Vaccines for adults 50 and older: what the current CDC schedule recommends

The CDC’s Advisory Committee on Immunization Practices (ACIP) sets the adult immunization schedule, and that schedule has changed more in the past two years than in the prior decade, with real shifts to the pneumococcal, RSV, and COVID-19 recommendations. This page describes what the current schedule recommends for adults roughly 50 and older, as verified directly against live CDC source pages on the date above. It is not a personal recommendation. Age, underlying health conditions, prior vaccination history, and pregnancy all change how a recommendation applies to a given person, and that judgment belongs to a clinician or pharmacist, not to a general reference page. Because this schedule is reviewed by ACIP on an ongoing basis and has already changed more than once in recent years, treat anything below as a snapshot, not a permanent fact, and check the current CDC adult immunization schedule before assuming it still reads the same way by the time you read this.

Shingles: recombinant zoster vaccine (RZV, brand name Shingrix)

As of the current schedule, CDC recommends 2 doses of RZV, separated by 2 to 6 months, for immunocompetent adults aged 50 and older, regardless of whether they recall having had chickenpox or a prior shingles episode. CDC also recommends 2 doses of RZV for adults aged 19 and older who are or will become immunocompromised because of a disease or its treatment, a group for whom the second dose can sometimes be given sooner, 1 to 2 months after the first, when faster completion is warranted. This recommendation has held steady in recent years; the source page above was last updated in October 2024.

Pneumococcal vaccination

This is the recommendation with the most recent change and the most moving parts. The routine age for pneumococcal vaccination was lowered: CDC’s current recommendation, verified against a CDC source page updated in February 2026, is that pneumococcal vaccination applies to adults aged 50 and older who have not previously received a pneumococcal conjugate vaccine or whose vaccination history is unknown, not only adults 65 and older as in prior years.

Several vaccine products now exist, and which one applies depends on age and vaccination history:

• For adults 50 to 64 who need vaccination, the current options are PCV15, PCV20, or PCV21. If PCV15 is used, a dose of PPSV23 is recommended about a year later; if PCV20 or PCV21 is used, no further pneumococcal dose is needed to complete the series.
• For adults 65 and older who previously received both an older conjugate vaccine (PCV13) and PPSV23 before turning 65, the current schedule frames a further dose as a shared decision: the option is to get a single dose of PCV20 or PCV21 at least 5 years after the last pneumococcal vaccine dose, or to receive no additional pneumococcal vaccine.

Because the product options and timing depend heavily on exactly which pneumococcal vaccines a person has already received and when, this is a case where the specific product and schedule genuinely needs to be worked out with a clinician or pharmacist who can see that history, rather than inferred from a general age cutoff alone.

Influenza (flu)

CDC recommends annual influenza vaccination for essentially all adults. For adults aged 65 and older specifically, the current schedule states a preference, not a requirement, for one of three higher-immunogenicity options over a standard-dose unadjuvanted flu vaccine: the high-dose inactivated vaccine (Fluzone High-Dose), the recombinant vaccine (Flublok), or the adjuvanted inactivated vaccine (Fluad). If none of those three is available at a given vaccination opportunity, the current guidance is that any age-appropriate flu vaccine should still be given rather than delaying vaccination. This preferential recommendation for 65 and older was current as of a CDC source page updated in January 2026.

COVID-19

This is the area that has shifted the most in framing. As of the current 2025-2026 season guidance, verified against a CDC source page updated in November 2025, COVID-19 vaccination is no longer recommended universally for all ages the way it was in earlier seasons. The current recommendation is framed, in CDC’s own words, as individual-based decision-making for people aged 6 months and older. Within that framework, CDC’s guidance specifically notes that vaccination is recommended for adults aged 65 and older under this individual-based approach, and that the risk-benefit balance is most favorable for people 65 and older, people at high risk for severe COVID-19 for other reasons, and people who have never been vaccinated against COVID-19. For adults who do get vaccinated with the 2025-2026 vaccine, the current schedule calls for 2 doses for those 65 and older, versus 1 dose for most people aged 12 to 64. Because this represents a genuine change from the earlier blanket recommendation, and because COVID-19 vaccine policy has continued to be revisited within ACIP, this is a recommendation worth rechecking against the live CDC page, or with a clinician, closer to the time of any vaccination decision rather than relying on this summary alone.

RSV (respiratory syncytial virus)

CDC’s current recommendation, verified against a source page updated in February 2026, is a single dose of RSV vaccine for all adults aged 75 and older, and for adults aged 50 to 74 who are at increased risk of severe RSV illness. That increased-risk group for the 50-74 range includes people with certain chronic heart, lung, kidney, liver, neurologic, or blood conditions, moderate or severe immune compromise, severe obesity, or those living in a nursing home, among other qualifying conditions a clinician can identify; the current guidance also notes that a patient’s own account of having a qualifying condition is considered sufficient, without requiring separate lab documentation, to support vaccination. The eligibility age for the risk-based group was expanded from 60-74 to 50-74 in 2024-2025, so a 50- to 59-year-old with a qualifying condition is now included, where they previously were not. Three RSV vaccines are currently licensed and recommended for adults in this age range (Arexvy, mResvia, and Abrysvo), and the current guidance states no preference among the three. As of now, RSV vaccination is a single dose rather than an annual vaccine: people who have already received one dose are not currently recommended to get another.

Td/Tdap (tetanus, diphtheria, pertussis)

The routine adult booster schedule here has stayed stable while the vaccines above shifted, and the source page above, though last formally updated in 2022, still reflects CDC’s current guidance because the underlying recommendation has not changed since. Adults who have completed the primary tetanus and diphtheria series and received at least one dose of Tdap at age 10 or older continue with a Td or Tdap booster every 10 years. Adults who completed the primary series but never received a dose of Tdap as an adolescent or adult are recommended to get one dose of Tdap, then continue with Td or Tdap every 10 years after that. Pregnancy has its own separate recommendation, a dose of Tdap during each pregnancy, that this page does not cover in detail.

Why this page will need rechecking

Three of the six vaccines above (pneumococcal, COVID-19, and RSV) have had a meaningful age, dosing, or framing change within roughly the last two years, and ACIP continues to revisit COVID-19 vaccine policy in particular. That pace of change is the honest reason this page states a verification date rather than presenting the schedule as fixed. Whatever is true on the date above may not be true by the time it is read months later. The current CDC adult immunization schedule, and a conversation with a clinician or pharmacist about individual health history, are the two things that should override anything on this page if the two ever disagree.