What Do Doctors Want You to Understand?

Vaccines are one of the parts of a checkup backed by strong evidence. Our guide to what to expect at your annual physical explains why. This guide covers which vaccines adults need, and when.

The yearly flu shot is not where adults usually fall behind. The gaps show up with the vaccines that start at a certain age. Only about 29% of adults 50 and older have both doses of the shingles vaccine.⁸ About 41% of adults 75 and older have ever had an RSV vaccine.³ Each of these vaccines guards against an illness that hits harder as you age.⁵ ⁶ ⁷

That is why doctors think about adult vaccines as milestones, not a long list. Turning 50 is a vaccine birthday. So is turning 75. So is a new diagnosis, like diabetes or lung disease. Each one can add a vaccine to your list.

Here is what that means for you. The vaccine you are due for is often the easiest, most useful thing to get done at a checkup.

Which Vaccines Do Adults Need, and When?

This list follows the current adult schedules from the CDC and the American Academy of Family Physicians. For the vaccines below, the two agree.¹ ² ⁴

Every year: flu. All adults should get a flu vaccine each year.² ³ If you are 65 or older, a stronger flu vaccine is preferred. But do not wait for it if your clinic or pharmacy does not have it. Any flu vaccine for your age is much better than none.² ³ Only about 42% of adults got a flu vaccine in the 2024–2025 season.³

Every 10 years: tetanus, diphtheria, and whooping cough. Adults need one dose of Tdap if they did not get it as a preteen or teen. After that, they need a booster every 10 years. You may need one sooner after a deep or dirty wound.²

Through age 26: HPV. HPV (human papillomavirus) is a common virus. The vaccine is recommended through age 26. From 27 to 45, it is a shared decision. That means you and your doctor decide together, based on your risk.²

Through age 59: hepatitis B. Hepatitis B is a virus that damages the liver. Adults 19 to 59 who never got the vaccine should get it. At 60 and older, it is recommended if you have risk factors. Anyone 60 or older who asks for it can get it.²

At 50: shingles. About 1 in 3 people in the U.S. will get shingles in their lifetime. The risk rises with age.⁵ The vaccine is two shots, given 2 to 6 months apart. It is for all adults 50 and older.² ⁵ In adults 50 and older with healthy immune systems, it is more than 90% effective against shingles. It is also more than 90% effective against long-lasting nerve pain after shingles.⁵

At 50: pneumonia. The pneumococcal vaccine protects against serious infections caused by one type of bacteria. These include pneumonia and blood infections.⁷ It is recommended for all adults 50 and older. Younger adults need it too if they have certain conditions.⁷ You need one or two shots, depending on the type.²

At 75, or at 50 with some conditions: RSV. RSV (respiratory syncytial virus) is a common lung and airway virus. Adults 65 and older are at the greatest risk of being hospitalized with it.³ Everyone 75 and older should get one RSV vaccine. So should adults 50 to 74 at higher risk. This includes people with chronic heart or lung disease, a weakened immune system, or certain other conditions, and people who live in nursing homes.⁶ It is one shot, not a yearly shot. The best time to get it is late summer or early fall.⁶

During pregnancy. A Tdap shot is recommended during each pregnancy, ideally between weeks 27 and 36.² An RSV vaccine late in pregnancy, given September through January, is one way to protect the baby. The other way is an antibody shot for the baby after birth.²

If you missed childhood vaccines. Adults with no proof of immunity to measles, mumps, and rubella should get one MMR dose. People born before 1957 are generally considered immune.²

Why Has Vaccine Advice Been So Confusing?

Since 2025, the federal vaccine advisory process has changed a lot. In March 2026, a federal court paused a June 2025 flu vaccine vote by the federal advisory committee.³ The CDC's adult schedule page still shows its July 2025 version.¹ That version already lists RSV for adults 50 to 74 at higher risk.¹

Doctors' groups, including the American Academy of Family Physicians, now publish their own schedules.³ ⁴ For most adult vaccines, their advice matches the CDC. The most confusion is around COVID-19.

The family doctors' group recommends an updated COVID-19 vaccine for all adults. It puts extra emphasis on people 65 and older, people at higher risk, and people who have never had one. For people 65 and older, it recommends two doses each season.³ The FDA's approved use is narrower. It covers adults 65 and older and younger adults with at least one condition that raises the risk of severe COVID-19.³ That list is broad. It includes obesity, diabetes, heart disease, lung disease, smoking (now or in the past), and not being physically active.³

What this means for you: most adults who want a COVID-19 vaccine will qualify.³ Many health insurers have pledged to keep covering vaccines on the federal list at no cost to you. That pledge runs through the end of 2027. Pharmacy rules vary by state, though, so check first.³

What Does This Mean for You?

Start with your record. Ask your doctor's office or pharmacy what they have on file. Write down any vaccines you got somewhere else.

Next, think about more than your age. Some health problems move vaccines earlier. A weakened immune system makes the shingles vaccine recommended from age 19.⁵ Certain conditions bring the pneumonia vaccine before 50.⁷ Heart disease, lung disease, or diabetes with complications can make you eligible for RSV at 50.² ⁶ For RSV, your own report of a condition is enough.²

Plan one fall visit. Flu, COVID-19, and RSV vaccines can be given together.³ Expect a sore arm or some tiredness afterward. Side effects of the shingles and pneumonia vaccines usually pass within 2 to 3 days.⁵ ⁷ Get the second shingles dose even if the first one made you feel unwell.⁵

QUESTIONS WORTH ASKING

• "Based on my age and health, which vaccines am I due for today? Can I get them at this visit?"

• "Do any of my conditions move a vaccine earlier for me, like RSV or pneumonia?"

• "What do you recommend for me on COVID-19 this season? Which schedule does your office follow?"

• "Did I finish the shingles series? If I only had one dose, what should I do now?"

• "Will my insurance cover this here, or should I go to a pharmacy?"