Which Vaccines Do You Need in 2024-25? Here Are Experts’ Recommendations for All Ages

It can be rare to find people who are fully up-to-date on vaccines, says Hareesh Singam, MD, infectious disease doctor at the Cleveland Clinic. Looking at just seasonal virus vaccines as part of the full recommended vaccination schedule, in the first week of June 2024, the Centers for Disease Control and Prevention (CDC) estimated that only 48% of US adults had received the current season’s flu vaccine, 22% were up-to-date on Covid shots, and 24% of adults age 60 and up had received the RSV vaccine. 

Vaccination rates improve for older adults, but gaps persist. “About 66% of adults over 65 years of age have received recommended pneumococcal vaccinations, but there are marked disparities between different groups: 70% of White adults over 65 years have been vaccinated, but only 55% of Black and Asian adults and 46% of Latinos,” says Ryan Maves, MD, professor of infectious diseases at Wake Forest School of Medicine and chair of the COVID-19 Task Force with the American College of Chest Physicians. “If you look at other recommended vaccines, the rates are even lower. Only about 20% of adults over 50 years of age have received zoster (shingles) vaccination, for example.” 

Thankfully, Dr. Maves says, the national childhood vaccination rate has remained pretty stable in the US over time. But according to the American Academy of Pediatrics, exemptions from school requirements are creeping upward—hitting an all-time high in recent years.

It’s easy to forget the damage caused by vaccine-preventable diseases. On average, smallpox killed three out of every 10 people who got it—amounting to millions per year—before it was declared officially eradicated (eliminated) in 1980 following a global vaccination effort. Dr. Maves points to measles as another example. “Most people in the US don’t have a lot of perspective on measles, given how rare it has been during our lifetimes—but over half of these people with measles required hospitalization, it is incredibly contagious, and deaths do occur.” US cases of meningitis and tuberculosis turned up in spring 2024, too, in unprecedented numbers compared to recent decades.

Dr. Singam adds: “Given that Covid-19 disturbed many vaccine schedules and increased vaccine hesitancy, there has been a rise of many preventable diseases.”

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Why is vaccine coverage dropping? 

The CDC notes that measles was officially eliminated from the US in 2000. Yet cases are now creeping back. Dr. Maves says in 2024, there were 11 outbreaks and 151 measles cases compared to four outbreaks and 58 cases in 2023. Cases of Haemophilus influenzae type B (HiB), varicella (chickenpox), pneumococcal disease, and whooping cough—all of which have effective, protective vaccines—are also increasing, Dr. Singam adds. 

Troubling patterns like these are why the World Health Organization (WHO) has named vaccine hesitancy as one of the top 10 threats to global health. This delay, reluctance, or refusal to get vaccinated against disease intensified with the rollout of the Covid-19 vaccine, as we entered what the WHO called an “infodemic”: a flood of confusing, often conflicting information about the vaccine. A 2022 study published in the Journal of General Internal Medicine found that about 73% of Americans reported exposure to vaccine misinformation during the pandemic. This exposure is a direct predictor of vaccine hesitancy, and not just over the Covid vaccine. Health authorities are concerned this hesitancy is spilling over into public beliefs about other vaccines, too. 

Because vaccine misinformation has a wide reach, experts want to set the record straight about infectious disease protection for all ages.

Why are vaccines given at different ages?

The CDC’s standard vaccine schedule, outlined below, aims to protect individuals when they’re typically most vulnerable to a disease, explains William Schaffner, MD, the Medical Director of the National Foundation for Infectious Diseases and professor of infectious diseases at Vanderbilt University Medical Center. “It all has to do with how frequently the diseases you might encounter were historically associated with different age groups.”

Back in the day, Dr. Schaffner says, many infectious diseases occurred primarily in infancy, childhood and adolescence. These illness rates informed what we now consider “baby shots” and childhood vaccine schedules.

Importantly, if a child misses a shot, there’s no need to start over—a doctor can simply administer the right doses to get them back on schedule. There’s no upper limit to how many vaccines can be administered in one doctor’s visit, either (in most cases). “[Multiple vaccinations at once] is more a matter of individual tolerance than anything scientific,” Dr. Schaffner says.

In the United States, childhood vaccination rates are comparably high to the rest of the world, too. While vaccination coverage slipped during the pandemic, it’s bouncing back (though still not reaching pre-pandemic levels).

The CDC reported that for the 2022-23 school year, approximately 93% of kindergarten-aged children had received all required vaccines, which was two percentage points lower than the 2019-2020 school year. While this might not sound like a lot, just one percentage point amounts to about 35,000 kids without vaccine protection—enough to jeopardize herd immunity against preventable diseases, like measles.

Complicating matters more, childhood exemptions from state vaccination requirements increased in 41 states last year, exceeding 5% in 10 states. According to the CDC, exemptions over 5% limit achievable vaccination coverage, increasing the risk of preventable disease outbreaks. 

Current rates for childhood vaccinations by age two:

• DTaP: 93.8% have 3 doses; 81.0% have 4 doses
• Polio: 93.0%
• Measles, mumps, rubella (MMR): 93.0%
• Haemophilus influenzae type b (Hib): 93.4% have the primary series; 79.1 have the full series
• Hepatitis B: 92.1%
• Chickenpox: 91.1%
• Pneumococcal conjugate vaccine (PCV): 92.8% have 3 doses; 82.7% have 4 doses
• Hepatitis A: 88.4% have 1 dose; 47.7% have 2 doses (which rises to 80.0% by age 35 months)
• Rotavirus: 76.6%
• Influenza: 61.3%

Do childhood vaccines last for life?

