What vaccines do I need if i'm 50 or older?

Two women hiking in a forest

The VCH Travel Clinic recommends the following vaccines for clients who are 50 or older.


Shingles is a reactivation of the chickenpox you had in previous years. The risk of shingles increases as we get older.

Shingles can cause severe blisters, pain & burning on the torso, limbs or face. For 1 in 5 people with shingles the long term nerve pain can go on for months or years. This is called post-herpetic neuralgia.

Shingrix provides 97% protection in the 50 – 69 age group and 91% protection in the over 70 age group. Shingrix will protect against shingles for at least 10 years.

Shingrix causes pain at the injection site & a small number of people report fever & feeling unwell for 2-3 days.

Shingrix may be given after an episode of shingles but wait until the lesions heal. Canada’s National Advisory Committee on Immunization recommends waiting one year after a shingles episode to administer Shingrix.

Cost: 2 doses, 2-6 months apart, $160 per dose. Many extended health plans pay for the vaccine.

Prevnar – 20

Prevnar -20 protects against pneumococcal disease. (Pneumonia, meningitis and blood infections) & replaces Prevnar -13 & Pneumovax -23.

The people most at risk of complications from this infection are children, people ≥ 65 & those with certain medical conditions:

  • Chronic kidney disease
  • Chronic liver disease
  • Cardiac or lung disease
  • Diabetes
  • HIV infection
  • People without a spleen
  • Immunocompromised- either through medication or illness
  • People who have received a solid organ or stem cell transplant
  • Malignant neoplasms, including leukemia and lymphoma

Anyone who has had Prevnar – 13 and/or Pneumovax – 23 should receive Prevnar -20 a year or more after last pneumococcal vaccine.

Cost: $150. the duration of protection is expected to be long, but current data is only available to 5 years.

Fluzone - high dose

As people age, they become more susceptible to influenza-related complications due to immunosenescence, a natural and progressive weakening of the immune system over time. As a result, seniors are less responsive to standard dose influenza vaccine. This is the rationale for the development of Fluzone High-Dose

Fluzone High-Dose contains 4 times the antigen of a standard dose influenza vaccine (60μg vs 15μg per dose) & is 24% more efficacious than the regular flu vaccine.

It is indicated for patients 65 years of age and older but may be safely given to anyone 50 & older.

Cost: $85

Respiratory Syncytial Virus (RSV) Arexvy

RSV is a respiratory illness that is transmitted from person to person by droplets.

In Canada, RSV causes:

  • 300,000 cases of the common cold.
  • 200,000 in physician visits
  • 15,000 hospitalizations
  • 1,000 deaths.

In 60 years and over, the vaccine decreases the risk of RSV acute respiratory infection by 72%, RSV pneumonia by 83% and severe RSV requiring oxygen or hospitalizations by 94%

The vaccine can cause pain at the injection site, tiredness, headaches, muscle and joint pain, fever, chills and runny nose. Rare side effects that showed up in studies but are likely NOT caused by the vaccine are atrial fibrillation & reversible neurologic disease.

Arexvy contains the same adjuvant, AS01 (the substance added to vaccines to increase the immune response) as Shingrix. AS01 can cause significant local reactions, and if time permits, it might be better to administer these vaccines at different times.

Arexvy is one dose that, if given in the fall, will provide protection for 2 RSV seasons.

Cost: $270


    • What vaccines do I need if I’m over 50?