Vaccines for over 60 in Thailand differ from other expats here as immune response weakens with age (this phenomenon is called immunosenescence), where you get the same infection but have worse outcomes. Most over 60 expats and retirees in Thailand are working off a schedule from their home country, and it doesn’t account for living here. This article covers: the core age based vaccines, plus the Thailand specific ones.
The core vaccines for over 60 in Thailand and internationally
Shingles (Shingrix)
One in three people get shingles in their lifetime and the risk climbs sharply after 50. Post herpetic neuralgia is the real reason to vaccinate, which is nerve pain that can last months or years. This is why it is a key vaccine for those over 60 in Thailand globally.
This vaccine has two doses, which should be given 2–6 months apart (or 1–2 months if immunocompromised). Common adverse effects include sore arm, fatigue, sometimes a rough 24–48 hours.
Influenza
You should get this vaccine annually because strains change frequently. If you are over 65, a higher dose or adjuvanted formulations are preferred at that age. This may be something you’d like to bring up with your doctor. Thailand has two flu seasons (June–Oct rainy season peak, plus a smaller cool season bump) which differs from the timing advice from Europe/US.
Pneumococcal
Pneumonia and invasive bacterial infections have higher stakes when you’re over 60, making it a key vaccine for over 60 in Thailand and elsewhere. MedConsult offers pneumococcal cover as a two-step course: one dose of Prevnar 13 (PCV13) first, then Pneumovax 23 (PPSV23) at least one year later, which widens protection from 13 to 23 strains of the bacteria.
If you already had PCV20 or PCV21 abroad, you don’t need anything further, ask before you pay.
Tetanus diphtheria pertussis (Tdap/Td)
You need a booster every 10 years. This vaccine for over 60 in Thailand is particularly important if you have exposure to: gardening, motorbike scrapes, animals or do any rural travelling.
RSV, the one most people over 60 haven’t heard of
This vaccine is recommended for everyone 75+, or between the ages of 50–74 if you have heart or lung disease, diabetes, or a weakened immune system. The RSV vaccine is a single dose, and does not need annual boosters.
What living in Thailand adds to your list
None of the vaccines for over 60 in Thailand below are ‘extras.’ The CDC’s Yellow Book guidance for Thailand recommends several of them specifically for longer-term residents, not just short stay tourists
Rabies (pre-exposure)
The misconception worth correcting first: the pre-exposure rabies vaccine does not make you immune. If you’re bitten or scratched, you still need to come in for treatment. What it does is change what that treatment looks like.
Without pre-exposure vaccination, a bite means rabies immunoglobulin plus a four or five dose vaccine course, started urgently. Immunoglobulin is expensive, not always in stock at every facility, and genuinely hard to source outside Bangkok and the major tourist provinces. With pre-exposure vaccination already in your record, you skip the immunoglobulin entirely and need only two booster doses.
For someone over 60 living here, that matters in a specific way: if you’re bitten in Chiang Rai, Krabi, or Isaan on a Saturday, the difference between “we need to find immunoglobulin” and “two shots and you’re fine” can be days of stressful travel.
Who should consider it: anyone living here long-term, especially if you walk, cycle, garden, or spend time outside built-up areas. Soi dogs are the obvious risk, but macaques around temples and viewpoints account for a significant share of exposures, and monkeys are far more likely than dogs to approach a person carrying food. Cat scratches count too.
Schedule: typically three doses over 21–28 days, or a shorter two-dose intradermal schedule, our GP will advise which suits your timeline.
Hepatitis A
Hepatitis A spreads through contaminated food and water in shellfish, salads, ice, unwashed produce, and food handlers. In Thailand it’s a background risk rather than a dramatic one, and most long term residents have eaten out thousands of times without incident. The reason to vaccinate anyway is age.
Hepatitis A is genuinely mild in children and often mild in young adults. It is not mild after 50. Older adults are far more likely to be hospitalized, more likely to develop jaundice severe enough to interfere with daily life, and the illness commonly drags on for six to eight weeks of fatigue rather than a few days. Fulminant liver failure is rare but concentrates almost entirely in older patients and those with existing liver disease.
Who should consider it: essentially every over 60 resident or frequent visitor who hasn’t already been vaccinated or had the infection. It’s one of the highest value per baht vaccines for over 60 in Thailand on this list.
A note on immunity: if you grew up in a country with poor sanitation, or you’re old enough to have had an undiagnosed episode of jaundice in your twenties, you may already be immune. A blood test for hepatitis A antibodies costs less than the vaccine course and can save you both doses.
Hepatitis B
Hepatitis B is where the standard over 60 advice and the reality of living in Thailand diverge most sharply.
