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Adult Immunizations

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Childhood immunization programs have reduced vaccine preventable diseases among children, but Canada's population has a number of adults who remain vulnerable to these diseases. Childhood immunization does not provide lifelong immunity against some diseases such as tetanus (lockjaw) and diphtheria, so booster shots are required for some vaccines to maintain immunity.

Adults who were not adequately immunized as children may also be at risk for vaccine preventable diseases. Please read on to learn more about recommended adult immunizations and the diseases you can be protected against.

Routine Adult Immunizations

While your age, health status, occupation, lifestyle or travel plans may put you at risk for other vaccine preventable diseases, all adults are recommended to have the following routine immunizations:


Tetanus, Diphtheria, Pertussis

Tetanus (also called lockjaw) is caused by a germ found in our environment most commonly in soil, dust and manure. If you have a cut or skin wound that gets infected with the tetanus germ you may get tetanus.  Tetanus causes painful cramping of the muscles and convulsions that can be severe enough to break bones. Even with treatment, 1 out of 10 people who get tetanus can die.


Diphtheria is a contagious disease that is caused by germs that infect the nose, throat or skin. It causes a thick coating at the back of the throat and can lead to breathing problems, heart failure and nerve damage. Even with treatment, it too kills 1 out of 10 people who get this disease.


Pertussis (also called whooping cough) is a very contagious respiratory infection that can cause respiratory illness, outbreaks and even death. It is spread from person to person through coughing and sneezing. People with pertussis develop violent coughing spells that can lead to vomiting. The cough can last for two weeks or more. This disease is most severe among young infants.


Pertussis in adolescents and adults is increasing. This may be due to better recognition and diagnosis of the disease as well as decreasing protection from childhood immunization. Adolescents and adults with untreated pertussis are the most common source of infection for young, unimmunized or partially immunized infants.

The National Advisory Committee on Immunization recommends that all adolescents and adults receive a one-time dose of tetanus, diphtheria and pertussis vaccine (Tdap) to provide increased protection against pertussis. Adolescents in Ontario currently receive this as their 14-16 year booster.


All adults 19-64 years of age who have not had a pertussis containing booster are eligible to receive Tdap in place of one of their recommended 10 year Td boosters. A booster for tetanus and diphtheria (Td) is recommended every 10 years after that to ensure long-lasting protection against these diseases.



Polio is a serious disease caused by the poliovirus. It can be spread from person to person through coughing and sneezing. The virus can also spread indirectly through feces. An infected person who does not properly wash their hands after going to the bathroom can spread the virus by touching another person, food, water or objects. The virus first causes infection in the throat and the intestinal tract. In some cases, the virus multiplies and spreads through the blood, infecting nerve cells in the spinal cord and brain. If the nerve cell damage is severe, muscles can become weak or completely paralyzed. Some people die of polio, but it has become a rare disease because of routine immunizations.


Adults who have completed the primary series of polio vaccine during childhood do not generally require a booster dose of polio (IPV). However, unimmunized adults or those with unknown immunization history who may be exposed to imported polio cases in Canada or are travelling to countries where there are polio outbreaks should receive the polio vaccine.


Measles, Mumps, Rubella

The combined measles, mumps, rubella vaccine (MMR) is recommended for individuals who have not previously been immunized against or been infected with all of these viruses. Measles, a severe illness caused by a virus, results in high fever, runny nose, cough, inflammation of the eyelid and a rash. Mumps, an infection caused by the mumps virus, can cause fever, headache and swelling of the salivary glands around the jaw and cheeks. Rubella, also known as German measles, is an infection caused by a virus. It can lead to fever, sore throat and swollen glands. If woman gets rubella in the early part of her pregnancy her baby may be born with birth defects.

Adults born prior to 1970 are assumed to be naturally immune to measles and mumps. Adults born 1970 and later without evidence of immunity for measles and mumps should received one dose of MMR vaccine.


A 2nd dose of MMR vaccine is recommended for young adults (18-25 yrs), post secondary students, persons who received killed measles vaccine (1967-1970), health care workers and those who plan to travel internationally.


All women of reproductive age should have at least one documented dose of rubella vaccine or evidence of immunity. Women of childbearing age, who are not pregnant, should be vaccinated if needed. Women should avoid pregnancy for three months following MMR vaccination.



Influenza is a serious respiratory disease. Every year new strains of influenza circulate around your community. Immunization is the best way to protect you against influenza. The vaccine is recommended annually for everyone 6 months of age and older, particularly those at high risk of complications from influenza, such as those with chronic health conditions, the elderly or infants and children.


Pneumococcal Disease

Adults over the age of 65 can also receive one dose of pneumococcal polysaccharide vaccine (Pneu- P-23), which protects against meningitis, septicemia (blood poisoning) and pneumonia caused by the streptococcus pneumoniae bacteria. Revaccination is only recommended for those with certain high risk conditions.


Herpes Zoster (Shingles)

Anyone who has had Chickenpox can develop Shingles, but it is most common in people over 50. The risk of getting shingles continues to go up as people get older. Shingles is a painful rash that usually appears on one side of the body or face. People with Shingles may also have a fever, headache, chills and an upset stomach. For 20% of people who develop Shingles, severe pain can continue and cause a condition called post-herpetic neuralgia. This pain can be severe and last the rest of their life. One dose of the herpes zoster vaccine (Zostavax) is recommended for people 60 years and older. While herpes zoster vaccine is currently not publicly-funded (free) in Ontario, it can be purchased through your health care provider.


Other Immunizations

You can also receive other vaccines based on your occupation, underlying medical conditions, lifestyle and age. Examples of these vaccines include Hepatitis A and B vaccines, chickenpox vaccine and meningococcal vaccines. Talk to your healthcare provider or call the health unit to speak to a nurse about your risks and needs for immunization.


Travel Vaccines

Vaccine needs vary depending on your travel destination. It is recommended to contact your health care provider or local travel health clinic 6 to 8 weeks before your trip to allow time for the vaccines to take effect. For more information on travel vaccines please visit the Public Health Agency of Canada website or contact your local travel clinic.


What else do I need to know?

Some vaccines are publicly funded (free) for certain groups. To find out if you are able to receive free vaccine, please contact the health unit. If your do not qualify for the free vaccine, you may choose to purchase the vaccine(s). Some drug plans may also cover the cost of these vaccines. After you receive a vaccine, update your immunization record (Yellow Card) and keep it in a safe place.

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Page Last Modified: Friday, 15 March 2013.