For the 2026-27 season, CDC advises adults 65 and older to get a yearly flu shot, with a high-dose, adjuvanted or recombinant vaccine preferred, and the 2026-27 COVID-19 vaccine. Many also need a one-time RSV vaccine (all adults 75 and over, and some ages 50 to 74), a pneumonia vaccine, the two-dose shingles vaccine and a tetanus booster every 10 years. Medicare Part B pays for the flu, COVID-19 and pneumococcal shots, and Part D pays for the rest, but which ones a person needs depends on health history, so the doctor or pharmacist decides.
This page is a plain-language guide, not medical advice. Vaccine guidance changes from season to season, so every date below is the date shown on the official page we read on 12 October 2026. In New York you will see two sources: CDC, and the New York State and New York City health departments, which announced on 10 September 2026 that they endorse the recommendations of the American Academy of Family Physicians (AAFP) and other medical societies. They agree on most points for people 65 and over; where they differ, we say so.
Which vaccines do adults 65 and older need this season?
| Vaccine | What the sources say for age 65+ | Medicare part |
|---|---|---|
| Flu | One dose each season. High-dose, adjuvanted or recombinant preferred (CDC, 1 Sep 2026) | Part B |
| COVID-19 | 2026-27 vaccine recommended for all adults, especially 65 and older (CDC, 8 Oct 2026) | Part B |
| RSV | One dose for all adults 75 and older, and for ages 50 to 74 at increased risk (CDC) | Part D |
| Pneumococcal (pneumonia) | One dose of PCV20 or PCV21 if never vaccinated; depends on past shots (CDC) | Part B |
| Shingles (Shingrix) | Two doses, 2 to 6 months apart, ages 50 and older (CDC) | Part D |
| Tetanus (Td or Tdap) | Booster every 10 years (CDC adult schedule) | Part D |
Which flu shot should someone 65 or older ask for?
CDC’s 2026-27 guidance, published 1 September 2026, says adults 65 and older should preferentially get a high-dose, adjuvanted or recombinant flu vaccine (Fluzone High-Dose, Fluad or Flublok). If none is available, any other age-appropriate flu vaccine is acceptable, so nobody should skip a shot to wait for a preferred one. CDC’s page also says flu vaccination ideally happens in September or October and can continue while flu is circulating.
The AAFP guidance that New York endorses adds a fourth option for 65 and older, the mRNA vaccine mFlusiva. The CDC page we read did not mention it. AAFP also advises people 65 and over to avoid July and August shots unless later vaccination may not happen. NYC Health suggests asking your provider which one is best.
What is the COVID-19 vaccine guidance this fall?
CDC’s page, updated 8 October 2026, says a 2026-2027 COVID-19 vaccine is recommended for all adults 18 and older, and that it is especially important for people 65 and older. That page does not state a number of doses. The AAFP 2026-27 guidance, which NYC and New York State endorse, says adults 65 and older should receive two doses each season, the second 6 months after the first.
Three timing notes from our check on 12 October. The NYC Health Department clinic page said COVID-19 vaccines were not yet available at its immunization clinics and that the 2026-2027 vaccines were expected soon. The Medicare.gov COVID-19 page still described coverage of the 2025-2026 formula. And the AAFP document notes that since 2025 every licensed COVID-19 vaccine has been approved for adults 65 and older or younger people with a high-risk condition. Call ahead before going.
Who should get the RSV vaccine?
According to CDC’s RSV guidance for adults (page dated 24 February 2026), one dose is recommended for all adults 75 and older and for adults 50 to 74 at increased risk of severe RSV. RSV is not currently an annual vaccine, and people who already had one dose should not get another at this time.
CDC lists chronic heart, lung, kidney or liver disease, diabetes with complications or treated with insulin or an SGLT2 inhibitor, a weakened immune system, severe obesity and living in a nursing home among the increased-risk factors, and says other conditions or frailty can count. Late summer or early fall is the best time, though any time of year is acceptable. There are three licensed vaccines, Arexvy, Abrysvo and mResvia, and CDC has no preference among them.
How does the pneumonia shot schedule work (PCV20 and PCV21)?
