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8 Vaccine Questions You Should Be Asking This Fall
Vaccine recommendations can vary by age, health and timing. These questions can help you sort out what you need this fall
AARP
With so many new and improved vaccines available to older adults, it’s easy to feel like a pincushion — and to start wondering whether some shots are really necessary. In a 2026 poll, the No. 1 reason adults over 50 gave for not getting a flu or COVID shot was that they saw no need.
Questions go further. When should you schedule these vaccinations? Which vaccines can be given together? And could some offer health benefits beyond protecting against infection?
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Here’s what to ask your health care provider or pharmacist to best protect your health.
1. If I’m due for flu, COVID and RSV shots, can I get them at the same time — and will side effects be worse?
All three at the same visit is fine, says Dr. C. Buddy Creech, director of the Vanderbilt Vaccine Research Program — though spacing them out is “completely legitimate too,” he adds.
Some people can get two or three shots and barely notice; others feel crummy for 18 to 24 hours after just one. “It doesn’t mean the vaccine’s working better or worse,” Creech says. “It just means we’re built differently.” And, he adds, acetaminophen or ibuprofen should handle any mild discomfort.
There’s also a practical case for same-day shots: fewer trips to the pharmacy or doctor’s office. And if you’re worried about being overwhelmed, Creech notes that today’s flu, COVID and RSV vaccines together deliver less immune stimulation than a single childhood vaccine once did.
“Our immune systems are remarkably sophisticated,” Creech says. “It takes a lot to overwhelm [them].”
2. Do I still need the shingles vaccine if I’ve already had shingles?
Fast answer: yes. The U.S. Centers for Disease Control and Prevention (CDC) recommends the two-dose Shingrix series for most adults 50-plus, even if you’ve already had shingles.
“Shingles is the chickenpox waking up in our body,” says Dr. Aileen Pangilinan, lead physician for geriatrics vaccine management at Connecticut’s UConn Health. The virus that causes chickenpox remains dormant in the body and can reactivate later as shingles — and having shingles once doesn’t guarantee it won’t happen again.
“That’s what the vaccine tries to prevent … sometimes more reliably than having shingles itself,” Pangilinan says.
Recurrence isn’t common — roughly 5 to 10 percent over a decade — but the odds may rise if you’re immunosuppressed, something that can become more common with age or if pain from a prior episode was severe or prolonged.
3. If I already had a pneumonia shot, am I done for life?
Maybe — and the answer depends on which vaccine you received and when.
Dr. Jeff Goad, professor of pharmacy practice at Chapman University and immediate past president of the National Foundation for Infectious Diseases, has simple guidance for adults who’ve never had a pneumococcal vaccine: ask for one. Your pharmacist or doctor will sort out the right formulation for your age and health history — no seasonal deadline to meet.
For adults who have had a pneumococcal vaccine before, the recommendation depends on which one. A newer PCV20 or PCV21 generally completes the job. PCV15 is followed by PPSV23. People who previously received older PCV13 or PPSV23 may need another vaccine, depending on their age and vaccination history. If you’re not sure which vaccine you received, ask your pharmacist or doctor to check your records.
And if you can’t find your records? Don’t let that stop you, Goad says. “Can’t find it, can’t prove it, [get] it again.”
4. I’ve heard RSV is different from flu and COVID vaccines — do I need it every year and do I even qualify?
Unlike flu and COVID vaccines, the RSV vaccine is currently one and done. No annual commitment, no booster — at least not yet. Research is ongoing to determine how long protection from the shot lasts.
As for who qualifies, the CDC recommends a single dose for all adults 75 and older and for adults 50 to 74 who carry increased risk — think chronic lung or heart disease, diabetes, a weakened immune system or residence in a nursing home. If you’ve already received a dose, you’re covered.
That increased risk comes down to biology, Creech explains. Our immune systems follow a U-shaped curve across a lifetime, strongest in middle years and more vulnerable at the extremes — which is why, for adults 65 and older, a simple cold can turn into something worse.
For the first time, he adds, “we have a vaccine that really does keep a cold a cold and limits the number of hospitalizations in those over 65.”
And timing? The CDC recommends late summer/early fall (the virus tends to circulate in the fall and winter), although RSV protection lasts for at least two years, so whenever you’re ready is the right time.
Creech says there’s one caveat. Vaccine protection does gradually wane — from roughly 80 percent effectiveness in year one to around 50 percent by year three, depending on the vaccine brand. But even as the numbers soften, the vaccine continues doing its most important job: keeping you out of the hospital.
