Updated August 2026 | Originally published March 2020
To keep their health, most people focus on diet and exercise. Both matter — but vaccines are among the most cost-effective health interventions available, and most adults are behind on at least one. The CDC publishes an updated adult immunization schedule every year, and healthcare providers recommend using it as the starting point for any vaccination discussion. Below, we summarize the vaccines recommended for adults, starting with the newest addition to the schedule — RSV — and moving through the full list. If you have questions or concerns, bring them to your primary care provider (PCP); that conversation is always the right starting point.
A note on the current environment: In 2025 and 2026, the Department of Health and Human Services (HHS) made several changes to vaccine policy and the Advisory Committee on Immunization Practices (ACIP), including removing all 17 sitting ACIP members in June 2025. A federal court issued a stay in March 2026 that largely reverted the childhood and adult immunization schedules to their January 2025 versions. Keep.Health follows the scientific consensus from independent medical organizations — the American Academy of Pediatrics (AAP), the American College of Physicians (ACP), and the Infectious Diseases Society of America (IDSA) — rather than politically driven policy changes. All recommendations below reflect that consensus.
What vaccines do adults need?
RSV — Respiratory Syncytial Virus (Adults 50 and Up, at Risk; Everyone 75 and Up)
Respiratory syncytial virus (RSV) is a respiratory illness most people associate with infants, but it kills thousands of older adults every year — causing an estimated 60,000–160,000 hospitalizations and 6,000–10,000 deaths among U.S. adults aged 65 and older annually, numbers comparable to seasonal influenza. Three RSV vaccines are now approved for adults with no preference for one over another: Arexvy (GSK), Abrysvo (Pfizer), and mRESVIA (Moderna). Current guidance recommends:
- All adults 75 and older: one dose.
- Adults 50–74 at increased risk: one dose if you have chronic conditions including heart failure, chronic obstructive pulmonary disease (COPD), diabetes, obesity, or asthma. ACIP expanded this recommendation to include adults aged 50–59 at increased risk in April 2025.
- RSV vaccination is a single lifetime dose for most adults — additional doses are not currently recommended.
Good news for those who want to combine shots: a 2024 New England Journal of Medicine study found that Arexvy given at the same time as a high-dose influenza vaccine produced immune responses just as strong as either vaccine given alone, with side effects limited to mild fatigue, muscle soreness, or short-term arm pain.
COVID-19 (All Adults — Shared Decision-Making)
The COVID-19 vaccine schedule has changed significantly since 2020. As of October 2025, ACIP updated its recommendation so that adults of all ages are advised to discuss COVID-19 vaccination with their clinician based on individual risk factors, benefits, and preferences — a framework called shared clinical decision-making (SCDM). In practice this means:
- Adults 65 and older: COVID-19 vaccination is strongly recommended.
- Adults 6 months–64 years: discuss with your doctor, with particular attention if you are immunocompromised, have chronic conditions, or work in a high-exposure setting.
- The 2025–2026 COVID-19 vaccines include Moderna’s Spikevax (approved for ages 6 months and older) and mNexspike (approved for ages 12 and older), plus Pfizer-BioNTech’s updated vaccine.
The independent evidence on COVID-19 vaccines remains clear: they reduce severe illness, hospitalization, and death, especially in older adults and those with underlying conditions. Discuss your personal risk profile with your PCP and make an informed decision.
Shingles (Adults 50 and Up)
Without a vaccine, approximately one-third of older US adults will get shingles — a painful reactivation of the chickenpox virus that can cause nerve damage and vision loss lasting months or years. Anyone who has had chickenpox is at risk, which means about 95% of adults.
Shingrix is the gold-standard vaccine, given in two doses two to six months apart, and it provides strong protection well beyond five years. The CDC recommends it for all adults 50 and older, and most insurance plans cover it. Do not skip the second dose — protection drops significantly without it.
Influenza — Flu (All Adults, Every Year)
ACIP reaffirmed in July 2025 its recommendation for annual flu vaccination for all people aged 6 months and older, and voted that all influenza vaccines should be thimerosal-free single-dose formulations. Flu vaccine effectiveness varies by season, but even a partially effective vaccine reduces your risk of serious illness and hospitalization. For adults 65 and older, the CDC prefers Fluzone High-Dose or Fluad — higher-dose or adjuvanted formulations that produce a stronger immune response in older adults. Get vaccinated in October; flu season typically peaks between December and February.
Pneumonia (Adults 65 and Up; Younger Adults with Risk Factors)
Pneumonia kills roughly one in twenty older adults who get it. Current CDC guidance recommends PCV20 (Prevnar 20) alone, or PCV15 (Vaxneuvance) followed by PPSV23 (Pneumovax 23), for adults 65 and older and for younger adults with certain risk factors. Talk to your PCP about which option fits your vaccination history, particularly if you received an older pneumococcal vaccine before PCV20 was available.
Tdap / Td — Tetanus, Diphtheria, and Pertussis (Everyone, Every 10 Years)
Tetanus causes painful, life-threatening muscle spasms from bacteria found in soil and dust. Diphtheria can block the airway and cause heart failure. Pertussis — whooping cough — is a serious lung infection, particularly dangerous for infants and older adults. About 80% of older adults have not received a Tdap booster and are unprotected against whooping cough. Get a Tdap once if you’ve never had it, then a Td booster every ten years. If you’re going to be around infants, updating this vaccine is especially important.
HPV — Human Papillomavirus (Everyone Through 26; Adults 27–45 by Shared Decision)
HPV causes cervical cancer and several other cancers. The CDC recommends catch-up vaccination through age 26 for anyone not previously vaccinated, with shared clinical decision-making for adults aged 27 to 45. If you’re in your 30s and missed this vaccine, it’s worth a conversation with your doctor.
