Adult Immunization Schedule

What immunizations do adults need?

Immunizations help protect you from serious, preventable diseases. Keeping up to date with immunizations helps you stay healthy. As an adult, you need to be immunized against tetanus and diphtheria. 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. They also reduce the risk of severe infection or death.

The following is the recommended schedule for adult immunizations:

• Tetanus/diphtheria/pertussis: Bacteria that enter your body through a break in the skin can cause tetanus. Tetanus is a disease that can be fatal, but it is easy to prevent by keeping up to date on your shots. Diphtheria, also caused by bacteria, can cause serious problems when the bacteria release a poison into the bloodstream.

  You should complete a 3-shot series of the tetanus/diphtheria vaccine if you did not get the 3 shots as a child. The second shot is given 4 to 8 weeks after the first shot. The third shot is given 6 to 12 months later. You need a booster shot at least every 10 years. If you have a cut, scrape, bite, puncture wound, or 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 do not remember when you last had a shot.

  Because of increasing whooping cough (pertussis) outbreaks in the past few years, the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) recommends a booster shot of Tdap vaccine against tetanus, diphtheria, and pertussis for adults under 65 years of age who have not had a tetanus and diphtheria (Td) booster shot in 10 or more years. They recommend a single shot of Tdap to replace a single shot of Td. Tdap has not been approved for adults over 65.

• Influenza (flu): Flu is a viral infection that causes symptoms such as fever, headaches, body aches and pains, sore throat, and cough. It is very easily passed from one person to another. People who get flu may then develop pneumonia. Many older adults die each year from complications of flu.

  If you are older than 50, you should get the flu vaccine every year. The vaccine is also recommended if you are younger than 50 and have a chronic disease, have contact with people who are at risk for complications of the flu, or just want to avoid the flu. Women planning to become pregnant during the flu season should have a flu shot. The flu shot is safe during pregnancy. When there is a shortage of flu vaccine, the recommendations for who should get it may change. 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 nasal-spray flu vaccine may be used instead of a shot 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 an infection caused by a certain type of bacteria. The bacteria can infect the lungs (causing pneumonia), blood (causing bacteremia), or the covering of the brain (causing meningitis). The vaccine does not prevent pneumonia caused by other types of infection.

  You should get this 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. Some people may need a one-time second shot. The second shot should be given at least 5 years after the first shot. Ask your provider if the second shot is recommended in your case.

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 more serious in adults than in children.
• Hepatitis B: Hepatitis B is a viral infection of the liver. 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 are then exposed to the hepatitis virus, your healthcare provider will check your level of protection with a blood test. If your level is low, you will be given a booster shot. Otherwise you will not need another shot. 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 the hepatitis A shots if you are at risk--for example, through travel, your job (including military service) or 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.
• 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. Older adults born before 1957 are generally considered immune because measles and mumps were very common before 1957, so they have probably been exposed to these diseases.

  If you have had a measles shot, depending on when you received it, you may need a second one. Ask your healthcare provider.

  If a woman is not immune to rubella and becomes infected with the measles virus during pregnancy, the baby could also become 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 become pregnant. Women should avoid getting pregnant for at least 28 days after the shot.

• Meningococcal vaccine: This vaccine protects against most types of meningitis. The American College Health Association recommends that college freshmen, especially those who will live in dorms, get this shot before they start school. Some colleges require it. The shot is also recommended for people who have a weakened immune system or who do not have a spleen and for military recruits.
• Zoster (shingles) vaccine: Adults 60 years of age and older should get this shot. The vaccine can help prevent shingles, a painful rash caused by the same virus that causes chickenpox. The vaccine does not always prevent shingles, but, if you have had the shot and then get shingles, it can reduce the pain caused by the infection.
• HPV vaccine: This new vaccine prevents infection with the 4 most common types of the human papilloma virus that can cause cervical cancer. The vaccine is recommended for females who are 9 to 26 years old. It is best if the vaccine is given before a young woman becomes sexually active. It is a 3-shot vaccine. The second and third shots are given 2 months and 6 months after the first shot.
• Travel-related shots: Travel to some countries requires you to be immunized against typhoid, hepatitis A, and other diseases. The shots you need vary for different countries. Your healthcare provider or public health department can advise you.

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.