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Immunization Schedule for the Elderly

Table 1. Recommended immunization schedule for adult age less than 65 (not included vaccination recommendation for female of childbearing age) and adult age more than 65

Please read the table together with the foot notes below.


Adult age less than 65

Adult age more than 65

1. Influenza

1 dose annually

2. Tetanus,diphtheria, pertusis (TdaP)

Boost with Td every 10 years (after completion of 3 doses of primary vaccination)

3. Zoster  

1 dose

4. Pneumococcal polycaccharide (PPSV23)

1 or 2 doses

1 dose

5. Meningococcal

1 or more doses

6. Hepatitis A

2 doses

7. Hepatitis B

3 doses

Highlighted  For everyone who do not have previous infection or vaccination; zoster vaccine recommended regardless of prior episode of zoster

Highlighted Recommended if additional risk-factor is present (like occupational or lifestyle)
Footnote for Table 1.

  1. Influenza (flu) vaccination:

  • Annual vaccination against influenza is recommended for anyone above the age of 6 months

  1. Tetanus, vaccination:

  • Adults who are unsure or have incomplete primary vaccination should begin or complete a primary vaccination series.

  • For incomplete vaccination (less than 3 doses), complete the remaining doses.

  • Once  completed primary vaccination, booster should be obtained every 10 years.

  1. Zoster vaccination:

  • A single shot of zoster vaccination may be given for adults above the age of 60 regardless of prior episode of zoster infection.

  • Adult above the age of 60 with chronic medical conditions may be vaccinated unless they have severe immunodeficiency

  1. Pneumococcal polycaccharide (PPSV23) vaccination:

  • A single shot of pneumococcal vaccination is recommended for adult above the age of 65.

  • Pneumococcal vaccination should not be taken when receiving chemotherapy or radiotherapy for cancer treatment. The interval between vaccination and cancer therapy should be at least 2 weeks.

  1. Meningococcal vaccination:

  • A single shot of meningococcal vaccination is recommended for adult (regardless of age) who travels to countries in which meningococcal disease is hyperendemic or epidemic.

  1. Hepatitis A vaccination:

  • Hepatitis A vaccination is recommended for adults with:

    • Chronic liver disease

    • Travelling to countries in which Hepatitis A is highly or intermediately endemic.

  1. Hepatitis B vaccination:

  • Hepatitis B vaccination is given to new born babies in Malaysia. However, some people may not produce enough anti-body against Hepatitis B. It is recommended for adults whom do have immunity to Hepatitis B and has the following risk :

    • Chronic liver disease

    • End stage renal failure on regular hemodialysis

    • Travelling to countries in which Hepatitis B is highly or intermediately endemic

Where can I get the immunization?

In Malaysia, public hospital may provide certain immunization (such as influenza or pneumococcal vaccination) if you also have other chronic medical conditions that increase your risk of infection. Otherwise, you may have to get the immunization from private health facilities. Discuss with your doctor.


  1. Advisory Committee on Immunization Practices (ACIP) Recommended Immunization Schedule for Adults Aged 19 Years and Older. 2013. http://www.cdc.gov/vaccines/schedules/downloads/adult/mmwr-adult-schedule.pdf (accessed 25 April 2013).

  2. Centers for Disease Control and Prevention  http://www.cdc.gov/vaccines/pubs/downloads/f_imz_oldadults_pr.pdf (accessed 12 April 2013).


Last Review : 29 November 2013
Writer : Dr. Cheah Wee Kooi