Why Your Vaccine Schedule Looks Different Than It Did Five Years Ago
If your last thorough review of adult vaccines happened before 2020, your schedule is almost certainly out of date. Recommendations have shifted meaningfully in the last several years: RSV vaccines are now available for older adults and pregnant patients, the pneumococcal schedule has been simplified, hepatitis B is now recommended for all adults under 60, and COVID boosters have become annual for most people.
At Zimmer Medical Group, we review vaccine status at every annual physical, but many patients arrive surprised by what they are missing. This checklist, current as of 2026, is organized by age and risk. The official source — the CDC adult immunization schedule — is updated each year and should always take precedence for clinical decisions.
Every Adult, Every Year
Two vaccines belong on your calendar annually regardless of age:
- Influenza. An annual flu shot is recommended for everyone six months and older, with rare exceptions. For adults 65 and older, a high-dose, adjuvanted, or recombinant formulation is preferred.
- COVID-19. An updated formulation each fall is now recommended for most adults, with additional doses for immunocompromised patients.
Fall in Florida is the ideal window for both. Scheduling them before snowbird season travel protects both you and the family you visit.
One-Time or As-Indicated
- Tdap / Td. One dose of Tdap, then a Td or Tdap booster every 10 years. After a deep or dirty wound, you may need an earlier booster — especially relevant during hurricane cleanup.
- MMR. Adults born in 1957 or later without documented immunity need at least one dose.
- Hepatitis B. As of the 2022 ACIP update, all adults 19 through 59 should be vaccinated, and adults 60 and older with risk factors.
- Varicella. Two doses for adults without evidence of immunity born in 1980 or later.
- HPV. Recommended through age 26, and shared decision-making for selected adults 27 through 45.
If You Are Pregnant
Three vaccines are routine during pregnancy: influenza, Tdap (ideally 27 to 36 weeks to pass antibodies to the newborn), and RSV monoclonal or maternal RSV vaccine per current ACIP guidance. COVID-19 vaccination during pregnancy is also recommended.
Age 50 and Older: Shingrix Is Essential
If there is one vaccine we wish more adults would prioritize, it is Shingrix. The two-dose series for adults 50 and older prevents shingles and postherpetic neuralgia — a debilitating nerve pain syndrome that can last years. Our detailed overview of what every adult should know about shingles explains why the recombinant vaccine is so much more effective than the older live vaccine.
Age 60 and Older
- RSV. Current ACIP guidance supports shared clinical decision-making for adults 60 through 74 at increased risk, and a routine recommendation for adults 75 and older. One dose is considered long-lasting; annual redosing is not currently recommended. The CDC's RSV resource for older adults outlines who benefits most.
Age 65 and Older
- Pneumococcal. The schedule has been simplified. Most adults 65 and older who have not previously been vaccinated can receive a single dose of PCV20, or a dose of PCV15 followed by PPSV23 at least one year later.
- High-dose or adjuvanted flu. Preferred in this age group.
These protections are a cornerstone of healthy aging in St. Pete.
Adjustments for Chronic Conditions
Several conditions shift recommendations earlier or add doses:
- Diabetes mellitus: Hepatitis B vaccination, pneumococcal vaccination regardless of age, and RSV consideration at a lower age threshold.
- COPD and chronic heart disease: Pneumococcal and RSV vaccines earlier; high-dose flu strongly preferred.
- Immunocompromised patients: Additional COVID doses, specific pneumococcal sequencing, and caution with any live vaccines.
Florida-Specific Considerations
Hurricane season brings wounds, standing water, and disrupted care — keeping Tdap current matters here more than in most states. Snowbirds who travel between states should carry a current immunization record, since documentation of prior doses prevents unnecessary revaccination. Florida residents can access resources and school-age requirements through the Florida Department of Health immunization program.
Questions That Come Up at the Vaccine Visit
The schedule is one thing; the practical questions are what actually delay people. Here are the ones I answer most weeks.
Can I get more than one at a time?
For inactivated vaccines, yes, and it is the norm rather than the exception: flu and COVID in the same visit, or a pneumococcal dose alongside a shingles dose, each in a different arm. Expect a sore arm and perhaps a day of feeling run down, more so with the shingles series, so do not schedule it the day before a golf tournament. The official CDC adult immunization schedule is what we follow for spacing, and MedlinePlus has a plain-language summary of the adult vaccines and their side effects.
Which vaccines are live, and who should avoid them
MMR and varicella are live attenuated vaccines, and they are generally avoided in people whose immune systems are suppressed: anyone on methotrexate, a biologic for rheumatoid arthritis or inflammatory bowel disease, higher-dose prednisone for more than a brief course, or chemotherapy. The current shingles vaccine is not live, which is exactly why it can be given to those same patients, who are also at the highest risk of shingles; the National Institute on Aging explains why the risk climbs with age and immune suppression. If you are starting an immune-suppressing medication, tell us before the first dose so any live vaccines can be given first.
Finding records you no longer have
Most adults have no idea when their last tetanus booster was, and that is fine. Florida keeps a statewide immunization registry that pharmacies and clinics report into, so doses given in this state are often retrievable; prior employers, colleges, and the military are the other common sources. When records cannot be found, a blood test can confirm immunity to measles, chickenpox, and hepatitis B, and for tetanus we simply give a dose, since an extra one is harmless. Our articles on tetanus boosters and dirty wounds and the pneumococcal vaccine update cover the two questions that come up most after hurricane season and after 65.
Where to Get Them
You can receive most adult vaccines at your primary care office, a pharmacy, or your county health department. The advantage of getting them through your primary care practice is integrated record-keeping — your chart reflects exactly what you have had, when, and whether you are due. Our adult immunizations for the Florida lifestyle guide covers local options in more detail.
If you are not sure where you stand, bring your vaccine records to your next visit — or schedule a vaccine review with Dr. Zimmer. See which adult vaccines we offer. A 20-minute conversation can catch gaps that have been open for years.
