What to Expect at Your Annual Physical: Vaccinations

Lori M. Noble, MDLori M. Noble, MD, a primary care physician at Spruce Internal Medicine, located at Penn Medicine Washington Square, discusses what to expect at your annual physical.

As adults, many of us cannot recall the last time we had to get a routine series of vaccines. Maybe we just have a vague recollection of needing shots before college or before accepting a new job.

That being said, vaccines are an extremely important part of routine care well into adulthood. Some vaccines continue to be recommended for all age groups, while others are offered only at certain age milestones or in those with certain health conditions.

It is important to know what vaccines you may be eligible for, and remember, it’s just a sting or a pinch today that can help prevent disease tomorrow.

HPV Vaccination (aka Gardasil)

WHO: Males and females from age 9 to 26.

WHY: To protect you from four strains of the Human Papillomavirus, two of which cause genital warts in men and women, and two of which can lead to cervical cancer in women.


  1. The HPV vaccine is a series of three shots. The second is given two months after the first and the third is given four months after the second.
  2. Not all insurance companies are consistently covering the vaccine for young men, so check with your insurance company before visiting your doctor.

TDaP Vaccination (aka Adacel, Boostrix, Daptacel)

WHO: All adults age 19 and older should receive a single dose of Tdap to replace a single dose of the “every 10 year” Td booster.

WHY: To boost protection against pertussis (which is the infection that causes whooping cough in children), in addition to boosting protection against Tetanus and Diphtheria. There has been an increase in whooping cough in children because as adults, our protection (i.e immunity) against the infection goes down. We can then transmit it to children who are not fully vaccinated.

NOTES: All pregnant women should receive the vaccine with each pregnancy, regardless of prior vaccination.

Flu Vaccination

WHO: All adults once per year (typically August to February).

WHY: To protect against the influenza virus and complications, such as pneumonia.

NOTES: There are multiple kinds of flu vaccines, and your doctor will recommend the best one for you based on your age and any other medical conditions you may have.

Pneumonia Vaccination (aka Pneumovax)

WHO: One time in all adults age 65 and older AND in all adults under age 65 with any of the following: diabetes, COPD (i.e. emphysema), HIV, heart failure, asthma, chronic hepatitis, cancer or current smokers.

WHY: To protect against potentially deadly pneumonia infection and its complications.


  1. If the vaccine is given before the age of 65 for any of the above conditions, a second dose should be given as a booster at age 65.
  2. In those adults whose immune systems are poor (i.e. cancer patients on chemotherapy), a booster should be given every five years, regardless of age.

Shingles Vaccination (aka Zostavax)

WHO: One time in all adults, age 60 and older, who have ever had chickenpox (or whose chickenpox history is unknown).

WHY: To protect from the reactivation of the chickenpox virus, which can cause a painful, blistering rash, called shingles. The rash can leave behind permanent nerve damage at the site of the rash, leading to chronic pain.


  1. Adults whose immune systems are very poor should not get the vaccine.
  2. The CDC (Centers for Disease Control) currently recommends vaccinating all adults over the age of 50, but insurance companies are currently not approving the vaccine for those between the ages of 50-59.
  3. If you have Medicare, you may need to get this shot administered at your local pharmacy, NOT in the doctor’s office, in order to be covered by insurance. Ask your doctor or your pharmacist if this applies to you.

The relationship you build with your primary care doctor is one of the most important you’ll ever have. Primary care providers are there to listen to your special concerns and help you make informed decisions about maintaining your health. If you have additional questions, please speak with your physician.

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