Which vaccines should adults over 60 have? (shingles, pneumonia, flu, RSV)
The vaccines recommended for adults aged 60 and over, with the reasons, number of doses, order of priority and the clinic's prices, so families can plan one visit for their parents.
Most people think of vaccines as something for children, but immunity declines with age, leaving older adults more likely to catch infections and to become seriously ill. Pneumonia, flu and shingles, all preventable with vaccines, are among the leading reasons this age group ends up in hospital. Below is what to have first, how many doses each needs, and what can be given together in one visit.
Key takeaways
- Four core vaccines for 60+: flu every year · pneumococcal (pneumonia) · shingles · RSV. All can be given on the same day
- Do not forget the basic adult vaccines often missed: a tetanus booster every 10 years, and hepatitis B if you have no immunity
- People with diabetes, lung, heart or kidney disease benefit even more than average and should start at 50
- If choosing one at a time on a budget, the usual order is flu → pneumococcal → shingles → RSV
Why older adults need vaccines more than anyone
After 60 the immune system responds to new pathogens more slowly and less strongly, a process called immunosenescence. Illnesses a young adult shakes off in a week turn into pneumonia or complications needing hospital care in older adults. At the same time, viruses that lie dormant in the body, such as the shingles virus, reactivate as immunity weakens.
Diabetes, hypertension, heart disease, COPD and kidney disease, all common at this age, make infections more severe. A single infection can knock a well-controlled chronic condition off track, and vaccines lower that risk.
Recommended vaccines from age 60
| Vaccine | Protects against | Doses | Price at the clinic |
|---|---|---|---|
| Influenza | Flu and its complications, such as pneumonia and heart events | 1 dose every year | 490 baht/dose |
| Pneumococcal 20-valent (PCV20) | Pneumococcus, the main cause of pneumonia and bloodstream infection | 1 dose, once | 3,900 baht/dose |
| Shingles, recombinant | Shingles and post-herpetic nerve pain | 2 doses, 2–6 months apart | 6,900 baht/dose |
| RSV, adult | RSV, a cause of pneumonia in older adults | 1 dose (no booster currently recommended) | 9,500 baht/dose |
| Tetanus (Td/Tdap) | Tetanus from wounds | Booster every 10 years | 350 baht/dose |
| Hepatitis B | Chronic hepatitis and liver cancer | 3 doses if tests show no immunity | 450 baht/dose |
Prices include doctor and nursing fees, as published by the clinic until 31 December 2026. See the full list filtered for older adults on the vaccines page.
1. Flu: every year
The most important and cheapest vaccine on the list. Older adults with flu have a clearly higher risk of pneumonia, heart attack and stroke in the weeks after infection. One dose a year, ideally before the rainy season in April–June, but worthwhile whenever you have it. Read when to get the flu vaccine. Both the quadrivalent and trivalent vaccines are suitable for older adults.
2. Pneumococcal: a single dose
Pneumococcus is the leading cause of community-acquired pneumonia, and of meningitis and bloodstream infection in older adults. The current 20-valent conjugate vaccine (PCV20) is a single dose for adults who have not had it before, with no repeat. Anyone who previously had the 23-valent polysaccharide vaccine (PPSV23) or PCV13 should ask the doctor whether PCV20 is still needed and how long to wait.
Recommended from age 65 in general, and from 50 or earlier for people with diabetes, lung, heart, kidney or liver disease, smokers and regular drinkers.
3. Shingles: preventing pain that is hard to treat
The preferred choice is the recombinant 2-dose vaccine: over 90% effective even at 70–80, and safe for people with weakened immunity. The live vaccine is a cheaper single-dose alternative for people with normal immunity. Read the detailed comparison in shingles vaccine: live vs recombinant. Start from age 50, and have it even if you have already had shingles.
4. RSV: a newer vaccine for older adults
RSV used to be thought of as a toddler's illness, but data from the last decade show that in older adults it causes hospitalisation and death at rates close to flu, especially in those with lung or heart disease. The adult RSV vaccine is recommended from age 60 (some guidelines emphasise 75 and over, or 60–74 with risk factors) and from 50–59 with chronic conditions. One dose; current data do not call for a booster.
Because it costs more than the others on this list it is usually placed last for healthy adults, but it should move up for anyone with COPD, asthma, heart failure, or age 75 and over.
Basic vaccines Thai adults often lack
- Tetanus: childhood immunity ran out long ago, and an older adult cut by something sharp or grazed in a fall is genuinely at risk. One booster every 10 years (350 baht/dose)
- Hepatitis B: Thais born before 1992 were not vaccinated at birth. Test for antibodies (anti-HBs) and the virus (HBsAg) first; if neither is present, 3 doses (450 baht/dose)
- COVID-19: as advised by the Ministry of Public Health each year. Ask the doctor when a booster is due
One visit: what can be given together
Everything above is a non-live or protein vaccine except the live shingles vaccine, and all can be given on the same day in different arms; international guidelines set no required interval between them. In practice the doctor usually suggests 2–3 per visit so side effects do not pile up: for example, flu plus pneumococcal on the first visit, then the first shingles dose plus RSV on the next.
Before bringing an older parent, gather their list of regular medication, drug allergies and any vaccination record. The doctor takes a history and checks blood pressure before every injection. People on blood thinners can be vaccinated, with slightly longer pressure on the injection site. Message us on LINE with age and conditions and the team will check stock and help set the order before you travel.
Good to know: Older adults already collecting chronic medication can review their vaccines at the same appointment. See chronic condition care.
Frequently asked questions
Start with flu and pneumococcal at the first visit: they prevent the commonest reasons for hospital admission and are the least expensive. Then plan the first shingles dose and RSV for the next visit. The doctor can order these around his medical conditions.
Related services
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Sources
- Recommended Adult Immunization Schedule, United States U.S. Centers for Disease Control and Prevention
- คำแนะนำการให้วัคซีนป้องกันโรคสำหรับผู้ใหญ่และผู้สูงอายุ สมาคมโรคติดเชื้อแห่งประเทศไทย
- Respiratory syncytial virus (RSV) World Health Organization
This content is general information and does not replace an examination, diagnosis or personal advice from a doctor. Published 20 September 2026
Everyone's health is different
If you have a health condition, take regular medication, are pregnant or have unusual symptoms, let a doctor assess you first. Message us on LINE.
