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Healthy Aging & Preventive Care Article

Staying Healthy as You Age: Are You Keeping Up With Your Vaccines and Screenings?

You keep your medical appointments. You take your medications. Maybe you get your flu shot every fall.

So, you’re probably caught up on your preventive care—right?

Maybe. But as we get older, the vaccines and health screenings recommended for us can change. A vaccine you didn’t need several years ago may now be recommended. A screening test may become appropriate because you’ve reached a certain age or developed a particular risk factor. And some tests that sound like good preventive medicine aren’t recommended routinely for everyone.

That’s why staying healthy as you age isn’t simply about getting more medical care. It’s about getting the right care, at the right time, for the right reason.

Vaccines Worth Asking About

Vaccines aren’t just for children. Our immune systems and health risks change as we age, making certain vaccine-preventable illnesses more likely to cause serious complications.

Influenza (flu). The flu vaccine remains an annual recommendation for adults. For people 65 and older, CDC preferentially recommends certain flu vaccines designed to produce a stronger immune response. These include high-dose vaccines, recombinant vaccines (made without using the flu virus itself), and adjuvanted vaccines (made with an added ingredient that helps strengthen the body’s immune response).

Shingles. If you’ve ever had chickenpox, the virus that causes it can remain dormant in your body and reactivate years later as shingles. CDC recommends two doses of recombinant zoster vaccine (Shingrix) for adults 50 and older.

Pneumococcal disease. This is one recommendation people may remember differently. Pneumococcal vaccination isn’t something you necessarily wait until 65 to discuss anymore. Current CDC guidance recommends pneumococcal vaccination beginning at age 50 for adults who have not previously received an appropriate pneumococcal conjugate vaccine, with the exact vaccine schedule depending partly on vaccination history.

RSV. Respiratory syncytial virus can cause serious respiratory illness in older adults. CDC recommends a single RSV vaccine dose for everyone 75 and older and for adults 50–74 who are at increased risk for severe RSV disease. Unlike the flu vaccine, the RSV vaccine is not currently an annual vaccine.

Tdap or Td. Tetanus hasn’t disappeared just because we’ve grown older. Adults who have completed their primary vaccination series should receive Tdap if they haven’t previously received it, followed by a Td or Tdap booster every 10 years.

COVID-19 vaccination also remains part of adult preventive care, although recommendations have changed over time. Because vaccine guidance can change, it’s particularly important to check the current CDC recommendations and discuss your individual circumstances with your healthcare provider.

Screenings That May Belong on Your Radar

Vaccines are only one part of preventive care. Screening can identify certain diseases before symptoms develop when early intervention may make a significant difference.

But here’s the important part: not every screening test is appropriate for every person.

Bone Density

Osteoporosis can weaken bones without causing obvious symptoms—sometimes until a fracture occurs.

The U.S. Preventive Services Task Force (USPSTF) recommends osteoporosis screening for women 65 and older. It also recommends screening postmenopausal women younger than 65 who have one or more risk factors and are determined to be at increased risk for an osteoporotic fracture.

For men, the USPSTF currently says there isn’t enough evidence to determine the balance of benefits and harms of routine osteoporosis screening.

Mammograms

For women at average risk of breast cancer, USPSTF recommends mammography every two years from ages 40 through 74.

What happens at 75?

That’s where individualized healthcare becomes especially important. USPSTF currently concludes that there isn’t enough evidence to determine the balance of benefits and harms of screening mammography in women 75 and older. That doesn’t automatically mean “stop.” It means the decision may require a conversation with your healthcare provider about your health, history, and circumstances.

Colorectal Cancer Screening

Colorectal cancer screening is recommended for average-risk adults from ages 45 through 75.

Between 76 and 85, the decision becomes more individualized. Overall health, previous screening history and personal preferences should be considered. Someone who has never been screened, for example, may have a different discussion with their provider than someone who has consistently completed recommended screenings.

And remember, colonoscopy, a procedure that uses a small camera to examine the inside of the colon and rectum, isn’t the only colorectal cancer screening option.

Depending on your circumstances, several stool-based and visualization tests may be appropriate. Your healthcare provider can help you determine which option and schedule are right for you.

Lung Cancer Screening

This is an excellent example of why age alone doesn’t determine whether you need a particular screening.

USPSTF recommends annual low-dose CT (LDCT) lung cancer screening for adults ages 50–80 who have at least a 20 pack-year smoking history and either currently smoke or quit within the past 15 years.

