Which vaccines need a booster, and how long does protection last?

Which vaccines need a booster, and how long does protection last?

Not every vaccine needs a repeat dose. Some series last a long time, or for life, once they are complete. Others do need another shot later.

This overview is for healthy people in the Netherlands, based on the national immunisation programme (RVP), RIVM LCI guidelines and the Dutch travel health centre (LCR). It is information, not medical advice.

What is a booster?

A booster is an extra dose after a complete primary series, because protection wanes.

That is different from:

• the second or third dose of a series, such as hepatitis A or hepatitis B
• a yearly shot, such as the flu vaccine, because the virus changes
• extra doses after a bite or a wound, such as rabies or tetanus

Vaccines that do need a booster

DTP (diphtheria, tetanus, polio). Every 10 years after a complete series. Never vaccinated? Start with three doses. RVP says: after the DTP dose at age 14 you are protected for about 10 years against diphtheria and tetanus, and probably for life against paralysis from polio. LCR gives the same 10-year interval for travellers.

Pertussis (whooping cough). The acellular vaccine protects for about 4 to 6 years, according to LCI. Children get a booster at age 5. Adults have no fixed interval. If you are pregnant, RIVM advises a pertussis vaccine from week 22, in every pregnancy.

Typhoid. One dose protects for 3 years, says LCR. Protection is not complete. Repeat every 3 years if you are still at risk.

Japanese encephalitis. Two doses within a month give 2 years of protection. From one year later you can have a third dose. Then 10 years, according to LCR.

Tick-borne encephalitis. Three doses (months 0, 1 and 6). Then a booster after 3 years. After that every 5 years under 60, and every 3 years from age 60, according to LCI. For travellers aged 50 and over, LCR sometimes uses an extra primary dose.

Cholera. Ordinary travellers in the Netherlands usually do not get this. LCR says one vaccination protects for 6 months in children aged 2 to 5, and 2 years in older children and adults.

Meningococcal ACWY. One dose protects for at least 10 years, says LCR. For pilgrims to Mecca the certificate is valid for 5 years.

Yellow fever. Usually no booster. One dose protects for life in most people. The certificate has been valid for life since 1 July 2016. LCI does advise a repeat dose after vaccination in pregnancy, HIV, or laboratory work with the virus.

Rabies. Two doses before travel give lifelong basic protection, says LCI. No routine booster for travellers. After a bite, scratch or lick you always need extra doses.

Flu. Yearly, for people at extra risk. LCI says antibodies stay up for about 24 weeks. The vaccine wanes after about six months, and the virus changes.

COVID-19. An autumn round for risk groups. RIVM prefers 6 months after the previous dose, with a minimum of 3 months.

Pneumococcal. The older PPV23 vaccine is repeated every 5 years. After the newer conjugate vaccine PCV20, adults do not currently need a repeat dose, says LCI.

Vaccines that do not need a booster after the series

Hepatitis A. Two doses, at least 6 months apart. After the first dose: 1 year. After the second: 50 years, according to the public LCR page. LCI says healthy people do not need another dose. Models point to 50 years, possibly lifelong.

Hepatitis B. Three doses. Then lifelong in principle, if your body responded well. A booster is then not needed. Some jobs still use a blood test.

HPV. Two doses 6 months apart, in the RVP around age 10. LCI still sees good protection after 12 years. A later booster is not currently indicated.

MMR (measles, mumps, rubella). Two doses. Then probably lifelong against measles and rubella. For mumps this is less clear. After two doses, 99% are protected, says RVP.

Shingles. Two doses of Shingrix. RIVM says protection lasts at least 6 to 10 years. There is no standard third dose yet.

Dengue and chikungunya. LCR says it is still unknown how long vaccination protects.

Children: boosters in the national programme

Children already get repeat doses in the schedule. According to rijksvaccinatieprogramma.nl these include:

• 12 months: DKTP-Hib-HepB and pneumococcal
• 14 months: MMR and MenACWY
• 3 years: second MMR (some birth years later, via catch-up)
• 5 years: DKT
• 10 years: HPV, twice
• 14 years: DTP and MenACWY (DTP at 14 from birth year 2016)

After that, DTP is no longer in the childhood programme. For diphtheria and tetanus, a booster every 10 years remains wise, especially if you travel.

What this means for your records

Note the date, the vaccine name, and whether the series is complete. Then you can see if you need a booster, or only the next dose of the same series.

Vaxy keeps that on one phone. You are less likely to miss DTP after 10 years, or the second hepatitis A dose.

If you are unsure, ask your GP, the public health service or a travel clinic. People with a weaker immune system, pregnant people and some jobs often have a different schedule.

Short answers

Which vaccines need a booster? DTP every 10 years, typhoid every 3 years, plus tick-borne encephalitis, Japanese encephalitis and cholera. Flu and COVID-19 for risk groups every year.

How long does DTP last? 10 years against diphtheria and tetanus. Polio after the childhood schedule is probably lifelong against paralysis.

Do I need hepatitis A again later? Not after two doses. After the second dose, 50 years according to LCR.

Is yellow fever lifelong? Usually yes. Sometimes an extra dose is needed, for example with HIV.

Sources

• Dutch immunisation programme: schedule
• RVP: DTP vaccine
• RVP: MMR vaccine
• LCR: information on vaccinations
• LCI: tetanus
• LCI: hepatitis A vaccination
• LCI: hepatitis B vaccination
• LCI: yellow fever
• LCI: TBE vaccination
• LCI: pertussis vaccination
• LCI: HPV vaccination
• LCI: pneumococcal vaccination
• LCI: influenza vaccination
• LCI: COVID-19 vaccination
• LCI: rabies
• RIVM: COVID vaccination
• RIVM: shingles vaccination
• RIVM: vaccinations in pregnancy