Most adults need routine protection from at least five diseases: flu, COVID-19, tetanus, hepatitis B, and shingles. Beyond those, the specific vaccines you need depend on your age, health conditions, and whether you missed any childhood shots. Here’s a practical breakdown of what’s recommended and when.
Vaccines Every Adult Needs
A few vaccines apply to virtually all adults, regardless of age or health status.
Flu: One dose every year. September and October are the best months to get vaccinated. Adults 65 and older and pregnant people in their first or second trimester should avoid getting their flu shot in July or August, since protection can wane before the season peaks.
COVID-19: An updated vaccine is released each fall to match circulating variants. The timing mirrors the flu shot, with September and October being ideal for most people.
Tetanus, diphtheria, and pertussis (Tdap/Td): Every adult needs one dose of Tdap if they haven’t already had one, followed by a Td or Tdap booster every 10 years. If you get a deep or dirty wound, you may need a booster sooner.
Hepatitis B: This vaccine is now recommended for all adults ages 19 through 59, even without specific risk factors. Adults 60 and older are recommended to get it if they have risk factors for hepatitis B, such as diabetes, liver disease, or kidney disease. Depending on the vaccine used, the series requires two, three, or four doses.
Vaccines by Age Group
Ages 19 Through 26
This is the window to catch up on anything missed in childhood. HPV vaccination is recommended through age 26 for anyone who wasn’t vaccinated earlier. If you start the series before your 15th birthday, two doses are enough. Starting at 15 or later requires three doses, spaced at 0, 1 to 2 months, and 6 months. If you were born in 1980 or later and never had chickenpox or the vaccine, you need two doses of the varicella (chickenpox) vaccine. The same applies to MMR (measles, mumps, rubella) if you were born in 1957 or later and lack evidence of immunity.
Ages 27 Through 45
HPV vaccination isn’t routinely recommended after 26, but some adults ages 27 through 45 may benefit from it based on a conversation with their clinician. This is most relevant if you weren’t vaccinated when you were younger and are still at risk for new HPV infections. All other routine vaccines (flu, COVID-19, Tdap boosters, hepatitis B) continue to apply.
Ages 50 Through 64
Two new vaccines enter the picture here. The shingles vaccine (Shingrix) is recommended as a two-dose series for all adults starting at age 50, with doses spaced 2 to 6 months apart. This applies even if you’ve had shingles before or received an older shingles vaccine. The pneumococcal vaccine is also recommended for all adults 50 and older who have never received a pneumococcal conjugate vaccine. If you get PCV20 or PCV21, one dose completes the series. If you get PCV15 instead, you’ll need a follow-up dose of PPSV23 about a year later.
Adults ages 50 through 74 with chronic heart or lung disease, a weakened immune system, or certain other underlying conditions are also eligible for an RSV vaccine.
Ages 65 Through 74
Everything from the 50-plus list still applies. If you haven’t yet received a pneumococcal or shingles vaccine, now is the time. Adults in this range who previously received older pneumococcal vaccines (PCV13 plus PPSV23) may have the option to get PCV20 or PCV21, based on a discussion with their clinician.
Ages 75 and Older
All adults 75 and older are recommended to get an RSV vaccine, not just those with risk factors. This is a single-season vaccine targeting respiratory syncytial virus, which causes increasingly severe illness with age. Shingles and pneumococcal vaccines remain important if you haven’t completed those series.
Pregnancy
Pregnant people need a Tdap shot during every pregnancy, ideally between weeks 27 and 36, and earlier in that window is better. This timing allows the body to produce antibodies that cross the placenta and protect the newborn during the first weeks of life, before the baby can be vaccinated. It doesn’t matter when your last tetanus booster was, even if your pregnancies are only a year or two apart, a fresh Tdap dose is recommended each time. The annual flu shot is also recommended during pregnancy, though timing in the first or second trimester should ideally target September or October rather than midsummer.
Extra Vaccines for Chronic Health Conditions
Certain medical conditions put you at higher risk for infections that healthy adults can usually fight off. The pneumococcal vaccine is the most commonly added recommendation. It’s specifically called out for people with diabetes (type 1 or type 2), heart disease, lung disease including asthma and COPD, and kidney disease. If you have any of these conditions and are under 50, you likely still qualify for pneumococcal vaccination ahead of the general population.
People living with HIV should be up to date on hepatitis A, hepatitis B, pneumococcal, shingles, and meningococcal vaccines. Those with a CD4 count of 200 or greater may also need chickenpox and MMR vaccines depending on birth year. Adults with liver disease need both hepatitis A and hepatitis B vaccines in addition to the pneumococcal series. People with kidney disease on dialysis or approaching it need hepatitis B and pneumococcal protection as well.
Adults without a functioning spleen face particular risk from certain bacterial infections and should be current on meningococcal vaccines (both MenACWY and MenB), the pneumococcal vaccine, and the Hib vaccine. Immunocompromised adults, including those being treated for cancer, may qualify for the shingles vaccine starting at age 19 rather than 50, with a shorter interval of 1 to 2 months between doses.
How to Figure Out What You’ve Missed
If you’re unsure which vaccines you’ve had, your state’s immunization registry is the best starting point. Many states maintain online portals where you can look up your records. Your primary care provider or pharmacy can also access these records and compare them against current recommendations for your age and health profile. For some vaccines, like hepatitis B, a blood test can confirm whether you’re already immune. For others, like the polio series, self-reporting previous doses is acceptable if records aren’t available. If there’s truly no way to verify your history, re-vaccination is generally safe and often the simplest path forward.