Tetanus
The general recommendation is that you get a tetanus shot every 10 years. It's not a bad idea to get them at age 40, 50 or 60 so you can remember it. The good news about the tetanus shot is that if you haven't had it in 10 years you have two weeks after you would get a bad cut to when you should get the tetanus shot so it can always be done after the fact. About the only place you need to get it preemptively is if you're going to some wilderness area where there is no medical care.
Once as an adult you are supposed to get TDaP, which is a tetanus shot with the whooping cough shot added to it. If you're about to become a grandparent it's also highly recommended that you get this shot so that you don't inadvertently pass whooping cough onto the new baby. If you have had this shot you don't need to get another one.
Pneumonia vaccine
At age 65 that you should get the "pneumonia vaccine." Pneumovax 23 is the traditional one and is supposed to be paid for by Medicare. You only need it once in a lifetime. And there's a new one, Prevnar 13, the utitlity of which is highly suspect.
Adults younger than 65 who have diabetes, heart failure, kidney failure and a few other odd conditions are also recommended to have the pneumonia vaccine. These individuals also get a booster after five years.
The "pneumonia vaccine" is a bit of a misnomer. It doesn't stop pneumovia! It only stops the "invasive pneumococcal disease." That is doctor talk for meningitis or blood poisoning caused by the pneumococcus. These are both exceedingly rare conditions. The number of people who need to be given this vaccination to stop one of these infections is between 2000 and 20,000 people. And it only stops people from acquiring these infections. It doesn't necessarily stop them from dying from these infections.
Bottom line. Get the Pneumovax 23 at age 65. Skip the Prevnar 13.
Shingles shot
Generally at around the age of 60 you should consider getting the "shingles shot." But don't get it this year (2016)! The present vaccine is not very good. There is a new one coming out in about a year that's going to be much better. It's a two shots series. Wait until it comes out.
Shingles is a recurrence of childhood chicken pox. All people over about 50 were exposed to chickenpox as a childern, even if they don't remember having it. So they're at risk of a reactivation of the virus as they get older. That is what shingles is. The chicken pox virus hides in your body and then usually after age 60 it may come out again it manifest itself as shingles. This is a focal blistering rash on one side of the body. It often hurts. The good news is it always goes away. The bad news is it can be painful. That's why it's reasonalbe to get the shingles vaccine generally after age 60. At that age one has about a 2% chance per year of coming down with shingles.
If you already have had shingles as an adult you have a reduced chance of getting it again. But they do recommend a shingles vaccination after you had it. But, once again, wait until the new vaccine comes out.
Flu Shot
The flu shot is certainly recommended for people age 65 and older. Anybody else can get it to. The usefulness of it varies from year to year. It's nobody's fault. The vaccine manufacturers have to try to guess what type of flu is coming next year and do their best to make a vaccine that will cover it.
Influenza is a disease characterized by high fever, a barking cough, and terrible body aches. It's a virus. Once you get it there is really no good treatment for it. There is a pill, Tamiflu, that if you take it within 48 hours of getting influenza you may get better in four days vs. five days. Underwhelming. Better to get the shot.
We do give the flu shots in our office. We usually get the vaccine in September and you should get it sometime between then and December when flu season really starts. But whether you get the flu shot here in our office or the drugstore doesn't matter. It's the same shot.
There is a more concentrated flu shot it can be given to people over age 65. Its usefulness is highly suspect. Its absolute usefulness in older poeple is about 1% better than the regular flu shot.
Practical Points
Today the best place to get most vaccinations is at the drug store. Why is that? Simply because most Health Insurances do not pay the doctor. They pay us less than the vaccine costs. So if I give you one of these shots I have to dig into my pocket and give you $20 too. Makes a lot of sense, doesn't it? The other benefit of gettin it at the drugstore is that they are very good at extracting insurance payments and hopefully none of these vaccinations will cost you very much there. If you get any of these shots please give a call to our office and let us know that you've gotten them so that we can put them into the medical record. The drugstores will often say they will notify us but they usually don't.
Other Vaccines
There are vaccines for hepatitis A, hepatitis B and some other diseases. These are generally just recommended for travelers to exotic places. It may also be recommended for Health Care workers. They are generally not recommended for the average person.