The proportion of the world’s population aged 65 and above is rapidly increasing. Each year, Infections in this age group cause significant illness and death. Vaccinations are a front-line defense against these threats. Vaccinations are very safe, with only rare side effects. For most seniors, the risk of serious illness outweighs the small risk of vaccine side effects. Let’s look at the vaccines recommended for seniors.
Influenza (Flu): Influenza can cause serious symptoms such as fever, chills, sore throat, muscle aches, stuffy nose, and headaches. If it attacks the lungs, it can lead to serious complications such as pneumonia. Seniors are at higher risk for serious illness, especially if there are preexisting conditions such as diabetes, asthma or heart disease. Yearly flu shots are important for seniors, as immunity wanes over the months. New influenza strains emerge each year, so updated vaccines are needed to give the best protection against the current strains of the virus.
There are flu vaccines specifically designed for the senior population. The CDC
recommends seniors receive a higher dose vaccine, or an adjuvanted vaccine (one with an additional ingredient added that causes a higher immune response). These vaccines are potentially more effective in the older age group.
Medicare and private insurance will cover the cost of the flu vaccine. You can receive the flu vaccine at your provider’s office, local health department, or flu clinics in other locations such as schools, grocery stores, religious centers, or workplaces.
Pneumonia: Pneumococcal disease is a serious infection that can be transmitted through the air from person to person. It can cause pneumonia in the lungs and can cause serious illness and death (such as blood or brain infections), with the senior population being at higher risk. Those with underlying health issues such as diabetes or heart disease are at even greater risk. The CDC recommends a pneumonia vaccine for all adults aged 65 and older.
In the US there are two types of pneumococcal vaccines available.
Pneumococcal Conjugate Vaccines (PCV’s)
PCV15 (Vaxneuvance) protects against 15 strains of pneumococcal bacteria
PCV20 (Prevnar 20) protects against 20 strains of pneumococcal bacteria
PCV21 (Capvaxive) protects against 21 strains of pneumococcal bacteria
PCV 21 is a newer vaccine, so more data will be forthcoming as to its rate of effectiveness. However, Pneumococcal disease rates have decreased dramatically since the US started using these PCVs.
2. Pneumococcal Polysaccharide Vaccine PPSV23
PPSV23 (Pneumovax 23) helps protect against 23 strains of the pneumococcal bacteria.
Providers may give PPSV23 to clients who have previously received a PCV15, or the older PCV 13 vaccine. Check with your provider to determine which of these pneumonia vaccinations would be the best option for you.
RSV (Respiratory Syncytial Virus): RSV is a common respiratory virus that can be passed to others by droplets (airborne), or by contact with contaminated surfaces. It is usually a mild infection for adults but can cause serious illness in at-risk seniors with underlying conditions such as lung disease, heart disease, or weakened immune systems. Those living in nursing homes are at even higher risk.
The CDC recommends RSV vaccinations for everyone over 75, and those that live in nursing homes. They also recommend the vaccine for those 60-74 who have other confounding conditions such as lung and heart disease or weakened immune systems. They encourage getting the vaccine by early fall.
This is a change from last year, when the CDC was less urgent about the vaccine before RSV season, and advised persons 60 and older to ask their doctor if the RSV vaccine was a good choice for them. The CDC estimates that as many as 160,000 older Americans are hospitalized annually now from RSV with as many as 10,000 dying from an RSV infection.
COVID-19: COVID-19 is caused by a coronavirus called SARS-COV-2 that spreads easily from person to person. The COVID-19 virus can cause mild to moderate symptoms or can cause severe symptoms requiring hospitalization, intensive care, a ventilator for breathing assistance, and even death. If you have COVID-19, you will receive some “natural immunity” for a time, depending on the severity of your COVID-19 infection. Because the immune response to the virus is uncertain, getting a COVID-19 vaccine is a safe way to boost immunity. Waiting three months between having a COVID-19 infection and receiving the vaccine is recommended.
As the COVID-19 virus spreads, it has more opportunity to change and develop new variants. The same is true for the influenza virus. Therefore, it is important to have a yearly COVID-19 vaccination like an annual Influenza (flu) shot to protect you from the most recent COVID-19 variants.* The usual minimum interval between the two vaccinations is 2-6 months.
*COVID-19 recommendations can change rapidly, and booster doses might not follow a fixed annual schedule.
Tetanus: Tetanus (lockjaw) is a life-threatening illness caused by the bacteria Clostridium Tetani. Tetanus results from toxins produced by the bacteria that cause muscles to involuntarily contract and become rigid. The bacteria usually enter the body through a wound contaminated with soil or feces or a skin puncture with a dirty object such as a contaminated needle. Tetanus occurs mainly in those who have not been vaccinated or have not kept vaccinations up to date. The CDC encourages adults to receive a tetanus vaccination booster every 10 years.
The tetanus vaccine is not available alone but in conjunction with the diphtheria vaccine (Td), or a triple combination vaccine for tetanus, diphtheria, and pertussis (Tdap).
Private insurance usually covers these vaccines. If you have Medicare and receive the Td or Tdap from your provider's office, make sure they bill Medicare Part D for coverage.
Shingles: Chicken pox and shingles are related because they are both caused by the varicella-zoster virus. Once you have chicken pox, the virus remains dormant in your body and can reappear years later as shingles.
The shingles vaccine is the only way to protect yourself from a painful shingles outbreak. The vaccine is over 90 percent effective in preventing shingles and the accompanying nerve pain in individuals over age 50 with healthy immune systems.
About one in three adults will have shingles in their lifetime with the risk increasing with age. While the shingles vaccine protects against shingles, it also prevents the main complication of shingles known as postherpetic neuralgia (PHN). PHN is long-term nerve pain that remains after the shingles rash has subsided. PHN can remain for months or even years and the pain can be debilitating.
The shingles vaccine is called Shingrix. If you have had shingles, you can still receive the Shingrix vaccine to prevent future shingles outbreaks. The CDC doesn’t specify any time requirement between having shingles and receiving the Shingrix vaccine. Once the shingles rash has subsided, you can be vaccinated. The shingles vaccine is a two-dose series separated by two to six months.
Vaccines are very safe and can prevent or minimize several serious infections. If you have severe life-threatening allergies or have had an allergic reaction to vaccines in the past, discuss any future vaccinations with your primary care provider. The possible side effects of most vaccines are usually mild, only last a couple days, and can include:
· Redness, swelling, and tenderness at the injection site
· Feeling tired
· Fever
· Headache
· Nausea
· Diarrhea
· Muscle or joint pain
Serious conditions such as Guillain-Barre syndrome, have been reported very rarely in clinical trials but it is not clear that vaccines caused these conditions. If you have had Guillain-Barre syndrome, discuss any future vaccinations with your primary care provider.
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