With almost daily reports of new cases of measles popping up around the country, you may be concerned about your own immunization status. We all know that children are supposed to get vaccinated, and to receive “booster” shots, but what about adults? Here, we take a look at some of the recommended disease-preventing vaccines and boosters for people 18 and older.
If you were born before 1957, it is very likely that you are immune to measles because people born during that time lived through several years of epidemic measles, and therefore were likely infected themselves at some point. An estimated 95 to 98 percent of adults born prior to 1957 are immune to measles, according to the CDC. So if you fit this age category, you likely do not need to be vaccinated against measles. However, the “1957 Rule” does not apply to mumps or rubella (German measles). For this reason, your physician may recommend that you have the MMR shot, particularly if an outbreak of either disease is occurring. And if you are at high risk—you are a healthcare worker or you plan to travel overseas, for example—it’s a good idea to get the shot just in case.
Men and women born after 1957 who have not been vaccinated at least once with MMR definitely need to get the vaccine—either a single dose or, if desired, two. (The first shot confers about 95 percent protection; a second dose ups the protection to about 99 percent.) And all women of childbearing age should have at least one dose of MMR to protect against rubella, which is particularly dangerous for a fetus. But avoid the vaccine if you are currently pregnant or if you intend to become pregnant within four weeks of being vaccinated, since the vaccine contains live virus and there is a theoretical risk that it could be transmitted to the fetus.
There are two vaccines used to protect against the bacterial illnesses tetanus, diphtheria, and pertussis in adults: Td and Tdap. The CDC recommends that adults get a tetanus booster (Td) every 10 years. However, if you never had the Tdap vaccine—which protects against pertussis (whooping cough) in addition to tetanus and diphtheria—you should receive that vaccine in place of your Td booster (you can get it immediately; no need to wait for the 10-year mark). Thereafter, you should receive the Td shot every 10 years.
It’s especially important to get vaccinated against pertussis if you are a grandparent or someone who is around infants, for whom pertussis can be extremely dangerous or even fatal. And pregnant women can help protect their newborns by getting a Tdap vaccine with every pregnancy.
Shingles (herpes zoster)
This disease is caused by the same virus that causes chickenpox and produces a painful, even debilitating, rash. Anyone who has had chickenpox is at risk of developing shingles because the virus lies inactive in the body and can resurface years later. The CDC recommends that people age 50 and older get the new singles vaccine (Shingrix), regardless of whether they recall having chickenpox or not or whether they got the earlier shingles vaccine (Zostavax). Additionally, adults born after 1980 who have never had chickenpox or been vaccinated against it should get the chickenpox (varicella) vaccine. As with MMR, avoid the vaccine if you are pregnant or might become pregnant within one month of being vaccinated.
Some 350,000 to 620,000 older adults are hospitalized every year due to pneumonia (either bacterial or viral), and it is the fifth leading cause of death in people older than 65. This vaccine protects against Streptococcus pneumonia, the leading bacterial cause of pneumonia. The CDC now recommends that adults age 65 and over receive two different types of pneumococcal vaccine—the one that has long been advised for older people, Pneumovax 23, plus a newer one called Prevnar 13—to protect against bacterial pneumonia and its complications, such as blood infection and meningitis. Recent studies have shown that the second vaccine provides substantial additional protection in that age group.
When to get the Prevnar 13 vaccine depends on whether you’ve already been vaccinated against pneumonia, and if so, when. If you are over 65 and have never been vaccinated, you should get the Prevnar 13 vaccine as soon as possible, then get a follow-up shot of Pneumovax 23 six to twelve months later. If you have already received the Pneumovax 23 shot, you can get the Prevnar 13 shot anytime as long as it's been at least a year since the Pneumovax. Additionally, adults ages 19 to 64 who are immunocompromised or otherwise at high risk of pneumococcal infection should also speak with their doctors about receiving one or both vaccines.
The CDC recommends that all individuals 6 months and older receive the vaccine annually, but it's especially important for older adults. The flu not only makes you feel lousy for days, it can have very serious, even fatal, complications. While the shot may not be perfect, it is your best defense against influenza. Additionally, the more people who get vaccinated against influenza, the harder it is for the disease to take root in the community. By getting vaccinated, you are helping those around you stay healthy.
Bottom line: Talk with your doctor about what vaccines are right for you. Some adults may need to catch up on vaccines they did not receive as a child; others (such as those with compromised immunity) may need certain adult vaccines earlier than the general population. Your doctor can help you make those decisions. Remember, there is no better way than vaccination to protect yourself and your loved ones from many serious infectious diseases.
Originally published February 2015. Updated May 2018.