Everyone should think about:

Td

Protects against: Tetanus, a serious disease that causes painful tightening of the muscles and diphtheria, which causes a thick covering in the back of the throat.

Who should get it: Everyone, one every 10 years.

Why: Tetanus enters the body through a break in the skin, such as from a nail or a knife. It can lead to the locking of the jaw so a person can't open his mouth or swallow. Diphtheria leads to breathing problems, paralysis, heart failure and even death.

Cost: About $25 without insurance.

Tdap

Protects against: Tetanus, diphtheria and pertussis, also known as whooping cough. Pertussis is a highly contagious respiratory infection.

Who should get it: People between the ages of 19 and 64, especially child care workers and health professionals, should replace one of their Td doses with a dose of Tdap.

Why: Pertussis can be deadly in children. Adults who catch it can spread it easily to them. In adults, pertussis can cause a cough that lasts for months. Doctors said the cough can be so strong it can break blood vessels. There have been recent outbreaks in the United States.

Cost: About $50 without insurance.

Influenza

Protects against: The flu, a contagious respiratory virus that can cause severe illness and death.

Who should get it: Anyone who wants to protect himself from the flu should be vaccinated annually. Several high risk groups should make they receive a shot, including those over 50; pregnant women; people with chronic diseases such as HIV, heart disease, diabetes, liver disease or kidney failure; health professionals; child care workers; and college students living in dormitories.

Why: The flu kills about 36,000 people in the United States every year and hospitalizes 200,000 people.

Cost: About $15 without insurance.

Older adults should think about:

Pneumococcal

Protects against: Pneumonia, a bacteria that causes a high fever, cough and shortness of breath. It can lead to death.

Who should get it: People 65 and older, and people with chronic health problems such as diabetes, HIV, kidney failure or liver disease.

Why: Pneumonia kills more people in the United States each year than all other vaccine-preventable disease combined.

Cost: About $45 without insurance.

Zoster

Protects against: Shingles, a painful rash caused by the same virus that causes chicken pox. A person's immune system weakens and chicken pox comes back as shingles.

Who should get it: Everyone over 60 and people with chronic diseases. Health professionals should also consider it.

Why: Doctors say shingles is miserable for most people. The pain caused by shingles can remain with someone for months and in some cases it never goes away.

Cost: About $175 without insurance.

Younger adults should think about:

HPV

Protects against: Certain strains of the human papillomavirus, a sexually transmitted disease that causes genital warts and 70 percent of cervical cancers.

Who should get it: Women age 18 to 26.

Why: The vaccine prevents cancer and the embarrassment and irritation of genital warts. HPV can also cause abnormal pap smears, which require several expensive follow-up tests.

Cost: About $390 for the three doses without insurance.

Meningococcal

Protects against: Meningitis, a very serious bacterial infection. Although it isn't common in the United States, symptoms can progress rapidly and lead to death within 24 to 48 hours.

Who should get it: Anyone living in close quarters such as college students and members of the military, or people traveling to countries where meningitis is more common.

Why: Meningitis can lead to loss of limbs, permanent brain damage and death.

Cost: About $100 without insurance.

Varicella

Protects against: Chicken pox, a virus that causes an itchy rash all over the body.

Who should get it: Everyone 19 and older without evidence of immunity. People born in the United States before 1980 and people who have had a medical diagnosis of chicken pox are considered immune. Health care personnel, child care workers and pregnant women should not be considered immune just because of age.

Why: Chicken pox is much more severe in adults. About 1 in 500 children who get chicken pox end up in the hospital and this number increases to 1 in 50 for adults who get the disease.

Cost: About $200 for the two doses without insurance.

Other vaccines to consider:

Hepatitis B

Protects against: Hepatitis B, a serious disease caused by a virus that attacks the liver. It can cause cirrhosis of the liver, liver failure or death and is transmitted through blood.

Who should get it: Anyone who wants to protect himself from Hepatitis B, especially health professionals, public safety workers and people who work in schools. People with chronic diseases should also consider it.

Why: Hepatitis B can become a chronic disease. There are about 1 million people living in the United States with chronic hepatitis B and about 4,000 to 5,000 people die each year from it.

Cost: About $105 for the three doses without insurance. There is also a vaccine that protects against both Hepatitis A and B that costs $135 for the three doses.

Hepatitis A

Protects against: Hepatitis A, a liver disease caused by a virus. It can spread through feces or water or food contaminated with the virus.

Who should get it: High-risk groups such health care workers or IV drug users. If you have a liver disease or you are traveling to certain foreign countries, you should be vaccinated.

Why: Hepatitis A is the most frequently reported type of hepatitis in the United States. Although it usually does not cause long-term liver damage, about 100 people die every year from the disease.

Cost: About $50 for the two doses without insurance. There is also a vaccine that protects against both Hepatitis A and B that costs $135 for the three doses.

MMR

Protects against: Mumps, measles and rubella, which are all diseases that used to be common in the United States but have since been nearly eradicated because of vaccines.

Who should get it: Consult your physician. Physicians can check your immunity status to see if you need another dose.

Why: Outbreaks of these diseases still occur in the United States.

Cost: About $60 without insurance.

Vaccine cautions

- Talk to your physician if you are unsure of whether you need to be vaccinated or not.

- Children need some of these vaccines as well. Check www.cdc.gov for a childhood immunization schedule.

- If you have a chronic disease or you work in health care, you should consider getting many of these vaccines regardless of age.

- If you are pregnant or trying to get pregnant, it may be unsafe to get certain vaccines. Tell your physician you are pregnant before getting vaccinated.

- Everyone should keep a copy of their immunization records.

- Talk to your physician if you are unsure of whether you need to be vaccinated or not.

- Children need some of these vaccines as well. Check www.cdc.gov for a childhood immunization schedule.

- If you have a chronic disease or you work in health care, you should consider getting many of these vaccines regardless of age.

- If you are pregnant or trying to get pregnant, it may be unsafe to get certain vaccines. Tell your physician you are pregnant before getting vaccinated.

- Everyone should keep a copy of their immunization records.