CDC’s pneumococcal recommendations (page dated 25 February 2026) cover all adults 50 and older. What a person needs depends on which pneumococcal shots they already had, so bring the vaccine record. The rows below follow CDC’s page and its adult schedule notes (July 2025).
| Earlier pneumococcal shots | What CDC says |
|---|---|
| None, or history unknown | One dose of PCV20 or PCV21 (PCV15 is also allowed) |
| PCV15 was chosen | Follow with one dose of PPSV23 at least 1 year later |
| Only PCV13 | One dose of PCV20 or PCV21 at least 1 year after |
| Only PPSV23 | One dose of PCV15, PCV20 or PCV21 at least 1 year after |
| PCV13 and PPSV23, but PPSV23 not at age 65 or older | One dose of PCV20 or PCV21 at least 5 years after the last dose |
| PCV13 and PPSV23, with PPSV23 at 65 or older | Shared decision: PCV20 or PCV21, or no more |
| PCV20 or PCV21 already | No additional pneumococcal dose |
What about the shingles and tetanus shots?
For shingles, CDC says adults 50 and older should get Shingrix as two doses 2 to 6 months apart, there is no maximum age, and it can still help if someone has had shingles before. The CDC shingles page is dated 19 August 2025.
For tetanus, the CDC adult schedule says someone who has finished the primary series and has had at least one Tdap dose as an adult needs Td or Tdap every 10 years. Someone who never had Tdap should get one dose, then Td or Tdap every 10 years.
What does Medicare pay for?
Medicare.gov splits the vaccines between two parts. Part B covers the flu, COVID-19, pneumococcal and, for people who are eligible, hepatitis B shots. Part D, the prescription drug coverage, covers the other adult vaccines that CDC’s advisory committee recommends, including RSV, shingles and Tdap.
| Medicare part | Vaccines | What Medicare.gov says you pay |
|---|---|---|
| Part B | Flu, pneumococcal, COVID-19, hepatitis B (if eligible) | Nothing, if the provider accepts assignment |
| Part D | RSV, shingles, Tdap and other recommended adult vaccines | Nothing; no copayment or deductible for recommended vaccines |
Hepatitis B shots are covered if the person never completed the series, does not know their history, or has a medium or high risk, for example diabetes. Medicare.gov says flu coverage is usually one vaccine each season. If you have a Medicare Advantage plan, plans that include drug coverage also cover the RSV vaccine, per Medicare.gov, but confirm with the plan which pharmacies and offices are in network. See also what Medicare covers for home care.
Where can you get vaccinated in New York City?
| Place | What to know (NYC Health pages read 12 Oct 2026) |
|---|---|
| Doctor’s office, pharmacy, community clinic | NYC Health says flu vaccines are widely available at these. Call ahead for RSV, shingles and pneumonia shots |
| NYC Health Map | Searchable list of vaccination sites; updated through the season as sites receive vaccine. Filter by payment for low or no cost |
| NYC Health + Hospitals | NYC Health lists H+H sites for people with no or limited insurance |
| Fort Greene Health Center, 295 Flatbush Avenue Extension, 5th floor, Brooklyn | Mon to Fri, 8:30 a.m. to 3 p.m.; appointments recommended at 347-396-7943; adult flu (standard and high-dose), Tdap and pneumococcal listed; sliding scale fee if uninsured |
| 311 | NYC Health says to call 311 to find locations |
The clinic page lists no shingles or RSV vaccine, so for those, ask your doctor or pharmacy, where the Part D benefit applies. Our senior medical transportation guide explains rides to appointments.
What if the person is homebound?
We did not find a current NYC Health Department program that brings vaccines to homebound adults, so we do not list one. Practical steps instead:
- Call the primary care office first. Ask whether the practice or its visiting providers can vaccinate at home, and which vaccines.
- Call 311. Ask whether any in-home vaccination is available this season.
- Vaccinate the household. NYC Health says caregivers and close contacts of high-risk people should be vaccinated too.
Our guide to home health care versus home care explains which visiting services Medicare may cover.
What should caregivers and home health aides do?
The NYC Health flu page says people who care for, or are in close contact with, someone at high risk should get vaccinated. AAFP advises health care personnel to get a yearly flu shot and the updated COVID-19 vaccine, with RSV based on their own age and risk rather than their job.
