Influenza vaccination annually is recommended for virtually all adults. Effectiveness varies by year and viral match, but vaccination consistently reduces hospitalization and mortality — particularly in adults over 65 and those with chronic diseases. High-dose and adjuvanted flu vaccines (Fluzone High-Dose, Fluad) are preferentially recommended for adults over 65 based on superior immunogenicity and efficacy data in that population.
Shingles (herpes zoster) vaccination with the recombinant zoster vaccine Shingrix is recommended for all adults over 50 and for immunocompromised adults over 19. Shingrix requires two doses 2–6 months apart and provides >90% efficacy against shingles — dramatically superior to the older Zostavax. Shingles causes debilitating acute pain and, in approximately 10–18% of cases, postherpetic neuralgia — persistent nerve pain lasting months to years. The vaccine is highly effective and durable.
Pneumococcal vaccination protects against Streptococcus pneumoniae, a leading cause of pneumonia, bacteremia, and meningitis. Adults over 65, and younger adults with chronic lung disease, heart disease, diabetes, immunocompromise, or smoking history, should receive pneumococcal vaccination. Current recommendations involve PCV20 (Prevnar 20) for most adults — a single vaccine that replaced the prior two-vaccine series.
COVID-19 vaccination with updated formulas remains recommended annually for adults, particularly those over 65 and those with immunocompromising conditions, who are at highest risk for severe disease. Tdap (tetanus, diphtheria, pertussis) should be given once in adulthood with Td booster every 10 years. Hepatitis B vaccination is now recommended for all adults under 60 who haven't completed the series.