Updated November 20, 2023.
Clinical Editor: Megan Dodson, PA-C
As we age, our immune system weakens over time, putting us at higher risk for contracting certain diseases and becoming sicker from those diseases as a result. There are several diseases that are higher risk for seniors, including shingles, the flu, and more recently, COVID-19.
According to the CDC, almost 1 out of every 3 people in the United States will develop shingles in their lifetime, and that risk increases as you age. In recent years, an estimated 70 to 85% of seasonal flu-related deaths and 50 to 70% of seasonal flu-related hospitalizations have occurred in adults 65 years and older. And as we’ve seen over the past few years, COVID-19 related hospitalizations and deaths have also disproportionately affected the 65+ community.
These numbers could be drastically reduced through vaccination and prevention. Here are answers to a few common questions we receive from seniors and their family members about which vaccines for seniors are necessary.
What vaccines do seniors need?
The COVID-19 global pandemic gave rise to the need to develop vaccines to combat the outbreak of a novel coronavirus (known as SARS CoV-2), the virus that causes the disease COVID-19. Coronaviruses are a group of viruses that can be spread primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. Symptoms range from mild to severe, with a number of cases becoming fatal.
Older adults, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness. The Centers for Disease Control and Prevention (CDC) recommends that anyone over the age of 6 months receive one of the 3 COVID-19 vaccines available:
The CDC does not recommend one COVID-19 vaccine for seniors over another– the best vaccine is the one that is available to you. If you have questions about any of the vaccines, reach out to your primary care provider.
Everyone aged 5 years and older should receive one dose of the updated vaccine at least 8 weeks after their last vaccine.
People 65 years and older and those with immunocompromising conditions are also eligible to receive a second dose of the COVID-19 vaccine.
2. Influenza (flu)
The flu is a viral infection that is treatable, but can be deadly to vulnerable groups like seniors or adults living with chronic health conditions such as asthma and diabetes. One of the best ways to protect yourself from the flu is to get an annual flu vaccination. According to the CDC, adults 50+ should avoid the nasal spray influenza vaccine. It is preferred that older adults age 65+ receive one of the following vaccines for their flu shot:
High dose flu vaccine
- Brand name Fluzone High-Dose.
- Contains four times more antigen (the part of the vaccine that helps your body build up protection against flu viruses) than the regular vaccine. This vaccine contains more antigen so older people have a better immune response, and therefore, better protection against the flu.
Adjuvanted flu vaccine
- Brand name FLUAD.
- This is a standard dose made up of three inactivated flu vaccines with an adjuvant.
- An adjuvant is added to a vaccine to create a stronger immune response to vaccination.
Recombinant flu vaccine:
- Brand name Flublok Quadrivalent
- This vaccine has three times the amount of antigen compared to a standard-dose flu shot.
If none of these are available, it’s okay to get a regular (standard dose) flu vaccine. If you have questions about which vaccine is right for you, reach out to your primary care provider.
Shingles is a painful rash that appears on the body and is considered a reactivation of the chickenpox virus. Before the rash appears, people may feel intense burning and numbness where the rash usually develops. Others may experience symptoms such as a fever, headache and fatigue.
Shingles typically lasts between two and six weeks. However, treatment is available that can expedite the healing process. Prescription antiviral drugs used to treat shingles include:
- Acyclovir (Zovirax)
- Valacyclovir (Valtrex)
- Famciclovir (Famvir)
Since shingles can be especially painful, taking a cool bath or using a cold, wet compress may help relieve the itching and pain of the rash.
For seniors, complications from shingles can lead to serious, long-term health problems. The complications from shingles range from bacterial skin infections that can cause scarring to hearing and vision loss, nerve damage in the hands and feet and postherpetic neuralgia (PHN).
A vaccine, Shingrix, is available and is highly recommended for adults ages 50 and older before an outbreak occurs. The vaccine is given in two doses, two to six months apart. However, even if a senior has had shingles in the past, they can still take this vaccine to prevent a future outbreak.
Tetanus is an infection caused by a bacteria, Clostridium tetani , which can be found in the soil. The bacteria can enter the body through open wounds or cuts in the skin. Tetanus symptoms can include painful spasms, and may appear anytime from a few days to several weeks after the bacteria has entered the body.
