The Most Important Vaccines for Older Adults

August 2023

As people age, so do their immune systems. This decline in immune function makes older adults more susceptible to illnesses — and serious complications from those illnesses. They may also not build the same level of immunity in response to vaccines as they did when they were younger.

That’s why the CDC recommends several vaccines specifically for people over the age of 50 or 65. Here are four diseases that older adults should get vaccinated against.


If you’re over 30, chances are you’ve had chickenpox. Although you’ll typically remain immune to chickenpox for life, the virus that caused it remains dormant in your nerves. If this virus reactivates, it causes shingles, a painful rash that can develop anywhere on your body, including your face. Pain, itching, or tingling often occurs just before and after the rash develops. Shingles can also cause fever, headache, chills, or an upset stomach. More serious complications include long-term nerve pain or blindness from eye rashes.

The shingles vaccine, Shingrix, reduces the risk of shingles by more than 90% and protects you for at least seven years. It’s recommended for adults aged 50 and older. It consists of two doses, with the second dose given two to six months after the first.

Pneumococcal disease

One of the most serious pneumonia infections is caused by bacteria called Streptococcus pneumoniae or pneumococcus. Pneumococcus can cause infection in the lungs, ears, or sinuses, but it can also cause a serious blood infection or even meningitis, an infection in the lining of the brain and spinal cord. Severe pneumococcus disease can cause sepsis, an extreme reaction to infection that can turn deadly within days.

Fortunately, vaccination can protect against pneumococcal disease and is recommended for adults aged 65 and older. There are several pneumococcal vaccines: PCV15 (Vaxneuvance), PCV20 (Prevnar 20), and PPSV23 (Pneumovax23). Ask your doctor or pharmacist which one is best for you given your health history. You typically only need one dose of the vaccine.

Getting vaccinated against pneumococcal disease cuts the risk of pneumococcal pneumonia almost in half — and it’s about 75% effective against invasive pneumococcal disease.


The older you get, the more vulnerable you are to severe complications from the flu, like pneumonia or brain inflammation. Adults ages 65 and older make up the majority of flu hospitalizations each year. From 2010 to 2013, for example, more than half the hospitalizations and up to 85% of deaths from the flu were among adults 65 and older.

Because the immune systems of older adults don’t respond as well to ordinary flu vaccines, the CDC recommends a high-dose flu vaccine for those aged 65 and older. The three available high-dose flu vaccines are Fluzone High-Dose Quadrivalent, Flublok Quadrivalent, and Fluad Quadrivalent. These vaccines cut the risk of infection roughly in half and reduce the risk of hospitalization by more than a third.

The best time to get vaccinated is in September or October, before flu season arrives. But even if flu season has already started, it’s not too late to get vaccinated.


The older someone is, the higher is their risk for complications from COVID-19. Adults ages 65 and older make up 17.5% of the U.S. population but account for more than 75% of COVID-related deaths. The CDC recommends all adults get two doses of the Moderna, Pfizer-BioNTech, or Novavax vaccines and then one bivalent booster dose at least two months later. “Bivalent” means the vaccine was developed to fight two COVID-19 variants.

Older adults who are moderately or severely immunocompromised should get three initial doses of the Moderna or Pfizer-BioNTech vaccines, followed by one bivalent booster at least two months after their last dose. Additional boosters might be recommended later.

Common vaccine side effects

Injection-site redness, pain, and swelling are common localized side effects from many vaccines. Fatigue, headache, fever, chills, muscle pain, and nausea are common side effects from the shingles, pneumococcal, and COVID-19 vaccines. Side effects will usually subside within two to three days. If you have any questions about potential vaccine side effects or how to manage them, ask your doctor or pharmacist.

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