International guidance treats hepatitis B as universal for adults up to 59 and risk based after 60, the logic being that a 65 year old in a low prevalence country with a settled home life has limited exposure. That logic doesn’t transfer well to Southeast Asia. Thailand’s hepatitis B prevalence is substantially higher than Western Europe’s or North America’s, and the exposures that matter to an older person are medical ones: dental work, minor procedures, injections, blood draws, a hospital admission after a fall, and any care received while travelling in the wider region.
Standards at reputable Thai facilities are high. But over a fifteen- or twenty-year retirement here, you will accumulate more medical and dental contact than you would have at home, and some of it will be in places you didn’t choose in advance.
The practical recommendation: rather than deciding between A and B, take the combined vaccine. Twinrix protects against both in a single three-dose series at 0, 1, and 6 months, giving long lasting protection against both viruses for roughly the price of the two separate courses. For an over 60 resident, it’s the more sensible default.
Already vaccinated? Many people vaccinated decades ago don’t know whether it took. An anti-HBs antibody test will tell you, and we can test for hepatitis A and B immunity in the same blood draw.
Typhoid
Typhoid is a food and water borne bacterial infection, and like hepatitis A, it’s a risk that scales with how far you get from Bangkok’s better restaurants and hotels. Street food, rural travel, small guesthouses, and provincial trips all raise exposure.
The reason it belongs on an over-60 list rather than a backpacker one is that typhoid in older adults carries a higher rate of complications (with intestinal perforation and bleeding are the serious ones) and older patients tend to be treated more aggressively and admitted more often. Antibiotic resistance in the region has also made treatment less straightforward than it was twenty years ago.
Who should consider it: residents who travel domestically outside major cities, anyone spending time in Isaan or rural provinces, and those visiting neighbouring countries, particularly Cambodia, Laos, Myanmar, and the Indian subcontinent.
Schedule: a single injection, with a booster roughly every three years if exposure continues.
Japanese Encephalitis
This is the one most short stay visitors genuinely don’t need and most longterm residents should think about properly.
Japanese encephalitis is spread by mosquitoes that breed in rice paddies and standing agricultural water, and it circulates in pigs and wading birds. Transmission is overwhelmingly rural. A tourist spending ten days between Bangkok, Phuket, and Chiang Mai’s old town has very low risk. Someone who has retired to Chiang Rai, Udon Thani, Hua Hin’s outskirts, or anywhere with paddy fields within a few kilometres has meaningfully more.
Two things make it worth taking seriously despite the low absolute risk. First, most infections are asymptomatic, but of the small proportion who develop encephalitis, roughly a quarter to a third die, and half of survivors are left with permanent neurological damage. There is no treatment; management is supportive only. Second, incidence and severity are highest at the two ends of life: children and older adults. Being over 60 moves you into the group that does the worst.
At MedConsult: Imojev, given as a single dose. Note that Imojev is a live vaccine, so it isn’t suitable if you’re significantly immunocompromised or on immunosuppressive medication, an important check in this age group. Our GP will go through your medication list first.
Dengue and why it’s not on this list
You’ll see the dengue vaccine (Qdenga) advertised widely in Bangkok, and it appears on our own price list. It is a genuinely useful vaccine. It is also not licensed for people over 60.
The Thai product information indicates Qdenga for individuals aged 4 to 60. Above 60, safety and efficacy have not been established, not because there’s evidence of a problem, but because the studies simply weren’t done in that age group. Qdenga is also a live attenuated vaccine, which raises additional questions for anyone with a weakened immune system.
This is frustrating, because dengue is the mosquito borne infection over 60s in Thailand are most likely to actually encounter, and severe dengue skews towards older patients and those with diabetes, kidney disease, or heart conditions. Unfortunately, the group with the most to gain currently has the least evidence to go on.
What to do instead: mosquito bite prevention is the whole strategy. Aedes mosquitoes bite during daylight, particularly early morning and late afternoon, and breed in standing water around the home, plant saucers, buckets, gutters, and water features. Repellent, covering up at peak hours, and eliminating standing water on your property are unglamorous but genuinely effective.
If you’re under 60 and reading this for a partner or parent, the vaccine may be appropriate for you. Ask us.
COVID-19
Recommendations have shifted since the pandemic years. Most health authorities have shifted away from universal booster mandates, favoring a shared decision making approach where you and your doctor determine the best course of action together. Where that lands for most guidance is that the clearest ongoing benefit is in adults 65 and older and in anyone whose immune system is significantly weakened, which covers a good portion of this article’s readers.
The practical questions worth discussing with a GP: when you last had a dose, when you last had COVID, your age and health conditions, and whether you’re about to do something that raises exposure such as long-haul travel, a cruise, a hospital stay, or extended time with grandchildren.
“I don’t know what I’ve already had”
Some options for those who don’t know what they’ve already had include: bringing in any records you have (from your home country GP, your yellow card or digital records). Antibody testing can be useful for hep A/B but less useful for: tetanus, pneumococcal where we normally just revaccinate.
As a general rule: for most adult vaccines, an extra dose is safer than a missed one.