Recommended Vaccines for a 72-Year-Old Man in Good Health
A healthy 72-year-old man with a complete vaccination history should receive annual influenza vaccine, and if not already given, a 2-dose series of recombinant zoster vaccine (RZV) and pneumococcal vaccination (either PCV20 alone or PCV15 followed by PPSV23). 1
Annual Vaccinations
- Influenza vaccine should be administered annually, using either inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV) 1
- The high-dose formulation is an option for adults aged 65 years and older 1
One-Time or Series Vaccinations (If Not Previously Received)
Zoster (Shingles) Vaccination
- Recombinant zoster vaccine (RZV) is the preferred formulation, given as a 2-dose series 2-6 months apart (minimum interval 4 weeks) 1
- This is recommended for all adults aged 50 years and older, regardless of prior shingles episodes 1
- RZV is superior to the older live zoster vaccine (ZVL) and should be given even if the patient previously received ZVL 1
Pneumococcal Vaccination
Recent 2024 guidelines have expanded pneumococcal vaccination recommendations to include all adults aged ≥50 years 2. For a 72-year-old:
- Option 1: Single dose of PCV20 alone 1, 2
- Option 2: Single dose of PCV21 alone 2
- Option 3: PCV15 followed by PPSV23 at least 8 weeks later (or at least 1 year later if given at age 65+) 1
The sequential PCV13/PPSV23 approach has shown effectiveness of 80.3% against pneumococcal pneumonia in adults aged 65-74 years 3. All adults aged 65 years and older should receive at least one dose of PPSV23 1.
Routine Booster Vaccinations
Tetanus, Diphtheria, and Pertussis (Td/Tdap)
- Td or Tdap booster every 10 years 1
- If the patient received Tdap previously, subsequent boosters can be either Td or Tdap 1
- A repeat dose of Tdap after 10 years is well-tolerated and immunogenic 4
Vaccines NOT Routinely Recommended for This Patient
The following vaccines are not indicated for a healthy 72-year-old without specific risk factors:
- Hepatitis A and B: Only recommended for those with specific risk factors (chronic liver disease, diabetes, travel, etc.) 1
- Meningococcal vaccines: Not routinely recommended for this age group without specific risk factors 1
- HPV vaccine: Only recommended through age 26 years (or up to age 45 with shared decision-making) 1
- Varicella vaccine: Only for those without evidence of immunity 1
- MMR vaccine: Only for those born in 1957 or later without evidence of immunity 1
Important Clinical Considerations
- Multiple vaccines can be administered concomitantly on the same day without safety concerns 1, 5
- Concomitant administration of PPSV23 and influenza vaccine in the elderly is safe and not associated with higher adverse event rates 5
- When vaccines are not given on the same day, there is no required waiting period between most non-live vaccines 1
- The exception is PCV15 and PPSV23, which should be separated by at least 8 weeks 1
Summary Schedule for This Patient
Annually: Influenza vaccine 1
If not previously received:
- Recombinant zoster vaccine (2 doses, 2-6 months apart) 1
- Pneumococcal vaccination (PCV20 alone OR PCV15 + PPSV23) 1, 2
Every 10 years: Td or Tdap booster 1