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The Vaccines You Need at 50+

Here are details on the ones to get, the ones to skip

En español | If the word “vaccination” evokes images of childhood, it may be time to raise the subject with your doctor. It’s not just kid stuff: All adults — including those age 50 and older — need vaccines. And some of the adult vaccine recommendations from the U.S. Centers for Disease Control and Prevention (CDC) have changed recently. So even if you think you’ve been keeping up with your vaccines, you’ll want to review the CDC’s list of vaccine recommendations.

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Influenza vaccine

Who needs it: Everyone over 6 months of age unless you:

  • Have had a severe reaction to the flu shot in the past
  • Are allergic to eggs
  • Have a fever. If you do, wait until you are no longer sick to get the vaccine.

How often: Annually

Notes: Flu kills around 36,000 people every year in the United States, and older Americans are among the most vulnerable groups. Because each year’s vaccine is formulated to combat that season’s influenza strains, you should get a dose every year. Flu shots are given during the September-to-March flu season. If you are 50 or older, don’t get the nasal spray form of the vaccine, which did not prove effective in clinical trials in people over age 49.

Td (tetanus, diphtheria) and Tdap (tetanus, diphtheria and pertussis) vaccines

Who needs it: Everyone

How often: Once for Tdap; once every 10 years for Td booster

Notes: If you’ve never received a Tdap vaccine, you should be vaccinated once, even if you are over age 65 (this is a change from CDC’s prior guidance). Due to a rise in pertussis, or whooping cough, cases in the United States, the Tdap vaccine is especially crucial for people who have close contact with infants younger than 12 months of age -— including parents, grandparents, and child-care providers. If you have received Tdap in the past, you should get a Td booster every 10 years.

Talk to your doctor before getting the vaccine if you:

  • Have epilepsy or other nervous system problems
  • Had severe swelling or pain after a prior dose of Tdap/Td vaccine
  • Have or have had Guillain-Barre syndrome

Herpes zoster (shingles) vaccine

Who needs it: Everyone over age 60

How often: Once

Notes: Zoster vaccine is recommended for everyone over age 60, regardless of whether you’ve had a prior episode of shingles — a painful, blistering skin rash, caused by the varicella-zoster virus — which can be especially painful in older adults. Some experts recommend getting the vaccine only if you’ve had a prior episode of chicken pox. But the CDC recommends that everyone over 60 get vaccinated because more than 99 percent of Americans over age 40 have had chicken pox, even if they don’t recall getting the disease. Also, the older patients are, the more severe are their cases of shingles.

Do not get this vaccine if you:

  • Have ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of shingles vaccine
  • Have a weakened immune system because of:   

        o    HIV/AIDS or another disease that affects the immune system
        o    Treatment with drugs that affect the immune system, such as steroids
        o    Cancer treatment such as radiation or chemotherapy
        o    A history of cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma;
  • Are or might be pregnant

MMR (measles, mumps and rubella) vaccine

Who needs it: Adults born after 1956 that have not been immunized or are unsure of their immunization status. People born before 1957 — the year the first measles vaccine began to be tested — generally are considered immune to measles and mumps because they are likely to have had one of the diseases as a child. If you don’t know your immunization status, get a booster shot.

How often: Once

Notes: You should ask your doctor before getting this vaccine if you:

  • Have ever had a life-threatening allergic reaction to gelatin, the antibiotic neomycin, or to a previous dose of MMR vaccine
  • Are moderately or severely ill at the time the shot is scheduled
  • Are or might be pregnant. Also, women should avoid getting pregnant for four weeks after getting MMR vaccine.
  • Have HIV/AIDS or another disease that affects the immune system
  • Are being treated with drugs that affect the immune system, such as steroids
  • Have any kind of cancer
  • Are undergoing cancer treatment with x-rays or drugs
  • Have ever had a low platelet count (a blood disorder)
  • Have recently had a transfusion or were given other blood products

Hepatitis A vaccine

Who needs it: Adults age 50 and older that engage in certain behaviors — including same-sex male intercourse and illicit injectable drug use — that are considered high-risk behaviors for contracting hepatitis A. Because the disease can also spread through close personal contact, the shot is also recommended for people who have chronic liver disease, have close contact with a hepatitis A-infected individual or who travel to areas with a high incidence of hepatitis A.

How often: Once, but given in two doses over six to 18 months

Notes: If you or anyone close to you is adopting a child from a country with a high rate of hepatitis A, you should get the vaccine.

Hepatitis B vaccine

Who needs it: Adults 50 and older who are at risk for contracting hepatitis B. You are at risk if you:

  • Have sex with partners who are infected with hepatitis B
  • Are a man who has sex with other men
  • Have more than one sex partner
  • Inject street drugs
  • Have chronic liver or kidney disease
  • Are under age 60 and have diabetes
  • Have a job that exposes you to human blood or other body fluids
  • Live with people who have contact with people infected with hepatitis B
  • Live or work in institutions for the developmentally disabled
  • Are on kidney dialysis
  • Travel to countries where hepatitis B is common
  • Have HIV infection

How often: Adults getting hepatitis B vaccine should get 3 doses — with the second dose given 4 weeks after the first and the third dose 5 months after the second.

Notes: Get a booster if you are unsure of your immunization status.

Do not get the vaccine if you:

  • Have a life-threatening allergy to yeast, or to any other component of the vaccine
  • Have had a life-threatening allergic reaction to a previous dose of hepatitis B vaccine
  • Are moderately or severely ill when a dose of vaccine is scheduled

Meningococcal vaccine

Who needs it: Adults 50 and older who were never vaccinated. You are at increased risk for meningitis if you:

  • Are a college freshman living in a dormitory
  • Work in a laboratory in which you are routinely exposed to meningococcal bacteria
  • Are a U.S. military recruit
  • Are traveling to, or living in, a part of the world where meningococcal disease is common, such as parts of Africa
  • Have a damaged spleen, or your spleen has been removed
  • Have persistent complement component deficiency (an immune system disorder)
  • Have or may have been exposed to meningitis during an outbreak

How often: Once

Notes: If you are age 50-55 and have never been vaccinated, you should receive the meningococcal conjugate vaccine (MCV4), which is effective for life. People over age 55 should receive the polysaccharide vaccine (MPSV4), which provides three to five years of immunity; this is the only meningococcal vaccine licensed for people over age 55. Talk to your doctor about whether you should get this vaccine if you travel to countries with high incidence of hepatitis B; have had your spleen removed; or have certain blood deficiencies.

Pneumococcal vaccine (pneumonia)

Who needs it: Everyone age 65 and older, and people 50 and over with certain risk factors.

How often: Once

Notes: You should talk to your doctor about getting this vaccine if you are a smoker or have serious health problems, including chronic lung or heart disease, diabetes, asthma, leukemia, lymphoma or alcoholism. If you work around chronically ill people — for example, in a hospital or nursing home — you should get the vaccine even if you are healthy.

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