Vaccines

As you age, your immune system weakens, leaving you more prone to illnesses that lead to complications, hospitalization and even death. You may think that you’re immune because you received your recommended shots in childhood or were exposed to certain diseases, but this may not be enough to protect you now. To help ward off sickness (and to help prevent the spread of disease to others), you need new vaccinations and boosters throughout your life. Preventative vaccines for adults over 65 include influenza, pneumococcal, herpes zoster (shingles) and Tdap (tetanus, diphtheria and pertussis, aka whooping cough). These shots are routinely recommended for most adults, but you do need to talk with a doctor about your personal health condition before getting any vaccination.

A new flu vaccine is created each year based on research that attempts to pinpoint which strains of the virus will be most common. Also, the vaccine isn’t designed to be effective long-term. That’s why you need a new shot each year, preferably in early fall, before the onset of influenza season (though it’s never too late for the vaccine). Adults over 65 account for 85 percent of flu-related deaths and 58 percent of hospitalizations. Yes, it’s true that the shot only cuts your risk of getting the flu by 40 to 60 percent, but if you do get sick, the vaccine can help prevent severe complications. There are actually several flu shots designed specifically for people over 65: Fluzone High-Dose, Fluad and Flublok Quadrivalent. Before you get your shot, check with your doctor or pharmacist to see which of these options they recommend, based on your medical history and health.

According to a report in Vaccine, the top, peer-reviewed journal on immunization, the rates for vaccination—not only for flu, but for other recommended shots—for people of color in the United States are low, and with no sign of improvement. This seems to be particularly true for people of color who also have chronic health conditions. Researchers listed many reasons why this may be happening, two of which are lack of access to a regular health care provider and lack of medical insurance. There may also be cultural differences in how people view and trust immunization. Proponents of vaccination have conducted immunization drives and information campaigns but are concerned that they are not meeting target numbers and that the low rates are putting all older adults, not just those who aren’t white, at risk.

The CDC now recommends Shingrix as the preferred shingles vaccination for people over 50, saying it’s more than 90 percent effective at preventing the disease, compared to Zostavax’s 51 percent effectiveness rate. Plus, Zostavax is only effective for five years. If you’ve already had a Zostavax shot, you can still get Shingrix. Shingles (herpes zoster) is a reactivation of the chickenpox virus. In addition to two to four weeks of painful blisters, shingles can cause nerve pain that lasts for months or years. You are not immune to shingles even if you had chickenpox.

Chronic conditions can weaken your overall immune system, making you more susceptible to infections and serious complications from diseases. A pneumococcal infection can cause pneumonia, meningitis and blood infections that can invade other parts of your body and lead to very serious, sometimes fatal, complications. Older adults are more likely to develop these problems than younger adults. There are two pneumococcal shots: PCV13 (Prevnar 13) and PPSV23 (Pneumovax 23). The CDC recommends both for all adults over 65. If you have a chronic illness, a compromised immune system or cochlear implants, or if you smoke cigarettes, you should talk with your doctor about getting the vaccines before age 65. Both vaccines have fairly high rates of protection against invasive pneumococcal diseases in the older population.

If you haven’t had a booster, you may be putting your grandchildren at risk for whooping cough (pertussis). You can have this highly contagious respiratory illness without even realizing it, and it can be deadly to babies. DTaP is part of routine childhood immunization, but the protection fades over time, leaving you vulnerable to infection. Doctors recommend that all adults receive a one-time Tdap shot, a variety of the vaccine formulated for teens and adults. After that, you’ll still need a Td (tetanus and diphtheria) booster every 10 years.

Yes, do talk with your doctors about your health before traveling, but if you need shots, you’ll need them four to six weeks before your departure date. Travel can be an amazing experience, but it can also expose you to illness. You’ll want to be up to date on routine shots, including influenza, measles/mumps/rubella (MMR) and tetanus. Depending on your destination, you may also need vaccinations for hepatitis, typhoid, polio and more. Some shots required for travel in certain countries, like yellow fever, may be risky for people over 60 or with health conditions that suppress immunity. So, when you’re planning a trip, check to see what vaccines may be recommended and required—the Centers for Disease Control website has a useful tool for checking this—and speak with your doctor well before you book your tickets.

If you were born in the United States before 1957, you probably were exposed to measles during childhood, making you immune to the disease. After that year, the measles vaccine became routine, and those who have received it are also considered to be immune. This means most adults are probably in the clear. However, if you don’t know if you had the shot, and if you don’t remember having the measles as a child, it’s best to get vaccinated no matter how old you are. Measles can be deadly, particularly for people with compromised immunity, and it’s incredibly contagious. The virus can live up to two hours in the air, which means you can catch it if you just walk into a room (or plane) where an infected person had been earlier. Many countries are requiring measles vaccinations for travelers, and recent outbreaks in the United States have upped concerns about the disease at home. So, if you’re not sure about your immune status, you may want to get the shot, especially if you have grandchildren in your life.

States have vaccination requirements for school-age children, but adults aren’t legally required to get shots. Adults who work in schools, medical facilities, adult day care and nursing homes are usually required to have certain vaccinations under the conditions of their employment, for the safety of the children, patients and residents (as well as for themselves). Some rehabilitation facilities also require residents to have certain vaccines. Otherwise, federal and state governments strongly encourage adults to have recommended shots, but that remains a personal choice.

When it comes to studying vaccines, for the most part, adults over 65 have been lumped into the same research category as anyone older than 18. This means there is little specific guidance when it comes to the administration and effectiveness of vaccines for older adults. Much of the research used to support this quiz, for example, considered adult age but not specifically older adults; it is the best advice available at this time and offers valid guidelines for immunization. But geriatricians say it’s important to understand how vaccines work throughout a person’s lifespan. Older adults are especially susceptible to infection and complications that can affect daily life and their independence, so protection from disease is particularly important. Doctors hope that researchers will look at adult age differences in future studies to maximize disease protection and control throughout life.