Recommended Vaccines for a 50-Year-Old Male
A 50-year-old male should receive annual influenza vaccination, a one-time Tdap booster (if not previously received), and consideration for hepatitis A and B vaccination based on risk factors. 1
Core Routine Vaccinations
Influenza Vaccine
- Annual influenza vaccination is recommended for all adults 50 years and older. 1
- At age 50, standard-dose trivalent or quadrivalent inactivated vaccine is appropriate (high-dose formulations are reserved for those 65 years and older). 1
- The vaccine should be administered annually, ideally before the start of flu season. 2
Tetanus-Diphtheria-Pertussis (Td/Tdap)
- A one-time dose of Tdap is recommended if not previously received as an adult, followed by Td boosters every 10 years. 1
- This replaces one of the routine Td boosters and provides protection against pertussis in addition to tetanus and diphtheria. 2
Risk-Based Vaccinations to Assess
Hepatitis B
Recommend vaccination if any of the following apply: 2
- Diabetes mellitus (increasingly recognized as an indication)
- Chronic liver disease, end-stage renal disease, or HIV infection
- Healthcare worker or public safety worker with blood exposure
- Sexually active with more than one partner in the past 6 months
- Men who have sex with men or injection drug use
- Household contact of someone with chronic hepatitis B
The series consists of 3 doses at 0,1, and 6 months. 2
Hepatitis A
Recommend vaccination if any of the following apply: 2
- Chronic liver disease (most important medical indication)
- Men who have sex with men
- Illegal drug use (injection or non-injection)
- Travel to countries with high or intermediate hepatitis A endemicity
- Occupational exposure to hepatitis A virus
The series consists of 2 doses given 6-12 months apart. 2
Pneumococcal Vaccine
At age 50, pneumococcal vaccination is NOT routinely recommended unless specific risk factors are present. 2
Indications for PPSV23 at age 50-64 include: 2
- Chronic lung disease (including asthma), chronic heart disease, or diabetes
- Chronic liver disease, cirrhosis, or chronic alcoholism
- Cigarette smoking
- Immunocompromising conditions
- Functional or anatomic asplenia
- Chronic renal failure or nephrotic syndrome
If indicated, administer PCV13 first, followed by PPSV23 at least 8 weeks later. 2
Vaccinations NOT Routinely Recommended at Age 50
Zoster (Shingles) Vaccine
- Zoster vaccination is recommended starting at age 60 years, not at age 50. 1
- This should be deferred until the patient reaches 60 years of age unless there are special circumstances.
MMR Vaccine
- Only indicated if born in 1957 or later AND lacking evidence of immunity (documentation of vaccination or laboratory evidence). 2
- Most 50-year-olds born before 1957 are considered immune and do not require vaccination. 2
HPV Vaccine
- There is no routine recommendation for HPV vaccination in males over age 26. 3
- At age 50, HPV vaccination is not indicated. 3
Important Clinical Considerations
Common pitfall: Many clinicians forget to assess hepatitis B vaccination status in adults with diabetes, which has become an increasingly recognized indication for vaccination. 1
Documentation review: Always verify prior vaccination history, as many adults lack complete records and may benefit from catch-up vaccination, particularly for hepatitis A and B series. 2
Timing consideration: If multiple vaccines are needed, inactivated vaccines can be administered simultaneously at different anatomic sites without reducing effectiveness. 2