Hepatitis A and B (Everyone)
Hepatitis is a dangerous inflammation of the liver. Hepatitis B is now recommended as a universal adult vaccine for adults aged 19 to 59, with shared decision-making for those 60 and older. The combined hepatitis A and B vaccine (Twinrix) is available as a three-dose series and is particularly important for adults with liver disease, diabetes, or plans to travel to endemic regions. Hepatitis C vaccines remain in development.
MMR — Measles, Mumps, and Rubella (Everyone)
Measles is back. Outbreaks have increased sharply across the US in 2025–2026, driven by declining vaccination rates. The measles, mumps, and rubella (MMR) vaccine is safe, highly effective, and most people received it in childhood. Those born between 1963 and 1967, however, may have received an older, less effective formulation and should get re-vaccinated. If you’re unsure of your vaccination history, a simple blood test can check your immunity.
Meningitis / Meningococcal (Everyone, Especially Teens and Young Adults)
Meningococcal disease can become life-threatening within 24 hours. Even with antibiotics, 10–15% of patients die, and up to 20% suffer permanent effects including hearing loss and brain damage. Two vaccine types cover different strains: MCV4 — sold as Menactra and Menveo — covers four strains responsible for 70% of US cases, while serogroup B vaccines (Trumenba and Bexsero) cover one additional strain. Colleges, summer camps, and military service often require meningococcal vaccination. Boosters are available every five years.
Polio (Everyone — Confirm Childhood Series)
Most adults received the inactivated polio vaccine as children, in four doses at 2 months, 4 months, 6–18 months, and 4–6 years. Confirm with your doctor that you completed the full series. Adults who never received the vaccine, or who are immunocompromised and traveling to high-risk regions, may need doses now.
Cancer vaccines: the most exciting development in medicine right now
The word “vaccine” usually means preventing infection. A new class of therapeutic cancer vaccines, however, trains the immune system to recognize and attack tumor cells — and the results are starting to live up to the hype.
Moderna and Merck lead the field with intismeran autogene (formerly mRNA-4157/V940), a personalized messenger RNA (mRNA) cancer vaccine tailored to each patient’s specific tumor mutations. Five-year data from the Phase IIb KEYNOTE-942 trial, released in January 2026, show the combination of intismeran autogene and Keytruda (pembrolizumab) reduced the risk of recurrence or death by 49% in patients with resected high-risk Stage III/IV melanoma compared to Keytruda alone — a result that held stable from the three-year to the five-year mark, a strong signal of durable immune reprogramming. The combination also reduced the risk of distant spread or death by 59% and improved overall survival by 53% in exploratory analysis. A global Phase III trial (INTerpath-001) in adjuvant melanoma is fully enrolled, with interim data expected later in 2026.
Beyond melanoma, over 120 RNA cancer vaccine trials are now underway across lung, breast, prostate, pancreatic, and brain tumors — a dramatic expansion built on mRNA technology advances from COVID-19. Other companies actively developing cancer vaccines include ImmunityBio (bladder, lung, pancreatic, and glioblastoma), Agenus (cervical, colorectal, melanoma, and solid tumors), and Anixa Biosciences (breast and ovarian cancer).
Tuberculosis: a once-in-a-century breakthrough may be near
The current tuberculosis (TB) vaccine — BCG — was created in 1921 and offers limited protection against the most dangerous adult forms of the disease. That may finally change. The M72/AS01E vaccine candidate, originally developed by GSK and now sponsored by the Gates Medical Research Institute, showed approximately 50% efficacy against pulmonary TB in a Phase IIb trial — an unprecedented result in over a century of TB vaccine research. A Phase III trial launched in March 2024 reached full enrollment of 20,000 participants across 54 sites in South Africa, Kenya, Malawi, Zambia, and Indonesia in April 2025, ahead of schedule. In July 2026, the Gates Medical Research Institute and the Serum Institute of India reached a manufacturing agreement to ensure the vaccine can be produced at scale if the Phase III trial succeeds. TB remains the world’s leading infectious cause of death; a 50% effective vaccine would save millions of lives.
How to get vaccinated and what it costs
Most health insurance plans cover the cost of vaccines. You can get most vaccines at your local pharmacy — CVS, Walgreens, and most independent pharmacies carry the full adult schedule — or at your PCP’s office. The Vaccines for Children (VFC) program covers eligible children under 19 at no cost. If you’re uninsured or underinsured, ask your local health department about free or low-cost vaccination programs.
For a broader look at how vaccines fit into your overall preventive health strategy, see our articles on Immunity Against Aging and Setting Your Health Baseline: The Basics.
Frequently asked questions
What vaccines do adults need in 2026? Every adult needs an annual flu shot and a tetanus booster every ten years. Beyond those, the key age-based vaccines are shingles (starting at 50), RSV (starting at 50 for high-risk individuals, universally at 75), COVID-19 (discuss with your doctor), and hepatitis B if not previously vaccinated. HPV catch-up vaccination is recommended through age 26, with shared decision-making through age 45.
Is the COVID-19 vaccine still recommended? Yes, with nuance. As of late 2025, ACIP moved to a shared clinical decision-making model for adults under 65. For adults 65 and older, vaccination remains strongly recommended. For adults under 65, the benefits are greatest for those with underlying conditions, immunocompromise, or high-exposure occupations. Discuss your personal risk with your doctor.
What is a cancer vaccine and how does it work? Therapeutic cancer vaccines train the immune system to recognize and destroy specific cancer cells rather than preventing an infection. Unlike traditional vaccines, most cancer vaccines are personalized — built from a sample of the patient’s own tumor to target its unique mutations. They are not yet approved for routine use; the most advanced, intismeran autogene from Moderna and Merck, is currently in Phase III trials for melanoma with results expected in late 2026.
