Four essential vaccinations for grown-ups and why you need them

Editor’s Note:  This is an update of a post which was originally published in February, 2012. I’ve clarified discussion of the vaccine for tetanus, diptheria, and pertussis, based on my own experience.

We often think of vaccinations as being for children, but grown-ups need them too.

Do you know which ones you need? The U.S. Centers for Disease Control (CDC) has an excellent on-line tool to answer this question, based on your age, any chronic health conditions you have, and other factors.

When I took the quiz, the essential vaccinations for me were the four listed below.

Vaccine Suggested because…
Seasonal Flu (Influenza) Influenza vaccine is recommended for all adolescents and adults. The vaccine may be given as soon as it is available and throughout the influenza season. (Note: Adults older than 49 years of age, pregnant women, and anyone with chronic medical conditions should not receive the influenza nasal spray vaccine.)
Pneumococcal You indicated that you are at risk for pneumococcal disease. You have a chronic medical condition or weakened immune system.
Tdap – Tetanus, Diphtheria, and Pertussis You need one booster dose of tetanus, diphtheria, and pertussis vaccine if it has been 10 years or more since your last tetanus and diphtheria booster. Tdap may be given at an interval as short as 2 years since the last Td dose if protection against pertussis is needed. Close contacts of infants less than 12 months of age and healthcare workers having direct patient contact should receive a one time Tdap booster which may be given at an interval as short as 2 years since their last dose of Td. Later booster doses should be given using tetanus and diphtheria vaccine (Td).
Zoster (Shingles) Your age indicates that you need a single dose of this vaccine to protect against shingles. You should receive this vaccine even if you have already had shingles.

Why are these vaccinations essential?

Seasonal flu vaccine is recommended for all adolescents and adults because the flu can be deadly. The flu virus mutates so rapidly that every year a new vaccine must be produced.

Pneumococcal vaccine protects against bacterial infections of the lungs (pneumonia), the blood (bacteremia), and the covering of the brain and spinal cord (meningitis).

A single dose is recommended for everyone age 65 or older and for younger people with a chronic illness or other risk factors. According to the CDC, pneumococcal disease causes more than 6,000 deaths per year in the U.S., and more than half are adults who should have been vaccinated.

Shingles vaccine prevents a very painful reactivation of chicken-pox viruses, lurking beneath the skin. Everyone over 60 should get the virus— although in my experience—getting it was not easy.

Tdap vaccine protects against tetanus, diptheria, and pertussis—all of which are caused by bacteria.

*** tetanus (sometimes called lockjaw) is caused by toxin-producing spores of a bacterium named Clostridium tetani. (It’s a relative of  Clostridium botulinum which causes food poisoning from damaged or inadequately-processed canned goods. And from which botox is produced.)

The spores occur in soil and in the intestines of animals and humans. People can be infected with tetanus by puncture wounds, animal bites, abrasions, surgery, or burns.

The disease causes painful tightening of the muscles and can cause “locking” of the jaw, so that the victim cannot open his mouth or swallow. Between 40-60 cases are reported every year in the U.S. , and 30% of those who are infected die.

*** diphtheria is a bacterial infection of the upper respiratory tract. It’s now rare in the U.S. and Europe but hightly contagious and potentially fatal. Those at highest risk of death are children under 5 and adults over 49.

***pertussis is commonly called whooping cough because babies and young children with the disease have severe coughing spells which make it hard for them to breathe. When they finally do breathe in, there’s often a loud  “whooping” sound.

Keeping track of your vaccinations

Once I knew what vaccinations I needed, I used this table to keep track of (1) which ones I’d had, (2) the date and place I’d had them, and (3) whether and when I’d need another vaccination.

Name of Vaccine

Date Received

Place [1] 

Next Vaccine Due

Seasonal flu


My primary care physician’s office

As soon as the next fall/winter seasonal vaccine is available



Pharmacy (which provided the vaccine and gave the shot on-site)

Only one shot—no more needed

Td [2]


My primary care physician’s office

In 10 years, about mid-2021

Seasonal flu



As soon as the next fall/winter seasonal vaccine is available



My primary care physician’s office

Only one shot—no more should be needed

Seasonal flu



As soon as the next fall/winter seasonal vaccine is available

[1]  In my personal records, I included the name, address, and phone number of my primary care physician or the pharmacy where I got each vaccine.  All vaccines but the last one were given in Maryland. In July, 2012, I moved back to Washington state—a fact which turned out to be significant, as discussed below.

[2] This is the the vaccine I actually got, not the one I thought I got, as explained in the section below.

Staying current with vaccinations

Once you’ve had your essential vaccinations, it gets simpler. For me—and probably most of you—it’s just a flu shot every year as soon as the seasonal vaccine becomes available and a booster shot for tetanus and diptheria every 10 years.

Flu vaccine

The reason to get your annual flu vaccine as soon as the next fall/winter seasonal vaccine is available is that the flu season may come later than usual, as happened in parts of the country in 2011.. Or it may come earlier and strike unvaccinated people earlier and much more severely than usual.

Tdap vaccine

This one turned out to be a bit tricky for me. Several months after returning to Seattle in July, 2012, I developed a bad, hacking cough. Because the US experienced an epidemic of whooping cough in 2012, with more than 3,000 cases through July 14 in Washington state alone, I was concerned that I might had contracted whooping cough.

Was that possible, and, if so, how could it happen? After all I thought I had the Tdap vaccine in Maryland at the end of June. Here’s what I learned from my follow-up investigation and a visit to my primary care physician’s office in Seattle:

  • The information about Tdap – Tetanus, Diphtheria, and Pertussis on the CDC website is confusing and incomplete, starting with the use of the word “booster” in the first sentence:

You need one booster dose of tetanus, diphtheria, and pertussis vaccine if it has been 10 years or more since your last tetanus and diphtheria booster.

All adults should receive a one-time dose of Tdap as soon as feasible. Then, subsequent booster doses of Td should be given every ten years. Adolescents and adults who have recently received Td vaccine can be given Tdap without any waiting period.

  • The vaccination I received in Maryland was not Tdap, as I’d thought. It was Td— tetanus and diptheria only.
  • In fact, I don’t know whether I’ve ever been vaccinated for pertussis.
  • I did have a very bad cough that was going around in the Seattle area, but it turned out not to be whooping cough.
  • I still need to get a one-time Tdap vaccine to protect myself and others. There’s no waiting period after getting a Td vaccine.
  • I should get a Td booster every ten years after that.

What about you? Do you know your essential vaccinations? Have you talked to your doctor about which vaccinations you need? Have you had them yet? Do you keep a record of which vaccinations you’ve had, when you had them, and where? And do you keep that record in a safe place, such as, well, a safe?

3 comments… add one
  • Madeleine Kolb 02/09/2012, 5:29 pm

    A good point. Apparently, the connection between childhood vaccines and autism has been thoroughly discredited by the data, but not everyone is convinced.

    There was quite an interesting article along these lines in the Washington Post a few days ago. It was about a child who’d had the usual vaccinations and shortly afterward began to show troubling symptoms. The mother thought the vaccines were responsible, but she kept searching for another answer. It took years of testing, but finally the child was found to have an extremely rare genetic disease.

  • Catwoman 02/09/2012, 4:44 pm

    Such a great and informative article! I think this one should have been read by the trendy people who are campaigning against the essential vaccinations. I know that the “bio-life” and organic life are very fashionable things today, but we shouldn’t turn our backs to the medical science. And of course, we mustn’t risk our children’s health as well.
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