Vaccines are not just a childhood past time. They play an important role in protecting you in every phase of life. And they become particularly important during the elder years when risks to certain diseases climb higher.
For older patients in assisted living or larger, more populated care settings, vaccinations are even more important, as exposure risk to communicable diseases like the flu and pneumonia are higher.
“Certain vaccines are proven to be safe and very effective in preventing several diseases that can have very serious implications for aging populations,” remarks Dr. Ariel Cole, geriatrician at Florida Hospital.
Dr. Cole explains how four important vaccines can help keep people age 65 and older as healthy and vibrant as possible.
Immunizations are even more important as we age
“As we age, the immune system declines in its ability to fight off infections, which makes people ages 65 and older more vulnerable to diseases like influenza, pneumonia, and shingles,” explains Dr. Cole.
“People of this age group are also at a higher risk for serious complications related to these diseases compared to younger populations — The flu in a 40-year-old is very different than in an 80-year-old,” she continues.
According to Dr. Cole, “While a 40-year-old might be in bed for a few days nursing the flu with rest, an 80-year-old is more likely to experience more serious symptoms that could lead to hospitalization, and in the most serious and unfortunate circumstances, can even be a cause of death.”
The good news is that to some extent, the flu, pneumonia, shingles and other diseases are preventable by working with your physician to develop the right immunization protocol and schedule for you.
Dr. Cole walks us through four important vaccines to consider if you are age 65 or older:
1. Influenza (flu) vaccine
The influenza (flu) vaccine is recommended for everyone ages six months and older, with a special emphasis for those ages 65 and older and people with certain medical conditions.
It is important to note that getting the flu vaccine decreases your chances of getting the disease, but it’s not one hundred percent effective all the time. This is because the flu vaccine is developed each year based on predictions of the top three to four strains that are anticipated to be the most prevalent.
Dr. Cole recommends, “There is always the chance that different strains will emerge during the flu season, but due to the relative safety of the flu vaccine, it is always good to get it as a preventive measure.”
2. Pneumonia vaccine
Pneumonia can be very serious for people in advanced age, but there are now two different vaccines to help reduce this risk: pneumococcal conjugate vaccine (PCV13 or Prevnar 13®) and pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax23®).
Both vaccines are recommended for people ages 65 and older, in babies and children under two, and for those between two and 64 who are at an increased risk for pneumococcal disease due to certain medical conditions, according to the Centers for Disease Control and Prevention (CDC).
“Having access to both vaccines — recommended one year apart from one another — is important, because getting the two vaccines expands the protection against different bacteria and viruses that can cause pneumonia,” explains Dr. Cole. “We’ve seen dramatic decreases in the rates of some types of pneumonia with both vaccines,” she adds.
3. Shingles vaccine
Shingles is a viral infection caused by the varicella-zoster virus — the same virus that causes chickenpox. If you’ve had the chicken pox, the virus remains inactive in your nerve tissue, leaving the possibility for it to reactivate as shingles.
Like chicken pox, shingles can cause blistering red rashes, but it usually only occurs on one side of the body. “It tends to be very painful and disabling while you have it,” explains Dr. Cole.
In the last 15 years, the vaccine to prevent chicken pox has dramatically reduced the rates of the disease, but if you had chicken pox before the vaccine was available, it’s possible to get Shingles even years down the road. If you have shingles, you can pass the virus on to others in the form of chicken pox if they have not been previously exposed or immunized.
“If you have had chicken pox and get the Shingles vaccine, it can’t take the virus away (it will always remain in your body) but it can reduce the chance of it from reemerging as shingles,” advises Dr. Cole.
In fact, according to Dr. Cole, “The shingles vaccine is about 50 percent effective if given between the ages of 65 and 70; effectiveness of the vaccine beings to decrease over age 70 because the immune system isn’t as effective in responding to it.”
She stresses that this why it’s so important to get your vaccines when your physician recommends them. “Don’t wait — get those vaccines,” she emphatically states.
4. Tetanus and pertussis
You might not be worried about stepping on a dirty nail, but that’s not the only way to get tetanus.
Unlike other vaccine-preventable diseases that spread from person to person, tetanus is caused by bacteria that is found in soil, dust, and manure. It enters the body through breaks in the skin, which is most often a cut or puncture from the contaminated object. While a dirty nail could be a source of tetanus, you could also get the bacteria from something as simple as gardening, or getting a cut or scrape and being in contact with soil/dirt.
“Most people have been vaccinated for tetanus at some point in their childhood, but they tend to forget that a booster is recommended every 10 years,” advises Dr. Cole. “Tetanus can be a deadly illness, so it’s important to stay up-to-date with this vaccine,” she adds.
Today, tetanus is often given with a combined pertussis booster. Pertussis, or whooping cough caused by the bacterium Bordetella pertussis, can be very serious — even deadly — for more vulnerable populations, such as infants, young children, and older adults.
“Tetanus pertussis is a recommended vaccine for infants, and it’s also recommended for any adult that will be in contact with very young babies because it is very contagious and causes a cough that can last months,” explains Dr. Cole.
“Even if you’ve had the vaccine during childhood, immunity from pertussis can wane over time, so any parent or grandparent should have this booster to prevent the transmission of the disease to an infant that they have a lot of contact with,” she continues.
Even healthy people need vaccines
“Many people still think of immunizations are for children; they just don’t think of getting these, or they think, “Why should I do that if I’m healthy?”.”
She explains that there are other barriers to getting vaccines among adults, which were outlined in an article published by The American Journal of Medicine.
This article reported that self-reported immunization rates for tetanus, influenza and pneumococcal vaccines were lower than the national guideline goal rates. Common consumer-reported barriers included:
Lack of physician recommendations
Incorrect assumptions (i.e. healthy people don’t need these immunizations)
Surveyed health care providers suggested additional barriers facing patients include:
- Fear of needles
- Perceived side effects
- Lack of insurance coverage
To increase immunization rates, it’s important to overcome these barriers, such as the widespread myth that vaccines are unsafe and commonly cause serious side effects.
Vaccines have minimal risks and are generally very safe
“The risks for vaccines among people age 65 and older are the same as any population, aside from the possibility of less effectiveness with age,” clarifies Dr. Cole.
“Serious complications are very rare — for most patients, the benefits significantly outweigh the risks involved,” she adds.
She explains that with the influenza vaccine, it is made with completely “dead” forms of the influenza virus, so there is no scientific way you can get the flu from the vaccine. This vaccine is generally safe for all patients over six months of age.
This is a little different from the herpes zoster booster against shingles, which has more contraindications because it is made with a weakened (not dead) form of the virus. “The shingles vaccine is not recommended for people with impaired immune systems or on medications like steroids that suppress the immune system,” she advises.
Talk to your doctor about your immunizations
It’s important to sit down with your doctor and open the conversation about vaccinations to customize an immunization schedule that is best for you.
“While the pneumonia vaccine is generally recommended for people over age 65, some younger people might need this vaccine because of a medical condition or situation; or, if you have potential exposure to hepatitis A or B like healthcare workers, this vaccine might be recommended,” Dr. Cole explains.
“Your doctor can assess your risk for diseases and help you to determine what is best for your preventive health,” she adds.
“I’m always happy when patients bring up the topic about vaccinations — we are always encouraging patients to be advocates for their health and vaccinations are such an important part of preventing serious diseases for lifelong wellbeing,” concludes Dr. Cole.
Learn more about Dr. Cole and geriatric care at Florida Hospital.