Ask a Devoted Doctor: Vaccines

In this series, Dr. Lindsay Carter answers your questions on a range of topics. This information doesn’t replace health advice from your doctor. 

Q: Who needs to get flu and pneumonia vaccines?

A: It can be confusing to remember what you’re supposed to get and when! Here's what the Centers for Disease Control and Prevention (CDC) recommends for adults:

Flu vaccines:

• Who needs one? Everyone (people age 65 or older may need a higher-dose version)
• How often? Every year
• Why? Protects against the flu virus and severe cases of the flu

The reason that the flu shot is needed yearly is because every year, the virus changes a little. Each year, scientists make a new version of the flu shot to protect you from the new strain of the flu.

Pneumonia vaccines:

• Who needs one? People age 65 or older or age 19–64 with certain conditions (like chronic lung disease, chronic heart disease, cancers, diabetes, and many others)
• How often? One time* (1 or 2 doses, depending on which shot you get)
• Why? Protects against pneumonia and other diseases caused by the pneumonia bacteria

*As of January 2022, the CDC recommends that adults 65 or older or adults 19–64 with certain conditions get EITHER a new version of the pneumococcal vaccine called PCV20 (Prevnar 20®) one time, OR a different new version called PCV15 (Vaxneuvance®) one time. If someone gets PCV15, they also need to get another version called PPSV23 (Pneumovax23®) one year later.

If you got a pneumonia vaccine in the past, but it wasn’t PCV20 or a combination of PCV15 and PPSV23, you may need to get a new dose. Talk to your doctor for more information.

Q: Should I get the shingles vaccines if I already had shingles?

A: Yes! There are now 2 shingles vaccines: Shingrix and Zostavax. Shingrix is newer, and the CDC recommends it for everyone 50 and older. If you already got Zostavax, doctors still recommend that you get Shingrix.

Shingrix is very good at preventing shingles, even if you’ve already had shingles — because you can get shingles more than once! If you’re unlucky and still get shingles after you’ve had the vaccine, it still helps prevent a painful complication called post-herpetic neuralgia (when the pain from shingles doesn’t go away).

The vaccine can sometimes cause side effects like soreness where the shot was given, mild fever, and fatigue. These last about a day and will go away on their own.

Q: How many more COVID-19 boosters are doctors going to recommend?

A: If you feel like recommendations for the COVID-19 booster are changing all the time, you’re not alone! With the evolving pandemic, experts are doing their best to give us the best and most up-to-date information.

The latest news is around the updated booster, which targets the older strains of COVID-19 and the newer BA.4 and BA.5 omicron variants. The CDC now recommends this new booster for people 12 and older who have received the primary vaccine series. 

Some have raised concerns that the updated booster has not been tested much in humans, and they are worried about safety. Scientists haven’t done a lot of human testing of the new boosters because what’s in the vaccine and how it works haven’t changed. The only update is that it targets the newer variants — just like how the flu shot gets updated every year. This process of updating vaccines for new variants has been safe for many years. 

So are we going to need a new booster every few months, as the virus continues to change? Well, experts can’t predict what will happen next for sure, but the hope is that COVID-19 will become more predictable and that boosters will be updated and recommended once a year, like the flu shot. 

Q: Do I need the monkeypox vaccine?

A: The short answer: It depends. Just as we were getting used to one new virus, another one appears! 

The monkeypox virus is not actually new. It’s a virus that’s been in parts of Central and West Africa for many years. The current outbreak that began in May 2022 in Europe is a variant of that virus, which causes flu-like symptoms and a painful rash. 

Right now, the majority of cases have been in gay, bisexual, and other men who have sex with men. Because of this, the CDC is recommending the monkeypox vaccine for people who may be at higher risk based on sexual practices. But anyone who's been in close contact with someone with monkeypox is at risk. They may need to get the vaccine after that close contact to prevent them from getting the disease. If you think you may be at risk or have symptoms, talk with your doctor right away.

Q: Can I get more than one vaccine at once?

A: Yes! It’s safe to get multiple vaccines at the same time, and the vaccines work just as well.

You may be more likely to have some vaccine side effects, like a mild fever, if you get more than one shot at a time. This is your immune system responding, and the side effects will go away on their own in a day or so.

Some vaccines are more likely than others to cause pain where the shot was given. One way to lower your chance of having extra pain is to get the vaccines in different parts of your body. For example, you could ask to get one shot in your arm and one in your thigh, instead of getting them both in the same arm.