Health Advocate Blog

Answers to common questions about adult immunizations

Since August is National Immunization Awareness Month, we thought it would be a good time to tackle some common questions about adult immunizations and what you need to do to stay safe from infectious diseases.


Why immunize?

Some of these illnesses, once contracted, do not have a cure, and all may cause tremendous health problems or even death. Vaccines are among the safest medical products available, are very effective, and can prevent the suffering and costs associated with these preventable diseases.


Should all adults be immunized?

Yes. All adults require tetanus and diphtheria (Td) immunizations at 10 year intervals throughout their lives. Additionally, adults younger than 65 years of age should substitute a tetanus, diphtheria, acellular pertussis (Tdap) vaccination for one Td booster.

Adults born after 1956 who are not immune to measles, mumps, or rubella should be immunized.

Adults born after 1956 should be immunized against measles, mumps and rubella.

All adults aged 65 or older, as well as persons aged 2-64 years who have diabetes or chronic heart, lung, liver, or kidney disorders need protection against pneumococcal disease, and should consult their healthcare providers regarding this vaccine.

Seasonal influenza vaccination is recommended for all adults 50 years of age or older, women who will be pregnant during influenza season, and residents of long-term care facilities, as well as for all children 6 months through 18 years of age, and persons who have certain chronic medical conditions. Other individuals who should seek annual seasonal influenza immunization include healthcare workers and those who live with or provide care for persons at higher risk for influenza complications, including those who live with or who provide care for infants younger than 6 months of age.

Hepatitis B vaccine is recommended for adults in certain high-risk groups, such as healthcare workers and public safety workers exposed to blood on the job, household and sex contacts of persons with chronic hepatitis B virus (HBV) infection, sexually active people who are not in long-term, mutually monogamous relationships, people seeking evaluation or treatment for sexually transmitted disease (STD), men who have sex with men, injection drug users, travelers to countries where HBV infection is common, people with end-stage renal disease or chronic hepatitis, including people with hepatitis C, and HIV-infected persons. Hepatitis B vaccine is also recommended for anyone seeking protection from HBV infection. To increase vaccination rates among people at highest risk for HBV infection, hepatitis B vaccine is recommended for all adults in the following settings: STD treatment facilities, HIV testing and treatment facilities, facilities providing drug-abuse treatment and prevention services, healthcare settings targeting services to injection-drug users or men who have sex with men, correctional facilities, end-stage renal disease programs and facilities for chronic hemodialysis patients, and institutions and nonresidential daycare facilities for persons with developmental disabilities.

Hepatitis A vaccine is recommended for adults in certain high risk groups including travelers to countries where hepatitis A is common, people with chronic liver disease, people who have clotting-factor disorders such as hemophilia, men who have sex with men, and users of injection and non-injection illegal drugs. Hepatitis A vaccine can also be given to persons who wish to obtain immunity.

Varicella vaccine is recommended for all adults who have not had chickenpox and have not been immunized previously against chickenpox.

Meningococcal vaccination is recommended for adults (not previously immunized with the meningococcal conjugate vaccine) with asplenia or terminal complement deficiencies, who will be first year college students living in dormitories, are military recruits or certain laboratory workers, or who will be traveling to or living in countries in which meningococcal disease is common. The vaccine is also recommended for administration to all adolescents 11 to 18 years of age.

Adults 60 years of age and older should receive a single dose of zoster vaccine whether or not they report a prior episode of herpes zoster (shingles). Persons with chronic medical conditions may be vaccinated unless a contraindication or precaution exists for their condition.


Where can I obtain my immunizations?

Immunizations should be available from family doctors and internists. Additionally, your city or county health department or local hospital may hold clinics to administer influenza, pneumococcal, hepatitis A, and hepatitis B vaccines. Many pharmacies offer these and other immunizations. Clinics may also be available in shopping malls, grocery stores, senior centers, and other community settings.


How often do I need to be immunized?

Immunizations for pneumococcal disease (except for patients at particular risk for pneumococcal complications), measles, mumps and rubella are usually administered once, and offer protection for life. A single pneumococcal revaccination is recommended for persons who were vaccinated prior to age 65. Women 26 years of age and younger should receive three doses of the HPV vaccine to prevent cervical cancer. Seasonal influenza vaccine must be administered yearly because the strains in the vaccine are updated nearly every year and because protection from the vaccine does not last from year to year. Additional booster doses of tetanus and diphtheria vaccines (usually given as a combination Td vaccine) are required every 10 years to maintain immunity against these diseases. One of these booster doses should be the tetanus, diphtheria, acellular pertussis (Tdap) vaccine, for adults younger than 65 years of age. Two doses of hepatitis A are needed six to 12 months apart to ensure long-term protection. Hepatitis B vaccine is usually administered in three doses given over a 6 month period. Two doses of chickenpox vaccine are recommended for people 13 years old or older who have not had the disease or been immunized. If an adult has already had one dose of varicella vaccine, then only the second dose is necessary. One dose of zoster vaccine is recommended for persons 60 years of age and older.


What do these vaccines cost?

Out-of-pocket immunization costs may vary depending on insurance coverage. Check with your healthcare provider or clinic, and your health insurance plan to determine your costs. For Medicare beneficiaries, both influenza and pneumococcal vaccinations are paid for by Medicare Part B if your health care provider accepts the Medicare-approved payment. Zoster vaccine is covered under Medicare Part D.


Are there side effects to these immunizations?

Vaccines are among the safest medical products available. Some common side effects are a sore arm or low grade fever. As with any medicine, there are very small risks that serious problems could occur after getting a vaccine. However, the potential risks associated with the diseases these vaccines prevent are much greater than the potential risks associated with the vaccines themselves.


What vaccines do I need if I’m traveling abroad?

Contact your health care provider or the public health department as early as possible to check on the immunizations you may need. Vaccines against certain diseases such as hepatitis A, hepatitis B, yellow fever and typhoid fever are recommended for different countries. The time required to receive all immunizations will depend on whether you need one dose or a series of doses. A variety of books are available from libraries and bookstores that provide information on specific vaccines required by different countries as well as general health measures for travelers. You also can call the CDC information line for international travelers or visit the CDC Travel Web site at for up-to-date information on immunization recommendations for international travelers.


Should I have a personal immunization record?

Definitely! A permanent immunization record should be kept by every adult. It will help you and your healthcare provider ensure that you are fully protected against vaccine-preventable diseases. It can also prevent needless revaccination during a health emergency or when you change providers. Ask your provider for an immunization record, and be sure to take it with you every time you visit your provider so that it can be reviewed and updated.

Always consult your doctor to find out what shots are best for you. Don’t have a doctor at this time? Check whether or not your employee benefits package at work includes an advocacy service such as Health Advocate that can help you find medical care providers that meet your needs.


Are there vaccines that protect against communicable diseases for adults?

Yes! Immunizations are readily available for such common adult illnesses as influenza (flu), pneumococcal disease, hepatitis A and hepatitis B. Vaccinations against less common diseases such as measles, mumps, rubella (German measles), tetanus (lockjaw), diphtheria and varicella (chickenpox) are also needed by some adults. The Centers for Disease Control and Prevention (CDC)’s recommendations clearly identify people who are at risk for these diseases and who should be immunized to prevent these diseases and their complications. Consult your healthcare provider or local health department regarding your own immunization status as well as current immunization recommendations.