UNC Health Care

Vaccines for Adults: Here Are the Ones You Need

Talk of vaccines is everywhere—in the news, on social media, during Zoom meetups with friends and chats in the driveway with neighbors. With all this buzz about the coronavirus disease 2019 (COVID-19) vaccines, you may be wondering what other vaccines you should have.

If you have children, you’re aware of the many childhood vaccines that protect kids against once-devastating illnesses such as measles and polio. But grown-ups need shots, too.

We talked to UNC Health family medicine physician Sarah Ruff, MD, about the shots you need to protect your long-term health.

Flu Vaccine

Healthcare experts agree: Your best protection from the flu is an annual flu shot. During the 2018-2019 flu season, the flu vaccine prevented an estimated 4.4 million flu illnesses and 3,500 flu-related deaths. And that’s with only about half of the U.S. population getting the vaccine.

The flu vaccine can reduce your risk of flu by 40 to 60 percent, “and even if you get the flu after getting a flu shot, you get a milder form of the illness and are sick for fewer days,” Dr. Ruff says.

Flu viruses can change from one season to the next. Also, the body’s immunity to flu viruses, whether acquired naturally or through a vaccine, will decline over time. Getting the vaccine each year is the best way to stay ahead of the flu.

Tetanus, Diphtheria and Pertussis Vaccine

Tetanus, diphtheria and pertussis (whooping cough) are three diseases that can cause serious illness and death. The Tdap vaccine is given every 10 years to protect against them, and Dr. Ruff says it’s very important to make sure you are up to date on this shot.

If you end up in the emergency room with an injury such as a deep cut, dog bite or puncture wound from stepping on a nail, you will get a tetanus shot if it’s been more than five years since you had your last Tdap shot. Tetanus vaccines are good for 10-year intervals, but in the case of a possibly “dirty” wound that could carry tetanus bacteria, it’s safest to revaccinate if your last dose was more than five years ago, Dr. Ruff says.

This also could change depending on whether you have been vaccinated with the entire Tdap series, so be sure to talk to your healthcare provider if you have questions.

In addition, people who are pregnant receive a Tdap vaccine to help protect the baby from whooping cough.

“Every pregnancy, even if it’s only been two years, you have another Tdap, and that’s because it gives some immunity to the fetus,” Dr. Ruff says.

This is important because pertussis is a bacterial disease might look like just a cold in adults but can cause babies to be hospitalized if they are not fully vaccinated against it. Expectant mothers will get the shot in the third trimester of pregnancy. The other parent and any other family members who are going to be around the baby should make sure their Tdap vaccines are up to date.

Shingles Vaccine

All adults age 50 and older need the Shingrix vaccine, which protects against shingles. This vaccine is 90 percent effective in preventing shingles and even more effective in preventing complications from shingles.

“People think shingles is just a painful rash, but even when that goes away, some people have chronic pain in that area for their whole life,” Dr. Ruff says. “This vaccine will prevent not only the rash but the complications, like chronic pain.”

The Shingrix vaccine can cause some side effects similar to the flu shot and COVID-19 vaccines, such as fever, chills and body aches, typically the night of your vaccination.

“It’s just your immune system working extra hard,” Dr. Ruff says. “As with any vaccine, reactions may differ among different patients, so be sure to discuss with your healthcare provider.”

The Shingrix vaccine replaces the previously recommended Zostavax vaccine. Even if you received Zostavax, you should still receive your two doses of Shingrix.

Pneumonia Vaccine

Another important vaccine protects against pneumonia, a lung infection that causes more than 250,000 people in the United States to be hospitalized every year. A pneumonia vaccine can reduce your risk of getting pneumonia and lessen its severity if you do get it.

There are two types of pneumonia vaccines: the pneumococcal conjugate vaccine (PCV13 or Prevnar 13) and the pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax 23). All children younger than 2 receive the Prevnar vaccine as part of their routine childhood immunization series. Pneumovax is given to all adults who have a chronic disease, such as asthma, chronic obstructive pulmonary disease, heart failure, cancer or an autoimmune disease.

“Those conditions are ones that if you were to get pneumonia, you would get really sick and much more likely end up in the hospital, versus a 21-year-old healthy person with no chronic conditions,” Dr. Ruff says. “So if you have a chronic disease that qualifies you, you will get the Pneumovax after you turn 18.”

Then, all adults receive both pneumonia shots after they turn 65—regardless of whether they have a chronic condition. You’ll first get the Prevnar vaccine, and then you will get the Pneumovax vaccine a year later.

“Those who had the Pneumovax earlier in their life will still have the Prevnar vaccine and a second Pneumovax vaccine after they reach age 65,” Dr. Ruff says.

Hepatitis A and B Vaccines

Viruses that infect your liver, hepatitis A and B affect 2,000 to 3,000 people in the United States each year.

If you did not receive the hepatitis vaccines as a child and plan to travel outside the country, you should get them, Dr. Ruff says.

Hepatitis A virus is found in the stool of infected people. Hepatitis A can easily spread from one person to another by putting something in the mouth (even though it may look clean) that has been contaminated with the stool of a person with hepatitis A.

The hepatitis A vaccine is a two-dose vaccine given six months apart.

The hepatitis B vaccine is given to almost all children as part of their routine childhood immunization series. If you did not get it then, you should be sure to have it as an adult, especially if you have a chronic liver disease.

The hepatitis B vaccine is a three-dose series: You get your first dose, then your second one month later, and your third dose five months after that. There is also a combination hepatitis A-hepatitis B shot that you can get at your doctor’s office.

Measles, Mumps and Rubella Vaccine

The MMR vaccine protects against measles, mumps and rubella, three highly contagious diseases that can cause serious illness.

If you were born after 1957, didn’t get your MMR vaccine as a child and have never had measles, you need to talk to your doctor about getting the vaccines.

Adults who are going to be in a setting that poses a high risk for measles or mumps transmission should make sure they have had two doses of the vaccine separated by at least 28 days. These include:

  • College students
  • Teachers
  • Healthcare workers
  • Anyone who travels outside the country

“It’s one that all babies get now, but there may be adults who have not gotten it,” Dr. Ruff says. “And if you’re not sure, it’s an easy blood test that we can do to see if you’re immune or not.”

You may need additional shots if you travel outside the country. The Centers for Disease Control and Prevention has a list of vaccines that are recommended or required for the countries you plan to visit.


If you’re not sure which vaccines you need, talk to your doctor or find one near you.