with chronic liver disease, and others — and may also be given to any adult who wants protection. Both infections can cause serious liver disease and are entirely preventable through vaccination.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, and persistent infection with certain strains is associated with several cancers, including cervical, oropharyngeal, and anal cancers. The HPV vaccine is recommended routinely for preteens, but adults through age 26 who were not previously vaccinated are also advised to receive it.

For adults between 27 and 45, the decision involves a shared conversation with a healthcare provider, weighing individual risk and the likelihood of benefit given prior exposure. This is not a one-size-fits-all determination — a provider's guidance is essential for this age group.