Adult Immunization Schedule

Why is it important to keep my immunizations up to date?

Immunizations (also called vaccinations) help protect you from serious, preventable diseases. Keeping up to date with your shots helps you stay healthy. As an adult, you need to be immunized against tetanus, diphtheria, and pertussis (whooping cough). Depending on your age and health, you may also need protection against influenza (flu), hepatitis, measles, rubella, chickenpox, or streptococcal (pneumococcal) pneumonia. The shots do not guarantee that you will not get sick with these illnesses, but they make it much less likely. If you do get the infection after vaccination, the illness tends to be milder than if you had not been vaccinated. They also lessen the risk of severe or life-threatening infection.

What immunizations do adults need?

The following immunizations are recommended for adults:

• Tetanus/diphtheria/pertussis: Bacteria that enter your body through a break in the skin can cause tetanus. Tetanus, also called lockjaw, is a disease that can be fatal. It is easy to prevent by keeping up to date on your shots. Diphtheria is also caused by bacteria. It can cause serious problems when poison from the bacteria gets into the bloodstream. Pertussis, also called whooping cough, can cause severe coughing and vomiting. It spreads very easily. It can be a dangerous infection for babies, who might catch it from adults.

  You should complete a 3-shot series of the tetanus/diphtheria vaccine if you did not get the 3 shots as a child. After the first shot, you need to get a second shot 4 to 8 weeks later. You get a third shot 6 to 12 months later. Then you need a booster shot at least every 10 years. If you have a cut, scrape, bite, puncture wound, or any injury needing stitches, you should get a tetanus booster shot if it has been more than 5 years since your last shot or if you don’t know when you last had a tetanus shot.

  One shot of Tdap vaccine, which gives protection against pertussis as well as tetanus and diphtheria, is recommended for teens and adults. A single shot of Tdap can replace a single shot of Td.

• Influenza (flu): Flu is caused by a virus. It causes fever, headaches, body aches, sore throat, and cough. It can spread easily. Some people who get flu may then get pneumonia. Many older adults die each year from complications of flu, such as pneumonia.

  Everyone 6 months old and older should get vaccinated against the flu every year. This is especially important for people at high risk of serious flu complications, including:

  • young children
  • pregnant women
  • people with chronic health conditions like asthma, diabetes, or heart and lung disease
  • people 65 years old and older

  October is the best time to get the vaccine. If you think you are allergic to eggs, talk to your healthcare provider before getting the vaccine.

  The flu vaccine is available as a shot or nasal spray. The nasal-spray vaccine may be used if you are healthy, between the ages of 2 and 49, and NOT pregnant. The nasal-spray vaccine is not for everyone. It is NOT safe during pregnancy. If you are interested in getting the spray instead of the shot, ask your healthcare provider about it.

• Pneumococcal pneumonia: Pneumococcal disease is caused by bacteria. The bacteria can cause pneumonia if they infect the lungs. The bacteria can also infect the blood (bacteremia) or the covering of the brain (meningitis).

  You should get the pneumococcal shot if you are 65 or older. The shot is also recommended for younger adults who have chronic illnesses, such as diabetes or problems with the heart, kidneys, or lungs. You may need a second pneumonia shot if you got your first shot when you were younger than 65 and it has been more than 5 years since you got the shot. Ask your provider if you need a second shot.

  The pneumococcal shot does not prevent pneumonia caused by other types of bacteria.

Other shots you may need are:

• Chickenpox (varicella): A series of 2 shots of the varicella vaccine are recommended if you have never had chickenpox. This common childhood disease can be serious when adults have it.
• Hepatitis B: Hepatitis B is a very contagious liver infection caused by a virus. The vaccine is given as a 3-shot series. The second shot is given 1 to 2 months after the first. The third shot is given 4 to 6 months after the first shot. If you get the shots and then later are exposed to the hepatitis virus, your healthcare provider will check your level of protection with a blood test. If your level of protection is low, you will be given a booster shot. Otherwise you will not need another shot.

  Some of the people who have the greatest risk of hepatitis B infection are:

  • sexually active adults who have more than one sexual partner
  • sexual partners of people who carry the virus
  • men who have sex with other men
  • IV drug users
  • healthcare workers
  • public safety workers who work with drug abusers or who are exposed to blood
  • people who work at institutions such as prisons and homes for people who are disabled
  • volunteers and employees at homeless shelters
  • dialysis patients

  Ask your provider if you need this series of shots.

• Hepatitis A: Hepatitis A is also a viral infection of the liver. You may need hepatitis A shots if you are at risk of infection. For example, you may need the shots before you travel to certain places or if you are in the military. You may also need the shots if you have liver disease, use illegal drugs, have HIV, or are a man who has sex with men. Two shots are given 6 to 18 months apart.

  You can ask your healthcare provider if the combined hepatitis A/hepatitis B shot is available to you. This combined vaccine is given in 3 doses over 6 months.

• Measles/mumps/rubella (MMR): The shot for these 3 diseases is recommended if you were born in 1957 or later. You may not need the shot if you are already immune because you have already had the diseases. Measles and mumps were very common before 1957, so older adults have probably been exposed to these diseases and are already immune.

  If you have had 1 measles shot, you may need a second one. Ask your healthcare provider.

  If a woman is not immune to rubella and gets infected with the measles virus during pregnancy, the baby could also get infected. The infection could cause severe birth defects. Women who have not had rubella and did not get the MMR shot as a child should have the shot before they get pregnant. Women should avoid getting pregnant for at least 28 days after the shot.

• Meningococcal vaccine: This vaccine protects against meningitis caused by the most common strains of meningococcal bacteria. Meningitis is an infection of the brain and spinal cord. Meningococcal meningitis most often occurs in young people living in close quarters. College freshmen, especially those who will live in dorms, should get this shot before they start school. Some colleges require it. The shot is also recommended for military recruits. People who have a weakened immune system or who do not have a spleen should also get the shot.
• Zoster (shingles) vaccine: Adults 60 years of age and older should get this shot. It can help prevent shingles, which is a painful rash caused by the same virus that causes chickenpox. Anyone who has had chickenpox can get shingles. It usually occurs in middle-aged or older adults. The pain caused by shingles can last for months or years after the rash is gone. The vaccine does not always prevent shingles, but it can lessen the pain if you do get shingles.
• HPV vaccine: This vaccine helps prevent infection with the most common types of the human papillomavirus that can cause cervical cancer and genital warts. The vaccine is approved for females and males age 9 to 26 years old. It is especially recommended for females 11 to 26 and males 11 to 21. The vaccine is most effective if it is given before a young man or woman is involved in any sexual activity, but it is still recommended even if they have already started having sexual relations. It is given as a 3-shot series. The second and third shots are given 2 months and 6 months after the first shot.
• Travel-related shots: Travel to some countries requires shots against typhoid and other diseases. The shots you need vary for different countries. Your healthcare provider or public health department can tell you what shots you need before you travel.

Where can I get the shots?

You can get the shots from your healthcare provider and at most local health departments.

For more information contact:

National Foundation for Infectious Diseases
Phone: 301-656-0003
Web site: http://www.nfid.org.

Information is also available at your local health department.