What vaccine shots are recommended for adults (ab) with no known medical conditions?

Recommended Vaccine Shots for Adults Without Medical Conditions

All healthy adults should receive annual influenza vaccination, Tdap (one-time replacement for Td booster), and age-specific vaccines including HPV (through age 26 for women, age 21 for men), pneumococcal vaccines (starting at age 50), and herpes zoster vaccine (starting at age 50-60 years). 1, 2, 3

Core Vaccines for All Adults

Influenza Vaccine

• Annual influenza vaccination is recommended for all adults aged ≥19 years regardless of health status. 1, 4
• The 2024-2025 COVID-19 vaccine provides 33% effectiveness against ED/UC visits and 45-46% effectiveness against hospitalization in adults, supporting annual COVID-19 vaccination as well. 5

Tetanus, Diphtheria, and Pertussis (Td/Tdap)

• Administer one dose of Tdap to replace a single Td booster for all adults who have not previously received Tdap. 1, 4
• Continue Td boosters every 10 years after the Tdap dose. 1, 4
• For adults with unknown vaccination history, complete a 3-dose primary series with doses at 0,4 weeks, and 6-12 months, substituting Tdap for one dose. 4

Age-Based Vaccines

Human Papillomavirus (HPV)

• Women through age 26 years: 3-dose series (0,2, and 6 months). 1, 4
• Men through age 21 years: 3-dose series. 1
• Vaccination is recommended even for sexually active individuals, as they may not have been infected with all vaccine HPV types. 4

Pneumococcal Vaccines

• Adults aged ≥50 years: Single dose of PCV20 (preferred) or PCV15 followed by PPSV23. 2, 3
• For those choosing PCV15, administer PPSV23 at least 1 year later. 2
• The 2024 ACIP recommendation expanded age-based pneumococcal vaccination from age 65 to age 50 years. 3

Herpes Zoster (Shingles) Vaccine

• Adults aged ≥50 years: Recombinant zoster vaccine (Shingrix) is recommended regardless of prior chickenpox history. 6, 1
• A single dose of zoster vaccine was previously recommended at age ≥60 years, but newer guidelines favor Shingrix starting at age 50. 1, 4
• The recombinant vaccine (Shingrix) is preferred over the live vaccine (Zostavax) for all eligible adults. 6

Measles, Mumps, Rubella (MMR)

• Adults born during or after 1957 should receive ≥1 dose of MMR unless they have documentation of vaccination, laboratory evidence of immunity, or provider-diagnosed disease history. 4
• Adults born before 1957 can generally be considered immune. 4
• A second dose is recommended for healthcare workers, students in postsecondary institutions, and international travelers. 4

Varicella (Chickenpox)

• All adults without evidence of immunity should receive 2 doses of varicella vaccine, 4-8 weeks apart. 4
• Evidence of immunity includes: documentation of 2 vaccine doses, U.S. birth before 1980 (except healthcare workers), provider-diagnosed varicella or herpes zoster history, or laboratory evidence. 4
• Special consideration for teachers, childcare employees, college students, military personnel, healthcare workers, and international travelers. 4

Hepatitis Vaccines (Risk-Based, but Consider for All)

Hepatitis A

• Standard schedule: 2 doses at 0 and 6-12 months (Havrix) or 0 and 6-18 months (Vaqta). 2, 4
• Recommended for travelers to endemic areas, men who have sex with men, injection drug users, and anyone desiring immunity. 1, 4

Hepatitis B

• 3-dose series at 0,1, and 6 months for adults without prior vaccination. 1
• Particularly important for healthcare workers, sexually active persons not in monogamous relationships, and men who have sex with men. 1

Common Pitfalls to Avoid

• Do not assume birth before 1957 confers immunity for healthcare workers—they require documented MMR vaccination or laboratory evidence. 4
• Do not delay Tdap waiting for the 10-year Td interval—Tdap can be given as early as 2 years after the last Td dose. 4
• Do not confuse the live zoster vaccine (Zostavax) with recombinant vaccine (Shingrix)—Shingrix is now preferred and can be given to those without chickenpox history. 6
• Do not forget that HPV vaccination benefits even sexually active individuals—they may not have been exposed to all vaccine types. 4

Vaccination Coverage and Access

Despite these recommendations, adult vaccination coverage remains suboptimal, with only 44.8% receiving influenza vaccine and 30.6% of adults ≥60 years receiving herpes zoster vaccine in 2015. 7 Adults with health insurance, a usual healthcare provider, and regular physician visits have significantly higher vaccination rates. 7