Vaccines aren't a pediatric topic. Adult immunization is one of the most under-utilized preventive measures in primary care — partly because nobody walks you through what you need and when, and partly because the conversation tends to happen in 30 seconds at the end of a rushed visit. Here is the schedule, by age band, that we actually recommend to our patients.
Every adult, annually
- Influenza ("flu shot") — every fall. The strain changes year to year, so last year's shot doesn't carry over. Covered at $0 by most insurance.
- COVID-19 — at least annually, with the current circulating-strain formulation. More frequent for high-risk patients.
Every adult, every 10 years
- Tdap (tetanus, diphtheria, pertussis) — booster every 10 years. Get an earlier booster if you have a deep wound or are exposed to pertussis. Pregnant patients get a Tdap during every pregnancy regardless of timing — protects the newborn.
Ages 19–26 (and catch-up through 45)
- HPV (human papillomavirus) — 2 or 3-dose series. Originally marketed for younger adolescents, but the FDA-approved age range is now up to 26 (with shared decision-making to 45). Strongly recommended regardless of gender, and regardless of sexual history. Prevents most cervical, oropharyngeal, and anal cancers.
Ages 50+
- Shingrix (shingles) — 2-dose series, separated by 2–6 months. Highly effective at preventing shingles and its long-term complications. Often the most painful vaccine in the schedule but the most worth it — anyone who has had shingles will tell you so.
Ages 60+
- RSV (respiratory syncytial virus) — single dose, for adults 60+ with high-risk conditions or 75+ regardless of risk. New to the adult schedule as of 2024. Particularly important if you have heart or lung disease.
Ages 65+
- Pneumococcal — single dose of PCV15, PCV20, or PCV21 depending on history. Sometimes a follow-up PPSV23 a year later. Protects against pneumonia and bloodstream infections.
If you missed childhood vaccines
If you grew up outside the U.S. or had patchy records, catch-up doses of MMR (measles, mumps, rubella), varicella (chickenpox), and Hepatitis B are usually still appropriate. Titers can confirm whether you have immunity from prior exposure or vaccination — that saves you unnecessary doses.
Travel vaccines (when applicable)
Yellow fever, Typhoid, Hepatitis A, Japanese encephalitis, Rabies pre-exposure, Cholera — depending on where you're going and what you'll be doing. Plan 6–8 weeks ahead; some series need multiple doses spread over weeks.
What's covered at $0
Under the Affordable Care Act, all CDC-recommended adult vaccines are covered at $0 by every in-network insurance plan when given at an in-network provider. Travel vaccines are usually not covered and are cash-pay — typically $35–$300 depending on the vaccine.
The short version: most of the adult schedule is free. The reason it doesn't happen is rarely cost — it is that nobody walks you through the schedule. That conversation is a normal part of every annual physical at Linden, and the front desk will pull the vaccines from inventory while we're still in the room.