Barry Atwood getting a flu shot

Are you up to date on your shots?  Oh, you thought those were only for kids. They’re not, and a lot of adults haven’t had the vaccines they need to keep them from getting and spreading certain diseases.

Vaccine-preventable diseases

  • Chickenpox
  • Diphtheria
  • Flu
  • Hepatitis A
  • Hepatitis B
  • Human Papillomavirus
  • Mumps
  • Pneumococcus
  • Rubella
  • Shingles
  • Tetanus
  • Whooping cough
  • Meningococcal Conjugate and B

Barriers to adult vaccination

Some people think that whatever vaccines they got as children will protect them forever. In some cases, that’s true. The CDC’s Advisory Committee on Immunization Practices (ACIP) says there are exceptions.

  • Some adults were never vaccinated as children
  • Newer vaccines were not available when some adults were children
  • Immunity can begin to fade over time
  • As we age, we become more susceptible to serious diseases caused by common infections (such as flu and pneumococcus)

In a 2012 survey of 607 internists and family physicians in the United States, most agreed that it was the primary care physicians’ responsibility to make sure patients received recommended vaccinations. However, only an average of 30 percent reported that they assessed their patients’ vaccination status at every visit.

Ashley Levesque, Quality Assurance Coordinator for Maine’s Immunization Program, says things are improving.

We’re seeing a push to make immunizations a part of every doctor’s appointment, whether it’s the primary care provider or not. OB-GYNs, specialists, pharmacists, etc., can all be a part of recommending and administering vaccines.

Ashley Levesque, MPH
Quality Assurance Coordinator – Contractor
Department of Health and Human Services

Cost and access to vaccines can be barriers, but generally, they should be covered by insurance.

The Affordable Care Act (ACA) mandated that all insurance companies (with the exception of a few that were grandfathered) cover routine vaccines recommended by ACIP. As long as the vaccine is recommended by ACIP and has not already been received, the insurance company should cover it. There are some exceptions (such as travel vaccines), but your insurance company can tell you what they will cover.

Ashley Levesque

2019 recommended shots for adults

If you have no idea what immunizations are recommended for adults, here’s the current list, which gets reviewed every year by ACIP.

Flu (Influenza)

  • Flu vaccine every year.
  • A high-dose influenza vaccine that boosts the immune response is recommended for people over 65. Our immune systems weaken with age and, according to the CDC,“Fluzone High-Dose vaccine contains four times the amount of antigen (the part of the vaccine that prompts the body to make antibodies) contained in regular flu shots. The additional antigen is intended to create a stronger immune response”.
  • The influenza season runs through spring and it’s never “too late” to get a flu shot, says Ashley.

Tetanus, diphtheria, and acellular pertussis (Tdap)

  • Series of three shots if you are between 19 and 64 and have never been vaccinated.
    • Tdap
    • Two TD boosters
  • If you are pregnant, get Tdap vaccine during 3rd trimester of every pregnancy to help protect infant from whooping cough (pertussis).
  • TD booster shot every 10 years.

Herpes zoster/shingles

  • Series of two shots of Shingrix (RZV), whether or not you’ve been vaccinated with Zostavax (ZVL) previously, or whether you have had shingles or chickenpox before.
  • ACIP recommends Shingrix for those aged 50 and older.
  • You should not get this vaccine if you are pregnant or have a weakened immune system.

Pneumococcal

There are now two different types of pneumococcal vaccine: PCV13 and PPSV23

  • The CDC is recommending both at age 65 and older. They should not be given at the same time.
  • For those adults aged 19-64 with chronic medical conditions, such as heart, lung, liver disease, diabetes, alcoholism, or who smoke, ACIP recommends 1 dose of PPSV23.

Meningococcal Conjugate

  • Recommended for adults with certain medical conditions who are traveling in countries where the disease is common, and for microbiologists routinely working with Neisseria meningitidis or who are at increased risk during an outbreak.
  • Also recommended for first-year college students who live in residential housing (if not previously vaccinated).
  • Check with your health care provider to see if you should have more than one dose.

Meningococcal B

  • Recommended for adults with certain medical conditions and young adults up to age 23 who want protection or are at increased risk during an outbreak.
  • You should not receive this vaccine if you are pregnant.

Measles, mumps and rubella (MMR)

  • If you were born in 1957 or after and don’t have a record of being vaccinated or of having had measles, mumps or rubella, check with your health care provider about how many doses you may need.
  • One or two doses are generally recommended for anyone born in 1957 or later who was never vaccinated.
  • If you were born before 1957 you’re considered immune.
  • You should not get this vaccine if you have a weakened immune system.

Human papillomavirus (HPV)

  • Series of two or three shots (depending on age of first dose) if you’re a female 26 or younger.
  • Series of two or three shots (depending on age of first dose) if you’re a male 21 or younger.
  • Men who engage in sex with other men and transgender persons through age 26 should complete the series if they haven’t already done so.

Chicken pox (varicella)

  • Two shots for anyone 19 and older who has never had chickenpox or was never vaccinated.
  • You should not get this vaccine if you have a weakened immune system.

Hepatitis A

  • Two or three doses may be recommended if you have certain risk factors, such as homelessness, drug use; you travel to a country where the disease is common; or if you want protection.
  • Discuss with your health care provider.

Hepatitis B

  • Two or three doses may be recommended if you have certain risk factors or if you want protection.
  • Discuss with your health care provider.
  • Persons with risk for exposure to blood (such as persons with diabetes) aged younger than 60 years are encouraged to complete a Hepatitis B series.

Hib (Haemophilus influenza type b)

  • One or three doses may be recommended if you have certain risk factors.
  • Discuss with your health care provider.

Thinking about having a baby?

If so, rubella is one of those diseases you want to know about – before you get pregnant. A rubella infection during pregnancy can lead to serious developmental abnormalities and even death for your baby. A blood test can tell if you’re immune. If you aren’t, it’s recommended that you be vaccinated (one dose of MMR) before you conceive.

More information

The CDC has an easy to read adult vaccine schedule on its website. Some of the vaccines are recommended only if you never had one before. If you’re like most people, you can’t remember when you had your last tetanus booster, so how could you be expected to know if you got all the recommended series of shots as a child?

If you’re lucky, your devoted mother kept all your shot records just like she kept all your school pictures. If not, in some cases a blood test can tell if you’ve been vaccinated or have immunity to the disease in question.

Want to know even more? The College of Physicians of Philadelphia has a web site devoted to the History of Vaccines.