For sick days, CDC says to stay home and away from others while symptoms last. Return to normal activities when symptoms are improving and there has been no fever for at least 24 hours without fever-reducing medicine, then take added precautions for 5 days. NYC Health adds a well-fitting mask for those 5 days and says to get tested for flu and COVID-19 if you have symptoms, because treatment is available for people at higher risk.
On a visit, watch for new fever, cough or confusion and tell the family and the doctor. NYC Health says to call 911 for difficulty breathing, a pale or blue color around the lips, confusion or severe dehydration. For agency staff, New York’s flu mask rule for unvaccinated personnel was not in force when we checked, because the state said on 23 April 2026 that flu was no longer prevalent; see the state flu mask page, which can change. Cold weather brings other risks, covered in our heat and cold safety guide.
Getting to the vaccine appointment: advice from our nurse director
Anna Klyauzova, RN, MSN, MPA, Director of Patient Services at ProLife Home Care, on what she sees in practice:
Most older New Yorkers get to appointments with a relative, a Medicaid ride or a regular taxi. The ride is rarely the hard part. The hard part is the visit: who helps at the front desk, finds the right office, explains the symptoms to the doctor and remembers what was said? That is tough for someone with dementia, limited mobility or limited English.
Medicaid transportation and Access-A-Ride get a person to the clinic. An escort stays with them. If your father walks slowly, forgets what the doctor said or gets lost in a big hospital, I would book an escort. Our Medical Escort service sends a trained home health aide (HHA) to the home, goes with the patient to the clinic, sits in on the appointment if the patient agrees, helps with the conversation, writes down the doctor’s instructions and brings the patient home. We can arrange the transport too. It is available in all five boroughs and Nassau County and is private pay.
We are a licensed home care agency in Brooklyn and Queens, licence #2572L001, New York State Department of Health. For the vaccines themselves, ask the doctor or pharmacist. If you want to talk through care at home for a parent or spouse, see our nurse services and our guide to medication management. You can reach us at (718) 232-2777 or through our contact page.
Vaccine guidance and Medicare rules change during the season. Everything above was checked on 12 October 2026 against cdc.gov, medicare.gov, nyc.gov, health.ny.gov and the AAFP 2026-27 guidance, using the dates shown on each page. This page is general information, not medical advice. Confirm which vaccines and how many doses are right for you with your doctor, nurse practitioner or pharmacist.
Frequently asked questions
Which flu vaccine is best for someone 65 or older?
CDC’s 2026-27 guidance prefers a high-dose, adjuvanted or recombinant flu vaccine for adults 65 and older. If none is available, any other age-appropriate flu vaccine is acceptable, and the person should not wait. The provider can help with the choice.
Does Medicare pay for the flu shot, COVID-19 shot and pneumonia shot?
Yes. Medicare.gov says Part B covers all three, and you pay nothing if the provider accepts assignment. Part B also covers hepatitis B shots for people who are eligible.
Does Medicare cover the shingles, RSV and Tdap vaccines?
Medicare.gov says Part D covers them, with no copayment or deductible for vaccines that CDC’s advisory committee recommends. That applies to Part D or a Medicare Advantage plan with drug coverage, so check with the plan.
Who needs the RSV vaccine?
CDC recommends one dose for all adults 75 and older and for adults 50 to 74 at increased risk of severe RSV. It is not an annual vaccine, and someone who already had a dose should not get another at this time.
I got a pneumonia shot years ago. Do I need another?
It depends on which one. Someone who already had PCV20 or PCV21 needs no more doses, per CDC, but earlier PCV13 or PPSV23 shots can mean one more dose or a shared decision. Bring the vaccine record to the doctor or pharmacist.
Can the flu, COVID-19 and RSV shots be given at the same visit?
NYC Health says the flu vaccine can be given at the same time as the COVID-19 vaccine and, if eligible, RSV vaccines. AAFP says they can also be given with other routine vaccines, such as tetanus and pneumococcal. The provider decides what to give on the day.
Where can a senior get vaccinated in NYC if they have no insurance?
NYC Health says people with no or limited insurance can get low or no cost vaccines, including at NYC Health + Hospitals sites, and can filter the NYC Health Map by payment. The Fort Greene Health Center immunization clinic uses a sliding scale fee for uninsured adults. You can also call 311.
