Immunizations

Recommended immunizations

Your need for immunizations does not end when you reach adulthood. The specific shots (injections) you need as an adult depend not only on your age, lifestyle, overall health, pregnancy status, and travel plans but also on who you are in close contact with and what vaccines you had as a child. Tetanus and diphtheria shots need to be repeated every 10 years throughout adulthood in order to keep your Reference immunity Opens New Window.

Each year the U.S. Advisory Committee on Immunization Practices (ACIP), the American College of Obstetrics and Gynecologists, the American College of Physicians, and the American Academy of Family Physicians recommend a specific adult immunization schedule. (What is a Reference PDF Opens New Window document?) Your doctor will consider your medical and immunization history (and documentation) when deciding which shots you need.

Immunizations given during adulthood may include:^{Reference 8}

Flu (influenza) (What is a Reference PDF Opens New Window document?)

This immunization helps protect against Reference the flu Opens New Window. Flu viruses are always changing, so the flu vaccines are updated every year. Protection lasts up to a year for each flu vaccine type.

Who should get it?

• All adults need one dose each year. It is especially important for:
  • People at higher risk of severe flu.
  • Close contacts of people who are at higher risk, including people who live with or care for children younger than 6 months.

Healthy people ages 2 years through 49 years can usually get the nasal spray flu vaccine (FluMist) (What is a Reference PDF Opens New Window document?) instead of the flu shot. Pregnant women can get the flu shot but not FluMist. People ages 18 to 64 can get the intradermal flu shot instead of the regular flu shot. The intradermal vaccine gets injected into the skin instead of the muscle. And it uses a much smaller needle than the regular flu shot.

Adults ages 65 and older can get a high-dose flu shot.^{Reference 9} Studies are being done to see if the high-dose shot protects older adults better than the standard-dose shot.

For the most current CDC guidelines about the flu, go to www.cdc.gov/flu.

Opens New Window Flu Vaccines: Should I Get a Flu Vaccine? Opens New Window

Reference Flu Vaccine Myths

Hepatitis A (Hep A) (What is a Reference PDF Opens New Window document?)

This shot protects against Reference hepatitis A Opens New Window disease.

Who should get it?

• Anyone who will be in close contact with an adopted child from a country that has high rates of hepatitis A needs two doses. This includes household contacts and babysitters. This recommendation only applies for the first 60 days the child is in the United States.^{Reference 6}
• Adults who will be Reference traveling to certain foreign countries need two doses given at least 6 months apart.
• Adults who have certain risk factors, such as long-term (chronic) liver disease, also need two doses.

Hepatitis B (Hep B) (What is a Reference PDF Opens New Window document?)

This shot protects against Reference hepatitis B Opens New Window disease. Three doses are needed over at least 4 months.

Who should get it?

• Adults ages 19 to 59 who have diabetes need this shot if they have not had the shot before. This vaccine is optional for adults ages 60 and older who have diabetes and have not had the shot before.
• Other adults who have not had this vaccine series need this shot when occupation, travel, health condition, or lifestyle increases their risk of exposure.

A hepatitis combination vaccine (Twinrix) is recommended for those who are at risk for both hepatitis A and hepatitis B. This vaccine is approved in the United States only for those 18 years of age or older.

Pneumococcal

This shot does not necessarily reduce your risk of getting Reference pneumonia Opens New Window, but it can prevent some of the serious complications of pneumonia, such as infection in the bloodstream (bacteremia) or throughout the body (septicemia).

Your doctor can help you choose between the pneumococcal polysaccharide vaccine (Pneumovax, or PPSV) (What is a Reference PDF Opens New Window document?) or the pneumococcal conjugate vaccine (Prevnar, or PCV) (What is a Reference PDF Opens New Window document?).

Who should get it?

• All people 65 years of age or older need a shot. Some people may need a booster shot after 5 years.
• People ages 2 years to 64 years who have a chronic disease (such as diabetes or heart, lung, or liver disease) need PPSV.
• People ages 19 to 64 years who have asthma or who smoke cigarettes need PPSV.
• People ages 19 and older who have immune system problems, cerebrospinal fluid leaks, cochlear implants, no spleen, or a damaged spleen need both PCV and PPSV.

Shingles (herpes zoster) (What is a Reference PDF Opens New Window document?)

This shot (called Zostavax) protects against Reference shingles Opens New Window.

Who should get it?

• Adults ages 60 and older need one dose, whether or not they've had shingles before. People ages 50 to 59 can also get this shot.

Zostavax is not a substitute for the chickenpox shot (Varivax).

Opens New Window Shingles: Should I Get a Shot to Prevent Shingles? Opens New Window

Tetanus and diphtheria (Td) or Tetanus, diphtheria, and pertussis (Tdap) (What is a Reference PDF Opens New Window document?)

The Tdap shot protects against Reference tetanus Opens New Window, Reference diphtheria Opens New Window, and Reference whooping cough Opens New Window (pertussis). The Td shot does not protect against pertussis.

Who should get it?

