Why adult vaccines are easy to overlook
Vaccination is often framed as something that happens in childhood and then is complete. For a number of diseases, that framing is wrong. Immunity from some childhood vaccines wanes over years or decades. New vaccines have been developed that simply did not exist when today's adults were children. And some diseases pose greater risk as the body ages, making vaccination more valuable at 60 than it would have been at 20.
The adult immunization schedule maintained by the CDC covers more than a dozen vaccines. Some apply to everyone; others depend on age, occupation, travel plans, or underlying health conditions. Gaps are common because there is no automatic system prompting adults to stay current the way school enrollment requirements prompt childhood vaccination.
Cost, time, and uncertainty about what is actually needed are among the most common reasons adults delay or skip vaccines. Understanding which vaccines are broadly recommended is a practical first step toward closing those gaps. The list below covers the vaccines most frequently missed by American adults, based on public health guidelines.
Your vaccination records matter
Many adults have incomplete or unavailable childhood immunization records. If you cannot locate your records, a healthcare provider can order titer tests (blood tests that check for immunity to specific diseases) for some vaccines, or may recommend simply starting a series. State immunization registries may also hold records from recent years. Bring any documentation you have to your next appointment.
Vaccines most commonly missed by adults
Tdap booster (tetanus, diphtheria, pertussis)
Most adults received a DTaP series as children, but the protection from that series fades over time. Public health guidelines recommend one dose of Tdap for adults who have never received it, followed by a Td (tetanus-diphtheria) booster every 10 years. Adults who are pregnant or who will be in close contact with an infant should pay particular attention, since pertussis (whooping cough) can be life-threatening for newborns.
Many adults are current on tetanus after a wound visit but have never received the pertussis component as an adult. Checking which booster you received, Td or Tdap, is worth a quick call to your provider's office.
Pertussis protection from childhood vaccines fades and adults can unknowingly pass it to newborns.
Influenza vaccine
Annual flu vaccination is the most familiar adult vaccine, yet Centers for Disease Control and Prevention (CDC) data consistently show that a substantial portion of American adults skip it each year. The vaccine is reformulated annually because influenza strains change. Adults 65 and older have access to higher-dose or adjuvanted formulations, which are designed to produce a stronger immune response in older immune systems.
Getting vaccinated before flu season peaks, generally by the end of October, gives the immune system time to build protection. Even in years when the vaccine's match to circulating strains is imperfect, vaccination tends to reduce severity and the risk of complications.
Annual flu vaccination reduces not only infection risk but also the severity of illness if you do get sick.
COVID-19 updated vaccine
Updated COVID-19 vaccines are recommended annually for most adults, with the formulation adjusted to reflect currently circulating variants. Adults 65 and older, and those with certain underlying conditions, may be recommended an additional dose. Because guidance in this area has evolved and continues to be updated, it is worth checking the current CDC schedule or asking your provider directly about timing and eligibility.
COVID-19 vaccine guidance is updated regularly; confirming your status each year is the most reliable approach.
Shingles vaccine (Zoster)
Shingles is caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. The CDC recommends the recombinant zoster vaccine (RZV), given as two doses two to six months apart, for adults 50 and older. Even adults who have previously had shingles, or who received the older single-dose vaccine, are candidates for the current two-dose series.
Shingles can cause severe nerve pain (postherpetic neuralgia) that persists for months or years after the rash clears. Vaccination substantially reduces the risk of both shingles itself and this complication, which is more likely in older adults.
The two-dose shingles vaccine cuts the risk of postherpetic neuralgia, a painful and sometimes lasting complication.
Pneumococcal vaccine
Pneumococcal bacteria can cause pneumonia, meningitis, and bloodstream infections. Adults 65 and older are recommended to receive pneumococcal vaccination, and certain younger adults with chronic conditions such as diabetes, heart disease, or lung disease may also be candidates. Multiple pneumococcal vaccine types exist, so your provider can advise on which is appropriate based on your age and vaccination history.
This vaccine is one of the most frequently skipped among older adults despite being a standard recommendation. Adults who have had a pneumococcal vaccine before may still need an additional dose depending on which product they received.
Pneumococcal vaccination is standard for adults 65 and older but remains one of the most commonly missed.
Hepatitis B vaccine
The hepatitis B vaccine series is now recommended for all adults up to age 59 who were not vaccinated, and for adults 60 and older who want protection. Hepatitis B is transmitted through blood and certain bodily fluids and can lead to chronic liver disease or liver cancer if left untreated. Many adults in their 40s and 50s missed routine vaccination as children because universal pediatric programs were not in place until 1991.
A combined hepatitis A and B vaccine is available for adults who need both. A healthcare provider can test whether you already have immunity before beginning a series.
Many adults in their 40s and 50s were never vaccinated against hepatitis B because universal programs began in 1991.
HPV vaccine
Human papillomavirus (HPV) vaccination is recommended through age 26 for all adults who were not vaccinated earlier. For adults aged 27 to 45, the CDC notes that vaccination offers less benefit at the population level but may be appropriate for some individuals. This decision is best made with a healthcare provider based on personal health history and risk factors.
HPV is linked to several cancers, including cervical, throat, anal, and penile cancers. Adults who were not vaccinated as adolescents may have meaningful gaps in protection that vaccination can address.
HPV vaccination is recommended through age 26 and may be considered up to age 45 in consultation with a provider.
How to find out what you need
No single list applies to every adult. A healthcare provider can review your age, health history, and existing records to identify which vaccines you may be due for. The CDC's adult immunization schedule, updated annually, is publicly available and organized by age and health condition. It is a useful reference before an appointment.
Adults with chronic conditions, weakened immune systems, or certain occupational exposures may need vaccines beyond what is covered here. Pregnancy changes recommendations as well, so anyone who is pregnant or planning to become pregnant should discuss vaccination timing specifically. For those preparing for international travel, additional vaccines may apply. See what travel vaccines involve and when to plan ahead for more on that topic.
Vaccination fits naturally alongside other forms of preventive care. Routine health screenings cover conditions that vaccines cannot prevent, making both part of a complete approach to adult health.
This article provides general health information and is not a substitute for professional medical advice. Talk with a qualified healthcare provider about which vaccines are appropriate for your individual health situation.
