When was the last time you reviewed your vaccine history? For many adults, vaccines feel like something that mostly happens in childhood, but your immunization needs continue to change throughout your life based on your age, health history, and a number of other factors. For women in particular, vaccines can play an important role in reproductive health, pregnancy, cancer prevention, and healthy aging. Being “up to date” does not mean getting every vaccine available and memorizing an entire vaccine schedule. You simply need to know when it is time to check in and ask what may be appropriate for you in your current stage of life.
Vaccines Are Not Just a Childhood Concern
Vaccination does not end when you finish school. Some childhood vaccines require boosters because protection can decrease over time, and others, like shingles and certain pneumococcal vaccines, become important later in adulthood. A new health condition, medication, pregnancy, or even travel plans can also change what is recommended for you.
Adults can easily fall through the cracks because vaccination records may be spread across pediatricians, primary care providers, pharmacies, employers, and other healthcare systems. If you regularly see your OB/GYN but not another provider, your annual visit can be a valuable opportunity to review your preventive care more broadly. Your needs evolve, and reviewing them periodically helps you stay proactive.
The HPV Vaccine
Human papillomavirus, better known as HPV, is extremely common. Certain strains of the virus can lead to genital warts or cancers, including cervical, vulvar, vaginal, anal, and oropharyngeal cancers. The HPV vaccine helps prevent new infections, but does not treat an HPV infection that is already present, which is why vaccination is most effective before exposure.
Routine vaccination typically begins during adolescence, and catch-up vaccination is recommended through age 26 for people who were not adequately vaccinated earlier. Adults ages 27 through 45 may still benefit from HPV vaccination depending on individual circumstances.
It is important to note that being sexually active does not automatically mean the vaccine is no longer useful. You may have been exposed to one strain of HPV but not others included in the vaccine, and new partners can create opportunities for new exposure. Talk to your provider about what is best for you.
** HPV vaccination does not replace cervical cancer screening, so be sure to stay up to date with recommended Pap and HPV testing.
Vaccines During Pregnancy
Reviewing your history is especially important during pregnancy because certain vaccines can help protect both you and your baby. The following may be recommended during pregnancy:
- Tdap – Tdap protects against tetanus, diphtheria, and pertussis (whooping cough) and is recommended during every pregnancy, typically between 27 and 36 weeks. Receiving this vaccine during pregnancy allows protective antibodies to pass to your baby before birth, protecting your baby during the first months of life before they can complete their own vaccine series.
- Influenza – Pregnancy can increase the risk of complications from influenza, so flu shots are recommended during pregnancy during flu season. It can be given during any trimester. This also allows antibodies to pass to your baby, which can provide some protection after birth.
- RSV – Maternal RSV vaccination helps protect newborns from severe respiratory syncytial virus illness. With this vaccine, timing matters. Current ACOG guidance recommends maternal RSV vaccination during a specific gestational window and during RSV season for eligible patients. Your provider can help you determine whether maternal vaccination or another form of infant RSV protection is most appropriate for you and your baby.
- COVID-19 – Current ACOG guidance recommends COVID-19 vaccination during pregnancy. Recommendations may change over time as new formulations and evidence become available.
Some vaccines, including MMR and varicella, are generally not given during pregnancy because they are live vaccines. This makes a preconception visit a particularly helpful time to review your vaccination history and plan for recommended vaccination if you are not immune.
Vaccines for Women by Life Stage
There is no single vaccine checklist that applies to every woman, but there are some common milestones worth knowing.
Your 20s are a good time to review:
- HPV vaccination if you did not complete the series earlier
- Annual influenza vaccination
- Tdap status and recommended boosters
- Hepatitis B vaccination
- MMR and varicella immunity if your history is unclear
- Work, school, international travel, and certain medical conditions may create additional recommendations.
In your 30s and 40s:
- Make sure your earlier vaccine series were completed
- Stay current with flu and tetanus-related vaccines
- If you are between the ages of 27 and 45 and have not received the HPV vaccine, ask whether vaccination may still be beneficial for you.
- Pregnancy may change your vaccine needs, so review your immunization history during prenatal or preconception visits.
Additional vaccines become important as you get older. Beginning around age 50:
- Shingles vaccine is routinely recommended at age 50 for most adults
- Pneumococcal vaccination may be appropriate based on age, vaccination history, and health conditions
During later adulthood:
- RSV vaccination may be recommended based on age and risk factors
- Influenza, shingles, pneumococcal, and tetanus vaccines remain important
Certain health conditions, including diabetes, chronic heart or lung disease, kidney or liver disease, smoking, immunocompromising conditions, cancer treatment, and some medications, can change these timelines and affect recommendations. Age-based charts should always be viewed as a starting point, not a substitute for individualized care.
How to Find Out What You’re Missing
If you have no idea when you received your last vaccine, you are definitely not alone. Start by looking for any records you already have, which may be available through your current or former primary care, pediatrician, pharmacy records, school or employer health records, or state immunization registries, and bring whatever information you can find to your appointment. Even an incomplete record can help your care team determine your best course of action.
If you discover you missed a vaccine years ago, it does not necessarily mean you have to restart the entire series. In many cases, you can simply pick up where you left off or create a catch-up plan with your provider. You don’t need to figure it all out yourself!
At Essex County OB/GYN, we are here to help you understand what preventive care is appropriate for you at every stage of life. Contact us today to schedule your next visit.