• All adults need Td booster shots every 10 years throughout life.
• All adults need one shot of Tdap in place of a Td shot.

It's important to get the Tdap shot at least 2 weeks before having close contact with a baby.

ACIP has recommended that pregnant women get the Tdap shot during each pregnancy, even if a woman had the shot before. As of November 2012, the Centers for Disease Control and Prevention (CDC) has not yet made this recommendation official. For the most current information about the Tdap vaccine for pregnant women, see the CDC website www.cdc.gov/vaccines/pubs/preg-guide.htm#tdap.

Other immunizations

You may need or want additional immunizations if certain situations raise your chance for exposure to disease. Or you may have missed shots when you were younger. Or a vaccine may not have been offered when you were younger. These immunizations may include:

Chickenpox (varicella) (What is a Reference PDF Opens New Window document?)

This is important if you never had Reference chickenpox Opens New Window or never got this shot.

This shot (called Varivax) protects against chickenpox. Chickenpox infection can be very serious when it occurs after childhood.

Who should get it?

• Adults who are not already immune to the chickenpox virus need two doses, given at least 4 weeks apart.
• Women who don't have evidence of immunity and recently gave birth should get this shot.

Pregnant women and people with Reference immune system problems Opens New Window should not get this shot.

Human papillomavirus (HPV)

This is important if you never got this shot.

The vaccines Cervarix (What is a Reference PDF Opens New Window document?) and Gardasil (What is a Reference PDF Opens New Window document?) protect against two types of human papillomavirus (Reference HPV Opens New Window) that cause Reference cervical cancer Opens New Window. Gardasil also protects against two types of HPV that cause Reference genital warts Opens New Window. And it protects against some uncommon cancers, such as vaginal cancer.

Who should get it?

• Females 13 to 26 years old need either Cervarix or Gardasil if they did not get the shot when they were younger. Three doses are given over 6 months.
• Males 13 to 21 years old need Gardasil if they did not get the shot when they were younger. Three doses are given over 6 months.
• Males 22 to 26 years old who have a weak immune system or who have sex with men need Gardasil if they did not get the shot when they were younger. Three doses are given over 6 months.

If you already have HPV infection, talk with your doctor about whether to get immunized. The shot has not been shown to help existing HPV infection, but it may protect you from other HPV infections.

Measles, mumps, and rubella (MMR) (What is a Reference PDF Opens New Window document?)

This is important if you never got this shot or never had these diseases.

This shot protects against Reference measles Opens New Window, Reference mumps Opens New Window, and Reference rubella Opens New Window.

Who should get it?

• Adults born during or after 1957 may need one or two doses if they do not have evidence of immunity.

Women should avoid becoming pregnant for 28 days after getting the MMR shot. Women who are known or suspected to be pregnant and people who have impaired immune systems should not get this shot.

Meningococcal (conjugate or polysaccharide, depending on your age) (What is a Reference PDF Opens New Window document?)

This shot protects against a bacteria that causes Reference meningitis Opens New Window and blood infections (Reference sepsis).

Who should get it?

• Adults who have a damaged or missing spleen or who have certain Reference immune system Opens New Window problems need two initial doses and then a booster dose every 5 years.
• Adults who have a higher risk than others for getting and having severe problems from meningitis need one shot. This includes adults who will travel or live in areas of the world where the disease is common.

The meningococcal conjugate vaccine is usually given to people ages 2 years to 55 years who need this immunization. Adults older than age 55 are immunized with the meningococcal polysaccharide (MPSV4) vaccine, called Menomune. Some people may need booster shots.

Polio (IPV) (What is a Reference PDF Opens New Window document?)

This shot protects against Reference polio Opens New Window.

Who should get it?

• Adults whose travel or job puts them at increased risk for exposure to polio need three doses of this shot.
• Adults who never had the full series of oral polio vaccine (OPV) or inactivated polio vaccine (IPV) and who have an increased risk of being exposed to polio need the shots they missed.

Routine polio immunization is not recommended for adults (ages 18 and older) who live in the United States.

Consult your doctor or public health department if you missed an immunization or to find out whether you need a specific immunization. For more information about each vaccine, see the topic Reference Vaccine Information Statements.

Immunizations and pregnancy

Reference Before you become pregnant, discuss your immunization history with your doctor. Your immunity protects both you and your baby. Some vaccines (such as the ones for flu and Tdap) can be given during pregnancy. Some vaccines need to be given before or soon after pregnancy.

If you are pregnant, your children should still get their immunizations on schedule. You do not need to speed up or delay your other children's immunizations.

Immunization safety

You may worry that immunizations are dangerous if they are given when you have a cold or other minor illness. Talk to your doctor if you have concerns about the timing of shots. But keep in mind that shots can usually still be given during a mild illness, while medicines are being taken, and in other situations where you may not be in perfect health. There are very few reasons for which doctors suggest that a person postpone or not get an immunization.

For more information about vaccine safety studies and vaccine side effects, see the topic Reference Immunization Safety.

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