Q: I am a fairly healthy 65-year-old on Medicare. Which vaccines should I get?

A: There are a handful of vaccines recommended for those who are 65 and older and in good health.

Most are given to boost the immune system, because there is a slight decline in your body’s ability to fight infection as you age. Discuss with your healthcare provider if these vaccines are right for you.

The vaccines most commonly recommended are for shingles (Zostavax), pneumonia (Prevnar-13 and Pneumovax-23), tetanus (mostly Tdap) and influenza.

Zostavax prevents the rash caused by shingles and, most importantly, it alleviates the severe pain associated with the virus.

Although it is recommended and approved by most insurance companies for those 60 and older, Medicare does not pay for it. The average out-of-pocket cost for the vaccine is $250.

If you have a Medicare supplemental policy, it might cover a small portion.

Ideally, you should get the shingles vaccine before you begin receiving Medicare. It is a onetime vaccine, regardless of whether or not you have had shingles in the past.

Pneumovax-23 is recommended one time after age 65 to cover 23 important strains of pneumococcal pneumonia, which is one of the most dangerous pneumonias.

Some patients with certain chronic health issues might get this vaccine earlier, but it will need to be repeated once after age 65. Medicare covers the Pneumovax-23 vaccine.

Prevnar-13 was recommended in 2014 for patients 65 and older. It covers the same strains of pneumococcal pneumonia as Pneumovax-23, as well as a couple extra strains.

If you have not received the Pneumovax-23, you should start with Prevnar-13. The vaccines are usually taken about a year apart. Prevnar-13 is a onetime vaccine that is covered by Medicare after age 65.

The Centers for Disease Control and Prevention recommend everyone have a tetanus booster, or Tdap, every 10 years. Most people should receive a onetime Tdap to protect against pertussis (whooping cough).

Medicare might not cover Tdap unless other medical events occur.

An influenza or flu shot is recommended yearly for most age groups. Medicare and most insurance plans cover it.

The varicella (chickenpox) vaccine is also recommended but might be unnecessary for most adults.

About 99 percent of people over the age of 40 have had chickenpox and carry immunities against the virus.

Talk to your healthcare provider about whether you need the varicella vaccine, or any other vaccines.

Dr. William Kyle is an internal (adult) medicine physician in practice at Memorial Health University Physicians-Legacy Center in Okatie.