Many of the vaccines you receive in childhood will protect you for life—but not all of them. “This has everything to do with the nature of a virus and how that particular virus interacts with the immune system,” Dr. Schaffner says. He points to measles as an example. “It’s a very stable virus, it doesn’t change—basically, the virus today is the same as it was in 1935.” So, once you get vaccinated against measles, your protection extends for life.

In contrast, illnesses like the flu and Covid-19 are not at all stable. Because these viruses mutate, infectious disease experts have to keep up with the changes and constantly rework vaccine compositions. (Be sure you know Who Needs a Flu Shot This Year, from Infectious Disease Specialists.)

Still, the protection we get from certain longer-term vaccines simply declines over time. As examples: Tetanus starts to wane after about 10 years, meningococcal nets you about eight years of protection, and the pertussis vaccine declines after four.

Do I need vaccines as an adult?

The CDC updates its adult immunization schedule on an annual basis—though, Dr. Schaffner says compliance with the vaccination schedule “really plummets” among adults.

Adult vaccination rates

• Pneumococcal vaccination ages 19-64: 22.2%
• Pneumococcal vaccination ages 65+: 65.8%
• Hep A: 24.8%
• Shingles vaccination ages 50+: 32.6%
• Shingles vaccination ages 60+: 41.4%
• Tdap vaccination ages 13-17: 90.2%
• Tdap vaccination ages 19+: 43.6%
• Annual flu ages 18+: 47.0%
• HPV (at least one dose) ages 13-17+: 76.9%
• HepB ages 19+: 34.2%

Dr. Schaffner points to a few reasons for this trend. “First, people don’t recognize that vaccines are not just for kids,” explaining that these recommendations are rather recent to the last three decades or so. Additionally, “Doctors who care for adults spend a relatively brief period of time with the patient at each visit—and they’re almost always preoccupied with diagnosis and treatment issues”—instead of preventive care, like vaccines.

And while almost all childhood vaccinations are covered by either insurance or governmental programs, there’s often a financial hurdle for adults. “In the United States—shame on us—we have not yet created a comprehensive adult vaccination program,” Dr. Schaffner says.

Which vaccines do I need as an adult?

Since not all vaccines offer life-long protection, adults need to top-up their protection against illnesses like tetanus, Diptheria, and pertussis (whooping cough) with a Tdap booster. Some studies do suggest that the Tdap booster is unnecessary if you were fully vaccinated as a child, but the CDC still urges people to get it every 10 years or with each pregnancy. The major reason for this is the risk these diseases pose to children. For example, whooping cough is no picnic for adults, but it can be fatal for kids…especially for infants too young to receive their first vaccine dose.

In 2022, the CDC also announced it recommends vaccination against hepatitis B for all adults under age 60. “We have been administering the hepatitis B vaccine universally to children,” Dr. Schaffner says. The infection—which can lead to liver cancer down the road—has been largely eliminated among kids. “But it is continuing to occur substantially in adults.” He says that because the Hep B vaccine is so effective, widespread adult vaccination could eliminate the hepatitis B virus from the population as soon as 2030.

In May 2023, the US Food and Drug Administration (FDA) approved a respiratory syncytial virus (RSV) vaccine. It’s recommended for adults over age 60—and this year, it was approved for pregnant women and infants as well. Dr. Singam adds: “I also recommend [the RSV vaccine] for people with COPD, cardiovascular disease, chronic kidney or liver disease, [blood] disorders or diabetes, and who are moderately or severely immunocompromised.”

These guidelines exist because while RSV is fairly mild in healthy adults, it tends to be serious in people with pre-existing health conditions or weaker immune systems (such as infants and the elderly). People who need to be hospitalized due to RSV have a greater chance of dying than someone who is hospitalized with the flu, says Dr. Maves. If the vaccine can lower this rate of serious illness, it could mean a major impact for these high-risk groups. 

While the data on the RSV vaccine’s first season is limited, “several papers are pending on the vaccine’s impact,” Dr. Singam says. “However, from the clinical trials, the effectiveness of RSV vaccine in adults is between 83 to 89% during the first RSV season after vaccination.” 

Then there’s the HPV (human papillomavirus) vaccine. While commonly associated with preventing cervical cancer in women, the HPV vaccine is strongly recommended for all adolescents ages 11 and 12, says Ashley Lipps, MD, an infectious diseases physician at Ohio State University’s Wexner Medical Center. As a sexually transmitted disease, unvaccinated males can spread the virus to females—but they’re at risk of other cancers HPV can cause, including but not limited to head/neck, penile, and anal cancers. If the HPV vaccine was not available when you were an adolescent, the vaccine is strongly recommended for anyone under age 26, Dr. Schaffner says. That said, it’s now approved in some cases up to age 45.

“I would also mention that everyone aged 65 and older is eligible for the pneumococcal vaccine,” Dr. Maves says. This vaccine protects against the most prominent bacterial cause of pneumonia (and it’s available to people under 65 with underlying health conditions).

All adults should also be vaccinated annually against influenza and up-to-date on the latest Covid vaccine, Dr. Schaffner adds. 

And it’s generally safe to get them at the same time. As for those eligible for the RSV shot this fall: “We do have some data that co-administering [the flu, Covid, and RSV vaccines] all together is safe,” Dr. Maves says. 

In addition to a flu shot and Covid vaccine combo, most vaccines can be given at the same time. “There are a few exceptions to this,” Dr. Lipps says. The Prevnar-13 (PCV-13) should not be given with the meningitis vaccine or at the same time as the Pneumovax-21 (PPSV-23) shot. “This is because the immune response has been shown to be better when these vaccines are given at different times.” 

For the latest on health and wellness subscribe to The Healthy @Reader’s Digest newsletter and follow The Healthy on Facebook, Instagram, and Twitter. Keep reading:

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