The 5 Essential Adult Vaccines: What Your Patients Need to Know

Influenza Vaccine

Guidelines: The CDC and FDA recommend annual influenza vaccination for everyone 6 months and older. The 2025–2026 US recommendations include updates on strain composition, and specifically call for high-dose or adjuvanted vaccines for adults ≥65 to improve effectiveness in older adults.

Recent data: Interim estimates for the 2024–2025 season showed influenza vaccination reduced the risk for influenza-associated outpatient visits and hospitalization. Annual review of global surveillance data informs vaccine composition changes each season.

Influenza Cautions

Populations at Greatest Risk
•Older adults (≥65 yrs) •People with chronic disease, eg, heart, lung, diabetes, renal, or immunocompromised •Pregnant women •Residents of long-term care facilities

Risks of Neglecting Vaccine
•Increased rates of severe flu, pneumonia, hospitalization, and death in high-risk groups •Outbreaks with higher morbidity in healthcare and congregate settings •Loss of herd immunity, endangering those who cannot be vaccinated

2. Tdap (Tetanus, Diphtheria, Pertussis) Vaccine

• Guidelines: The CDC continues to recommend a one-time Tdap dose for adults who did not receive it as adolescents, followed by a Td or Tdap booster every 10 years. Pregnant women should receive Tdap with each pregnancy.

• Recent studies: A 2025 review suggests that, with high childhood uptake, regular adult boosters for tetanus and diphtheria may not be as necessary except in particular settings (such as for wound management, pregnancy, or travel). However, US and ACIP guidelines still support routine decennial boosters for broad protection, especially for pertussis.

TdaP Cautions

Populations at Greatest Risk
• Adults >65 yrs •Pregnant women (unvaccinated infants at risk) •Healthcare workers, caregivers, parents, babysitters •Those with wound exposure without timely boosters

Risks of Neglecting Vaccine
• Pertussis: higher risk of outbreaks with infants/children exposed to unprotected adults •Tetanus: life-threatening muscle stiffness, lockjaw, respiratory failure •Diphtheria: severe airway obstruction, cardiac complications

3. Shingles (Herpes Zoster) Vaccine

• Guidelines: CDC recommends 2 doses of recombinant zoster vaccine (Shingrix) for all adults aged ≥50 yrs, and for immunocompromised adults ≥19 yrs.

• Recent studies: A 2025 analysis found a 20% reduction in dementia diagnoses among vaccinated adults, suggesting broader health benefits beyond herpes zoster prevention. Efficacy in preventing shingles and related complications remains high.

Shingles Cautions

Populations at Greatest Risk
•Adults aged ≥50 yrs •Immunocompromised individuals: cancer, autoimmune disease, HIV

Risks of Neglecting Vaccine
•Increased chance of painful shingles and postherpetic neuralgia •Risk of vision loss, stroke, or secondary infections •Reduced quality of life due to chronic pain from PHN

4. Pneumococcal Vaccine

• Guidelines: The CDC and ACIP now recommend pneumococcal conjugate vaccine (PCV) for all adults aged ≥50 yrs (previously ≥65 yrs), with options for PCV15, PCV20, or PCV21. Vaccination is also recommended for high-risk adults aged 19–49 yrs.

• Recent data: These recommendations are based on improved coverage against invasive pneumococcal disease, pneumonia, and meningitis in adults, as recent studies highlight expanded serotype coverage and clinical protection.

Pneumococcal Infection Cautions

Populations at Greatest Risk
• Older adults (≥65 yrs) •Smokers, chronic heart/lung/kidney/liver disease patients •Immunosuppressed: cancer, HIV/AIDS, organ transplant

Risks of Neglecting Vaccine
• Greater risk for severe pneumonia, meningitis, sepsis, and death •Hospitalization and lasting damage to lungs and other organs• Outbreaks in care institutions and vulnerable groups

5. Human Papillomavirus (HPV) Vaccine

• Guidelines: Routine vaccination is recommended for adults up to age 26 yrs if not previously vaccinated; adults aged 27–45 yrs may consider vaccination based on risk and clinical decision-making.

• Recent data: The CDC and recent studies note reduced rates of HPV-related cancers, including significant drops in cervical cancer precursors among vaccinated populations. The vaccine’s safety and efficacy are well established, with benefits maximized when administered prior to HPV exposure.

HPV Cautions

Populations at Greatest Risk
• Sexually active adults •Those with new or multiple sexual partners •Immunocompromised individuals (lower viral clearance)

Risks of Neglecting Vaccine
• Higher likelihood of HPV-related cancers (cervical, oropharyngeal, anal, penile) •Increased prevalence of genital warts •Persistent infection and transmission within the community