Other common symptoms of tetanus include stiffness in jaw muscles, neck muscles and abdominal muscles. Tetanus may also lead to difficulty swallowing and painful body spasms caused by minor occurrences from loud noises to physical touch.
Not only is tetanus more severe in seniors, but its complications are also more serious. Depending on the severity of the muscle spasms, seniors are more susceptible to break bones. Tetanus infection in seniors may also block the main lung artery by a blood clot (pulmonary embolus). If the infection is left untreated, muscle spasms can become so intense that it may cause difficulty breathing, resulting in respiratory or heart failure.
According to a study done by the University of Tsukuba, Japan, tetanus is far more common in older adults, but can be prevented with vaccination. Adults should receive a preventive vaccine dose every 10 years, ensuring it is up-to-date if they ever get a cut in their skin, are bitten by an animal, etc. Adult vaccines for tetanus include:
- Tdap vaccine protects adults from tetanus, diphtheria and pertussis (whooping cough).
- Td vaccine protects adults from tetanus.
Tetanus vaccination is needed for some open wounds if it has been more than 5 years since the last dose of tetanus vaccine.
5. Whooping Cough
Whooping cough, also known as pertussis, is a contagious respiratory tract infection. Once infected, it usually takes about seven to 10 days for the first signs and symptoms to appear, but it can be three weeks or more. The symptoms may appear cold-like at first with symptoms that include:
- Runny nose
- Nasal Congestion
- Red, watery eyes
These symptoms worsen in the second week. Mucus accumulates inside your airways, causing an uncomfortable, “whoop”-sounding cough. Although many people do not develop the “whoop” characteristic, the coughing fits can be uncontrollable and painful.
Whooping cough is very common in children, so it’s a great idea for seniors to stay up to date on their vaccines if they are spending time with grandchildren. Additionally, seniors are still susceptible to whooping cough, especially if the vaccination has worn off. Some complications seniors may experience or develop include sleep apnea, insomnia, weight loss, pneumonia and eye infections.
Luckily, the whooping cough vaccination is safe and protects you from diphtheria and tetanus as well. It’s recommended for all adults to get a Tdap shot if they have never had one. Adults should then get a Td or Tdap vaccine every 10 years to stay up-to-date on vaccines and healthy (at least one of those boosters should be Tdap to make sure you’re still immune to whooping cough).
Pneumonia is an infection of the lungs that causes air sacs that may fill with fluid. According to the CDC, seniors 65 and older are more likely to get pneumonia. With symptoms ranging from mild to severe, it is important to make the distinction between pneumonia and its flu-like properties.
There are quite a few symptoms of pneumonia which include:
- Chest pain when breathing or coughing
- Fever, sweating and chills
- Low body temperature
- Nausea, vomiting or diarrhea
In seniors, an increasingly common symptom of pneumonia is confusion or changes in mental awareness. In terms of complications, pneumonia in the elderly can lead to several potentially severe health complications. These include:
- Bacteremia: A bacterial infection that can invade the body’s blood stream
- Lung Abscess: A pus-filled cavity in the infected lung area
- Acute Respiratory Distress Syndrome (ARDS): When the lungs become severely injured from pneumonia, respiratory failure may occur.
The pneumonia vaccine is an essential for seniors, especially if they have never received a pneumococcal conjugate vaccine before. There are different kinds of pneumonia shots for seniors, and the CDC recommends two pneumococcal vaccines for all adults 65 years or older:
- PCV20 (Pneumococcal conjugate vaccine): Protects against 20 strains of pneumococcal bacteria.
- PCV15 (Pneumococcal conjugate vaccine): Protects against 15 strains of pneumococcal bacteria.*
*If PCV15 is administered, the CDC recommends following the vaccine with a dose of PPSV23 (Pneumococcal polysaccharide vaccine) at least one year later, which protects against 23 strains of pneumococcal bacteria.
If you previously received a pneumococcal vaccine that was not PCV 15 or PCV20, talk to your healthcare provider about which pneumococcal vaccines you might need now.
What are some common side effects of these vaccines?
For most of the above vaccines, you might experience redness/swelling from the shot, headache, fever, chills, nausea, muscle aches and tiredness.
These vaccines address the most common, preventable diseases that affect older adults annually. Your doctor can advise on any other vaccines that may be needed. At your next appointment, be sure to ask your doctor which vaccines are right for you.
Stay informed on the key differences between COVID-19 and the flu so you can know what to look out for.
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