A “pack-year” helps measure lifetime smoking exposure. For example, smoking one pack a day for 20 years equals 20 pack-years.

If you don’t meet the eligibility criteria, that doesn’t mean you should simply request an annual CT scan “just to be safe.” Screening has potential harms as well as benefits, including false-positive findings, additional testing, incidental findings, overdiagnosis and radiation exposure.

More Testing Isn’t Always Better

It’s tempting to think that the more tests we have, the safer we are.

Medicine doesn’t always work that way.

Consider carotid artery ultrasound. The carotid arteries supply blood to the brain, and significant narrowing can contribute to stroke risk. It might therefore seem logical to routinely scan everyone’s carotid arteries as they get older.

However, USPSTF recommends against routine screening for asymptomatic carotid artery stenosis in the general adult population. This recommendation applies to adults without a history of stroke or neurologic signs or symptoms of a transient ischemic attack (TIA—sometimes called a “mini-stroke”).

That’s an important distinction between a screening test performed routinely in someone without symptoms and a test ordered because a healthcare provider has identified a clinical reason for it.

Another risk-based screening is abdominal aortic aneurysm (AAA) ultrasound. USPSTF recommends a one-time ultrasound for men ages 65–75 who have ever smoked. For men in this age group who have never smoked, screening is considered selectively rather than routinely.

Recommendations differ for women. Routine screening is not recommended for women who have never smoked and have no family history of AAA. For women ages 65 to 75 who have ever smoked or have a family history of AAA, there currently isn’t enough evidence to recommend for or against screening.

These examples reinforce one of the most important lessons in preventive healthcare:

The goal isn’t to get every test available. The goal is to receive the tests that are appropriate for you.

Don’t Forget the Basics

Advanced imaging and cancer screenings may seem like the most important parts of preventive care, but some of the simplest health checks still matter.

Blood pressure monitoring, cholesterol and cardiovascular-risk assessment, and appropriate diabetes screening can identify problems that might otherwise remain unnoticed. Medication reviews, smoking cessation, physical activity, nutrition, fall prevention, vision, hearing, dental health and mental wellbeing can also be important parts of healthy aging.

Your preventive-care needs won’t necessarily look exactly like those of your spouse, sibling, neighbor—or even someone the same age.

Your medical history matters.

So does your family history, previous screening history, vaccination record, medications, smoking history and other individual risk factors.

Make Preventive Care Part of Your Next Visit

You don’t have to memorize every guideline or keep track of every change yourself.

At your next healthcare visit, ask one simple question:

“Am I up to date on the vaccines and screenings that are appropriate for me?”

Bring your vaccination history if you have it, and make sure your provider knows about screenings you’ve received elsewhere. Ask whether anything is due now and when your next screening should occur.

And if a test or vaccine is recommended, don’t be afraid to ask why.

Understanding why something is recommended—and why something else isn’t—is part of making informed decisions about your health.

Growing older may change the preventive care you need. It doesn’t change the importance of taking an active role in it.

Staying informed, asking questions and working with your healthcare provider can help make sure your preventive care keeps pace with you.

Disclaimer

This article is for educational purposes only and is not a substitute for individualized medical advice. Vaccination and screening recommendations may vary according to age, medical history, risk factors, previous vaccinations and screenings, and other individual circumstances. Recommendations may also change as new evidence becomes available. Talk with your healthcare provider about which recommendations are appropriate for you.

Sources

  • Centers for Disease Control and Prevention (CDC). Recommended Adult Immunization Schedule, United States. Guidance for influenza, shingles, pneumococcal, RSV, Tdap/Td, and COVID-19 vaccination.
  • U.S. Preventive Services Task Force (USPSTF). Breast Cancer: Screening. Final Recommendation Statement, 2024.
  • U.S. Preventive Services Task Force (USPSTF). Colorectal Cancer: Screening. Final Recommendation Statement, 2021.
  • U.S. Preventive Services Task Force (USPSTF). Lung Cancer: Screening. Final Recommendation Statement.
  • U.S. Preventive Services Task Force (USPSTF). Osteoporosis to Prevent Fractures: Screening. Final Recommendation Statement.
  • U.S. Preventive Services Task Force (USPSTF). Abdominal Aortic Aneurysm: Screening. Final Recommendation Statement.
  • U.S. Preventive Services Task Force (USPSTF). Asymptomatic Carotid Artery Stenosis: Screening. Final Recommendation Statement.