5. Should I wait until my next doctor’s appointment before reviewing and updating my vaccines?
For most vaccines, no. “The vaccine has no idea where it is. It doesn’t care. It works the same,” Goad says.
A pharmacist can check your vaccine history, screen for any red flags and, depending on state rules, administer recommended shots — walk-in or by appointment.
There may also be a financial advantage to not waiting, Goad says. “The pharmacy, you only pay for the vaccine. There’s no visit charge.” At a doctor’s office, depending on your insurance and the reason for your appointment, you may also have a visit charge.
If you’ve had a serious vaccine reaction or have a health condition that could affect vaccination, check with your doctor or pharmacist for guidance before getting the shot. But for most adults, the pharmacy is ready when you are.
6. Can my medications affect how well routine vaccines work?
Usually not. Everyday pillbox medications — blood pressure, cholesterol and diabetes drugs — aren’t known to weaken routine vaccines, Pangilinan says.
“There actually is only one really broad class of medications that affect vaccines, and those are the ones that cause any type of immune suppression” — such as chemotherapy or certain rheumatoid arthritis drugs, Goad says.
Methotrexate, for example, can weaken the immune response to a flu vaccine. For that reason, the American College of Rheumatology guidelines recommend briefly pausing the medication after vaccination if the patient’s condition allows.
But here’s the counterintuitive part: Those same patients need the shot most, Goad says. The vaccine may not work as well, but, he says, “it’s still your best hope at preventing the disease.”
The bottom line: Share your full medication list with whoever gives the shot and let them weigh in.
7. Are there other benefits to vaccines, beyond keeping specific illnesses at bay?
Several studies suggest yes, though researchers say more work is needed to confirm or explain the findings.
A 2022 UTHealth Houston study of nearly 1.9 million adults 65-plus found that flu vaccination was associated with a 40 percent lower risk of developing Alzheimer’s disease over four years. That risk drops even further with the high-dose vaccine: A 2026 follow-up from the same team found up to a 55 percent lower risk of Alzheimer’s, compared with those who skipped the flu shot entirely.
And a 2026 Brown University School of Public Health study, tracking more than 500,000 older adults with a recent stay in a skilled nursing facility, linked the shingles vaccine to a 24 percent lower risk of dementia diagnosis over four years.
The pattern isn’t limited to flu shots. Observational research presented at IDWeek 2025, a leading infectious diseases conference, found that shingles vaccination, compared with pneumococcal vaccination, was associated with a 25 percent lower risk of heart attack or stroke, a 27 percent lower risk of blood clots, a 50 percent lower risk of vascular dementia and a 21 percent lower risk of death.
A more recent study, published this year in Nature Medicine, also found a link between the shingles vaccine and lower cardiovascular risk. In the study, researchers found that older adults who received the Shingrix recombinant vaccine had a 9 percent lower risk of cardiovascular disease, compared with those who received the older, discontinued Zostavax shingles vaccine. This suggests that the currently available vaccine has a protective effect.
“Having already shown that this vaccine is linked to a lower risk of dementia, we now find it may also protect the heart,” study lead Max Taquet, who’s at the University of Oxford, said in a statement. “If confirmed in clinical trials, vaccinating older adults against shingles could prevent hundreds of thousands of coronary heart diseases, strokes and cases of heart failure worldwide, making it one of the most impactful interventions we could offer to protect both the brain and the heart in later life.”
Shingles infection itself can trigger cardiovascular and neurologic complications, so researchers are still looking into whether the vaccine protects directly or prevents shingles in the first place.
8. When is the best time to get my vaccines?
There are better times to get some vaccines, but missing the ideal window doesn’t mean you should skip the shot.
Public health experts encourage most people to get their annual flu vaccine in September or October, so it’s at peak protection just as flu season kicks in. However, Creech emphasizes that “there is almost no such thing as too late.”
If it’s January, he says, get your flu vaccine — you never know when you’ll be exposed or when it’ll be “the one that really knocks you for a loop.”
COVID vaccine timing is still developing, Creech says, and there’s no established peak season. For older adults, he says, it’s reasonable to get an updated COVID vaccine as soon as you’re eligible for any updated version.
Late summer/early fall is best for the RSV vaccine, although the CDC states that any time is fine.
For pneumonia and shingles vaccines, there’s no seasonal window to consider. Once you’re due, you’re ready.
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