Five Vaccines Most Adults Have Never Thought About — But Probably Should
Ask the average American whether they are up to date on their vaccines, and the flu shot is almost certainly the first thing that comes to mind. It is the most visible, most frequently advertised, and most widely administered adult vaccine in the United States. But public health experts have long recognized a troubling blind spot: while flu vaccination rates hover around 50 percent among adults, uptake for several equally important — and in some cases more consequential — vaccines remains far lower.
This is not a matter of personal failure. Many of these vaccines are newer, less familiar to the general public, or simply not part of the cultural conversation around immunization. The following five vaccines deserve a place in that conversation.
1. RSV Vaccine: New, Powerful, and Widely Misunderstood
Who should get it: Adults 60 and older (recommended based on shared clinical decision-making with a physician); pregnant individuals between 32 and 36 weeks of gestation.
Respiratory syncytial virus, commonly known as RSV, has long been recognized as a serious threat to infants. What receives far less attention is its impact on older adults. Each year in the United States, RSV sends approximately 60,000 to 160,000 older adults to the hospital and contributes to 6,000 to 10,000 deaths in that age group.
The RSV vaccines approved for older adults — Abrysvo and Arexvy — represent a significant development in preventive medicine. Both demonstrated strong efficacy in clinical trials, reducing the risk of symptomatic RSV lower respiratory tract disease by approximately 83 to 94 percent in the first season following vaccination.
Common myth debunked: Many older adults assume RSV is only a concern for grandchildren they might be caring for. In reality, the virus poses an independent and substantial risk to adults 60 and older, particularly those with chronic lung or heart conditions. This vaccine is for your protection, not just those around you.
2. Shingles Vaccine (Shingrix): Extraordinarily Effective and Frequently Skipped
Who should get it: All adults 50 and older, administered as two doses two to six months apart.
One in three Americans will develop shingles at some point in their lifetime. The condition, caused by the reactivation of the varicella-zoster virus — the same virus responsible for childhood chickenpox — can produce an intensely painful rash and, in a significant portion of cases, a complication called postherpetic neuralgia: nerve pain that can persist for months or years after the rash resolves.
Shingrix, the recombinant zoster vaccine approved in 2017, changed the landscape of shingles prevention dramatically. Its efficacy exceeds 90 percent across all age groups studied, and protection remains strong for at least seven years based on current follow-up data. It is also recommended for adults who previously received the older Zostavax vaccine, which was far less effective.
Despite this profile, shingles vaccination rates among eligible Americans remain well below 40 percent.
Common myth debunked: Some adults believe that if they have already had shingles once, they cannot get it again. This is incorrect. Recurrence is possible, and Shingrix is recommended even for those with a prior shingles episode, provided they have recovered fully.
3. Tdap: The Whooping Cough Booster Most Adults Have Forgotten
Who should get it: All adults who have never received a Tdap booster; pregnant individuals during every pregnancy (27–36 weeks); adults in close contact with infants.
Tetanus and diphtheria boosters (Td) are recommended every ten years for all adults. What many Americans do not realize is that one of those boosters should specifically be the Tdap formulation, which adds protection against pertussis — commonly called whooping cough.
Whooping cough is not merely a childhood nuisance. In adults, it can cause severe, prolonged coughing fits that last weeks or months. More critically, adults who are unknowingly infected can transmit the bacteria to infants who are too young to be fully vaccinated — and in infants, pertussis can be fatal.
Despite the availability of Tdap for adults since 2005, surveys consistently show that a majority of American adults have never received it.
Common myth debunked: Many adults assume their childhood DTaP vaccinations confer lifelong protection against whooping cough. They do not. Pertussis immunity wanes significantly within five to ten years, making the adult Tdap booster both necessary and potentially life-saving for vulnerable people in your household.
4. Hepatitis B Vaccine: Now Recommended for All Adults Under 60
Who should get it: All adults through age 59 who have not previously been vaccinated; adults 60 and older based on individual risk factors and preference.
Hepatitis B is a viral infection that attacks the liver and can lead to chronic disease, cirrhosis, liver failure, and liver cancer. An estimated 800,000 to 2.2 million Americans are living with chronic hepatitis B infection, and a significant proportion do not know it.
In 2022, the CDC expanded its hepatitis B vaccination recommendation to cover all adults through age 59, removing the prior requirement for an identified risk factor. This change reflects an updated understanding of transmission patterns and the recognition that many adults at risk do not identify themselves as such.
A two-dose series using the newer Heplisav-B formulation, or the traditional three-dose Engerix-B or Recombivax HB series, provides durable protection for most recipients.
Common myth debunked: Hepatitis B is sometimes perceived as a disease affecting only people who inject drugs or have multiple sexual partners. In practice, hepatitis B can be transmitted through a wide range of exposures, including healthcare settings, shared household items, and routes that individuals may not recognize as risky. Vaccination removes the uncertainty entirely.
5. Pneumococcal Vaccine: Essential After 65 and Often Earlier
Who should get it: All adults 65 and older; adults 19–64 with certain chronic conditions, including diabetes, heart disease, lung disease, or a compromised immune system.
Pneumococcal disease encompasses a range of serious infections caused by the bacterium Streptococcus pneumoniae, including pneumonia, meningitis, and bloodstream infections. In the United States, pneumococcal disease hospitalizes approximately 150,000 adults per year and is associated with tens of thousands of deaths annually.
Several pneumococcal vaccines are available, with the higher-valency options — PCV20 and PCV15 paired with PPSV23 — now preferred for most adults. These vaccines cover a broader range of pneumococcal strains than earlier formulations and are particularly important for older adults whose immune systems respond less robustly to infection.
Common myth debunked: A common misunderstanding is that pneumonia is simply a bad cold that antibiotics will handle. In reality, pneumococcal pneumonia can progress rapidly, require hospitalization, and prove fatal — particularly in adults over 65 or those with underlying health conditions. Vaccination significantly reduces that risk.
Taking the Next Step
If any of the vaccines above are unfamiliar or overdue, the most straightforward action is to bring a list of questions to your next healthcare appointment. Your physician, nurse practitioner, or pharmacist can review your vaccination history, confirm which immunizations you have already received, and help you prioritize based on your age, health status, and lifestyle.
The flu shot is a worthy habit. But it is only one piece of a much larger picture. At Immuize, we believe that informed Americans make healthier choices — and that begins with knowing which options exist.
