8 Vaccines You Need After 50 — and 1 to Consider

Why you need it: COVID-19 has killed more than 1.2 million Americans since it started circulating in the U.S. and has hospitalized millions of others. It’s especially risky for older adults, who are more likely to suffer complications from an infection.

Talk to your doctor if: You’ve had a severe allergic reaction to a medication or vaccine in the past.

Parting shot: Make it easy on yourself and get your fall COVID-19 vaccine when you go in for your flu shot. Experts say there’s no need to schedule a separate appointment.

3. RSV vaccine

Who needs it: In recently updated guidance, the CDC says adults ages 75 and older should get the vaccine to protect against respiratory syncytial virus (RSV), as should people ages 60 to 74 who live in nursing homes or who have certain medical conditions that put them at increased risk for severe illness, like heart and lung disease.

How often: For now, you need to get it only once. However, the RSV vaccine is still pretty new, so recommendations could change.

What you need: Three vaccines have been approved for older adults: Arexvy, from manufacturer GlaxoSmithKline, Abrysvo, from drugmaker Pfizer, and mRESVIA, from Moderna.

Why you need it: RSV is often associated with children, but it can be especially dangerous for older adults too. Each year, it causes 60,000 to 160,000 hospitalizations and 6,000 to 10,000 deaths among adults 65 and older, according to the CDC. In clinical trials, the vaccines were found to significantly reduce the risk of serious symptoms from an infection.  

Talk to your doctor if: You’re in the 60-74 age range and are unsure whether your underlying health issues put you at greater risk for complications from an RSV infection.

Parting shot: The vaccine could be especially helpful when it comes to avoiding a fall/winter “tripledemic” — a name used to describe the convergence of flu, COVID-19 and RSV.

4. Pneumococcal vaccine

Who needs it: Healthy adults 50 and older, or adults 19-49 with certain risk factors (smoking or health problems such as chronic lung or heart disease, leukemia, lymphoma or alcoholism).

How often: Adults who haven’t received a pneumococcal vaccine should opt for either the PCV15, PCV20 or PCV21. If PCV15 is used, it should be followed by a dose of PPSV23 a year later. (If you’re immunocompromised, you may get it sooner.) 

Why you need it: Before COVID-19 came along, pneumococcal disease, which can cause pneumonia, killed more people in the U.S. each year than all other vaccine-preventable diseases combined. Young children and those over 65 have the highest incidence of serious illness, and older adults are more likely to die from it. Experts estimate PCV13 (one of the pneumococcal vaccines available) prevented more than 30,000 cases of invasive pneumococcal disease and 3,000 deaths in its first three years of use.

Parting shot: If you work around chronically ill people — say, in a hospital or nursing home — talk to your doctor about getting the vaccine, even if you’re healthy.

5. Tdap vaccine (tetanus, diphtheria, pertussis) and/or the Td booster (tetanus, diphtheria)

Who needs it: The Tdap vaccine came out in 2005, and along with protecting against tetanus and diphtheria, like the vaccine it replaced, it includes additional protection against whooping cough, also known as pertussis.

If you can’t remember ever getting this shot, you probably need it. Doing so, Katz says, can count for one of the Td boosters you’re supposed to get every 10 years. (You know the one … it’s the shot you wonder if you’re current on after you step on a rusty nail during your vacation.)

How often: Adults should receive a booster dose of either Tdap or Td (a different vaccine that protects against tetanus and diphtheria but not pertussis) every 10 years, the CDC says, or after five years if you get a severe wound or burn.

Why you need it: Due to a rise in whooping cough cases in the U.S., you really do need to be vaccinated against it, even if you’re over 65. In the first year after getting vaccinated, Tdap prevents the illness in about 7 out of 10 people who received the vaccine. 

Talk to your doctor if: You have epilepsy or other nervous system problems, had severe swelling or pain after a previous dose of either vaccine, or have (or have had) Guillain-Barré syndrome.

Parting shot: This vaccine is especially crucial for people — including parents, grandparents and childcare providers — who have close contact with children younger than 12 months.

6. Shingles (herpes zoster) vaccine

Who needs it: The CDC recommends that everyone 50 and older get the Shingrix shingles vaccine, even if they had the earlier recommended vaccine, Zostavax — which was much less effective — and even if they’ve already had shingles. 

How often: Shingrix comes in two doses, spaced two to six months apart. 

Why you need it: One in 3 people will get shingles, usually after age 50. The risk rises with age. By 85, half of adults will have had at least one outbreak. Chicken pox and shingles are caused by the same virus, varicella zoster. After a person recovers from chicken pox, this virus stays dormant for decades in the body, ready to appear when the immune system is weakened by stress, medication or disease.

This infection causes a red rash and painful blisters. About 15 percent of sufferers are left with extreme nerve pain — a condition called postherpetic neuralgia, which can last for months or years. Shingrix can protect 97 percent of people in their 50s and 60s, and 91 percent of those in their 70s and 80s. 

Talk to your doctor if: You are not feeling well or currently have shingles. There are few other reasons not to get the vaccine. 

Parting shot: Older adults should get this vaccine whether or not they remember having chicken pox as a child. Why? More than 99 percent of Americans over 40 have been exposed to the varicella zoster virus, even if they don’t recall getting chicken pox. 

7. Hepatitis A vaccine 

Who needs it: People 50 and older who are at high risk for hepatitis A, a disease of the liver. Infections result primarily from travel to another country where hepatitis A virus transmission is common, through close contact with a hepatitis A–infected individual, or recreational drug use.

How often: Once, but given in two doses over six months.

Why you need it: Hepatitis A rates in the U.S. have declined by more than 95 percent since the hepatitis A vaccine first became available in 1995. In 2016, there were an estimated 4,000 hepatitis A cases in the U.S.

Parting shot: This is a sneaky disease. You may not have any telltale signs — and the likelihood of symptoms decreases as you age.

8. Hepatitis B vaccine

Who needs it: Adults 50 and older who are at risk for contracting hepatitis B, a liver infection. Hepatitis B is transmitted when a body fluid (blood, semen, saliva) from a person infected with the hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact or contact with blood or open sores (say, from a job that exposes you to human bodily fluids) or sharing anything from a needle to a razor to a toothbrush with an infected person. Other risk factors for infection include being on kidney dialysis, traveling to countries where hepatitis B is common, or having HIV.

How often: Adults getting the vaccine need three doses — the second dose given four weeks after the first; the third dose five months after the second. There is also a combination vaccine for both hepatitis A and B called Twinrix, which is given in three doses over six months.

Why you need it: The CDC estimates that the number of new hepatitis B infections in 2021 was 13,300.

Talk to your doctor if: You have a life-threatening allergy to yeast or to any other component of the vaccine, or you are moderately or severely ill when a dose of vaccine is scheduled.

Editor’s note: This story, published March 15, 2021, has been updated to reflect new recommendations for COVID-19, flu, RSV and pneumococcal vaccinations. Barbara Stepko contributed reporting to this story.