Immunization shots are not only for children entering school. The following are general recommendations for people age 19 and older from the Centers for Disease Control and Prevention. Tetanus and diphtheria: Adults should receive a primary series of immunizations for tetanus and diphtheria and then another dose if the last vaccination was received 10 or more years ago. Almost all reported cases of tetanus occur in people who have never been vaccinated or who completed their primary series of vaccinations, but did not have a booster vaccination in the last 10 years. Influenza: Influenza vaccination is recommended for adults 50 years of age or older, as well as for pregnant women, and for people with certain medical conditions (including heart disease, diabetes and AIDS), residents of long-term care facilities, and healthcare workers and employees of long-term and assisted living facilities. Pneumococcal disease: Adults age 65 or older, as well as younger people with medical conditions such as diabetes or chronic heart, lung, liver or kidney disorders need protection against pneumococcal disease. Hepatitis B: This vaccine is recommended for adults in certain high-risk groups, such as hemodialysis patients or patients receiving clotting factor concentrates, healthcare workers, persons with multiple sex partners, and men who have sex with men. Hepatitis A: This vaccine is recommended for persons with chronic liver disease or clotting factor disorders, men who have sex with men, users of illegal drugs and people traveling to n or working in n countries with intermediate or high rates of hepatitis A. Hepatitis A is the most common vaccine-preventable disease contracted by international travelers. Measles, Mumps, Rubella: Adults born during or after 1957 should receive at least one dose of the measles/mumps/rubella vaccine unless they have a medical contraindication, such as leukemia or lymphoma, are pregnant or are planning to become pregnant in the following four weeks. Having rubella (German measles) during pregnancy can result in severe birth defects, miscarriages, and stillbirths. Varicella: Vaccination against varicella (chickenpox) is recommended for people who do not have reliable documentation that they had the disease or the vaccination and who might be at high risk of exposure to the varicella zoster virus. This includes teachers of young children, daycare and healthcare workers, residents and staff in institutional settings, military personnel and international travelers. Women who are pregnant or planning to become pregnant during the next four weeks should not receive this vaccine. Although less than 5 percent of adults are susceptible to infections by the chickenpox virus, adults are much more likely to die from chickenpox than are children. Meningococcal: The adult immunization schedule recommends that certain people consider the meningococcal vaccine. These include college freshmen, especially those who live in dormitories, and travelers to countries in the "meningitis belt" of sub-Saharan Africa and Mecca, Saudi Arabia. For more information, visit the Centers for Disease Control website at www.cdc.gov/nip or call the National Immunization Hotline at 800-CDC-INFO (800-232-4636).