A patient sat across from me last fall, a little sheepish, and admitted she hadn't had a vaccine since her kids were small. She wasn't anti-anything. Life just got busy, and nobody had ever sat her down to walk through it. That's more common than you'd think. Adults fall out of the vaccine habit the moment the pediatrician's office is no longer scheduling it for them.
That's a big part of why I built preventive vaccine administration into the rhythm of my practice. Not as a one-off shot, but as a yearly conversation. In my Los Angeles office, I keep a running record of what each member has received and what's coming due, so nothing quietly slips off the radar for a decade.
Why do adults need vaccines at all?
Because immunity isn't permanent, and the diseases we're protecting against haven't gone anywhere. Some childhood vaccines fade over time. Others — like the shingles and pneumonia vaccines — are designed specifically for the second half of life, when your immune system isn't quite as quick as it used to be.
I often tell patients that vaccines aren't only about you. When you're protected, you're less likely to carry an illness home to a newborn grandchild or an elderly parent recovering from surgery. In a dense, social city like LA, that matters more than people realize.
Which vaccines do most adults need?
It depends on your age, your health history, and your job, but a handful come up again and again. Here's what I review with nearly everyone:
- The yearly flu shot, ideally before the season ramps up
- Shingles, generally recommended once you're in your 50s
- Pneumococcal (pneumonia), especially with age or lung and heart conditions
- Tdap, with a tetanus booster roughly every ten years
- COVID-19 boosters, based on the current guidance
Some people also need hepatitis B, HPV, or RSV protection depending on their situation. If you have type 2 diabetes, a chronic lung condition, or you're on medication that affects your immune system, the calculus shifts — and that's exactly the kind of thing I'd rather work out together than leave to a guess.
How do I know which shots I'm actually due for?
Start by pulling together whatever records you can find — old pharmacy printouts, a photo of a vaccine card, anything. Then we fill in the gaps. During a routine visit I do a full immunization review, comparing your history against the current adult schedule and flagging what's missing.
If you genuinely have no idea what you've had, don't let that stop you. We can usually check titers with bloodwork, or simply re-vaccinate where it's safe to do so. Uncertainty is a reason to come in, not a reason to avoid it.
Are vaccine side effects something to worry about?
For the overwhelming majority of my patients, no. A sore arm, maybe a day of feeling run-down — that's the typical experience, and it usually means your immune system is doing its job. Serious reactions are rare, and I screen for allergies and contraindications before anything goes in.
What I won't do is pretend you have no questions. If you've had a bad reaction before, or you're nervous about a particular vaccine, tell me. We'll talk it through honestly. Part of practicing this way is having the time to actually answer.
Where does this fit into the bigger picture?
Vaccines are one piece of staying ahead of illness rather than chasing it. They sit alongside the rest of preventative medicine — your screenings, your bloodwork, the unglamorous checkups that catch problems early. The flu shot you got in October is the same instinct as the cholesterol panel you'd rather not think about: small steps now that spare you a much harder road later.
And because I coordinate care directly, I can line these things up so a single visit covers a lot of ground. No bouncing between a clinic, a pharmacy, and a portal that never quite syncs.
If it's been a while since anyone reviewed your vaccines — or you're simply not sure where you stand — I'd genuinely like to help you sort it out. Reach out anytime, and we'll go through your history together and build a plan that fits your life, not a generic checklist.