However, there are also vaccines that are crucial for older adults, including those that prevent shingles as well as booster shots to ensure ongoing protection against diseases like tetanus.

Medicare recognizes this and covers many vaccines during adulthood. Not all vaccines are covered in part or in whole by Medicare, but those recommended by the Advisory Council on Immunization Practices (ACIP) are more likely to be.

By July 2022, four were granted emergency use authorization (EUA) by the Food and Drug Administration (FDA):

Moderna: Available to people 6 months and older Pfizer-BioNTech: Available to people 6 months and older Johnson & Johnson (Janssen) (J&J): Available to people 18 years and older Novavax: Available to people 12 years and older

When the Coronavirus Aid, Relief, and Economic Security (CARES) Act was passed in March 2020, it directed that vaccines for COVID-19 would be covered for all Medicare beneficiaries. Not only that, there would be no cost-sharing for the vaccine itself or for the administration of the shot.

This was a break from tradition in that most vaccines are covered only when they are formally granted FDA approval rather than EUA. Of note, the FDA gave full approval for the Pfizer-BioNTech vaccine for people 12 years and older in July 2022. The FDA gave full approval for the Moderna vaccine for people 18 and older in January 2022.

The CDC recommends that everyone 6 months and older receive the COVID-19 vaccine and a booster if eligible.

Updated bivalent boosters from Pfizer-BioNTech and Moderna received EUA from the FDA. The CDC recommends one bivalent booster shot for all people over the age of 5, no matter the type of vaccine series initially received.

Children ages 5 years are only eligible to receive the bivalent Pfizer booster. Everyone ages 6 years and older can choose to get the Pfizer or Moderna bivalent booster.

In limited situations, a monovalent Novavax booster dose may be used in people ages 18 and older who are unable to receive an mRNA vaccine. In specific immunocompromised individuals, an additional primary mRNA dose is recommended.

In 2020, the CDC estimated 14,000 acute hepatitis B infections and 11,635 new chronic hepatitis B infections in the United States. In addition, the CDC estimated that 19,900 people were newly infected with hepatitis A in 2020.

Because almost everyone recovers from hepatitis A without treatment, Medicare Part B does not cover hepatitis A vaccination. It also limits coverage of the hepatitis B vaccine to those considered to be at a medium to high risk of infection or disease complications. These include people with:

Diabetes End-stage kidney disease Hemophilia Living with someone with hepatitis B

Healthcare workers who come into frequent contact with blood or bodily fluids are also considered to be at high risk.

The Centers for Disease Control and Prevention (CDC) estimates that there were around 5,000 flu-related deaths in the United States during the 2021-2022 flu season.

ACIP recommends that anyone 6 months of age and older gets vaccinated against influenza every year. This is especially true for older adults, people who are immunocompromised, or those with asthma, diabetes, or heart disease.

Accordingly, Medicare covers flu vaccination once every fall-winter season under its Part B benefit. The benefit will not cost you anything if your healthcare practitioner is a Medicare provider.

Three flu vaccines are recommended specifically for adults 65 and over and they are also covered by Medicare: Fluzone High Dose Quadrivalent, Flublok Quadrivalent, and Fluad Quadrivalent.

Tetanus is not common in the U.S. due in large part to widespread tetanus vaccinations in children and adults. Tetanus shots are first given during childhood (typically as part of DTaP or Tdap vaccination), while adults are encouraged to get booster shots every 10 years.

Medicare Part B pays 100% of the cost of a tetanus shot but only in specific cases. People with diabetic neuropathy, for example, often lack sensation in their feet. The shot is considered important for these individuals, as they may not realize that their foot has been contaminated.

In other cases, a person may sustain an animal bite or step on a nail and be given the shot afterward to protect against infection.

Unless there is an injury or a demonstrated need for the vaccine, you may need to turn to Part D to see if the tetanus vaccine is covered.

Indications for Tdap Vaccination

In addition tetanus shot, it is also recommended that you get either a Td ( which protects against diptheria and tetanus toxid) or Tdap (which protects against tetanus, diphtheria, and pertussis (whooping cough) booster as an adult, It is also recommended during the third trimester of pregnancy.

However, the Tdap vaccine is currently not covered under the Part B benefit and may or may not be covered by your Medicare Advantage plan or Part D plan. Check your plan’s formulary.

The pneumococcal vaccine protects against potentially deadly bacteria called Streptococcus pneumonia.

There are several different Pneumonia vaccines available. The CDC recommends PCV15 or PCV20 for people 65 and older who have never received a pneumococcal conjugate vaccine or whose previous vaccination history is unknown. In case PCV15 is used, PPSV23 should be administered one year later.

Keep in mind, however, that Medicare only pays for one dose of each vaccine. Any additional pneumonia shots, even at the recommendation of your healthcare provider, may come at an additional cost. This is the case even if you have an underlying lung condition, such as COPD, that puts you at higher risk for pneumonia.

Although shingles is typically self-limiting, it can cause a long-lasting pain syndrome called post-herpetic neuralgia in as many as 10% to 15% of cases. If shingles occurs near the eye or optic nerve, it can cause vision loss and even blindness.

There is one vaccine for shingles approved in the United States called Shingrix. It is an inactivated vaccine delivered in two doses two to six months apart.

Despite its high level of efficacy, Shingrix is not covered under the Medicare Part B umbrella. Certain Medicare Advantage plans or Part D plans cover one or both of the vaccines. Check your plan’s drug formulary for details.

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If you don’t know which vaccines you need, speak with your healthcare provider, who can review your medical records and help you catch up.