Older adults and vaccines: Experts on staying up-to-date on your shots

It’s not a long or especially attention-grabbing medical laundry list, but it is a vital one for those heading into their golden years.

It’s the list of must-have vaccines for older adults. Some of them are a continuation of protection afforded in earlier life. Others are designed to kick in with advancing years as immune systems weaken and the impacts of chronic health conditions weigh more on overall health.

COVID-19 vaccine

Without exception, both kinds are important in helping ensure a longer and less disease-ridden life, medical experts say. But some decry how vaccine hesitancy and pushback have grown, particularly since COVID-19 took hold.

“I’ll be honest with you,” said Cecil Bennett, MD, a family medicine physician in Newnan. “Right now it’s a struggle to convince my seniors to stay on a vaccine schedule because of the misinformation that’s out there on the COVID vaccine.”

Danny Branstetter, MD, Medical Director of Infectious Disease for Wellstar Health System, indicated that that makes dispensing accurate information to patients a crucial matter.

“So I continue to re-educate and address the benefits and the whys behind these vaccines and set the appropriate expectations,” he said.

“For vaccines such as your tetanus and pneumonia, those are really great at preventing significant invasive disease,” he said. “We may still get a mild infection with those like a mild cold, symptoms from the pneumococcus, and may actually have a little bit of a pneumonia, but we don’t develop complications like bloodstream infections and heart infections.”

Preventing and lessening disease are topline concerns for federal and local health officials and medical professionals who have grappled with COVID-19 for three years.

The Centers for Disease Control and Prevention’s recommendations on how older adults should respond to COVID-19 starts off with a blunt warning: “Older adults are more likely to get very sick or die from COVID-19.”

Stay current, they say, on COVID-19 immunizations and boosters.

That by no means supersedes concern over keeping current on other immunizations older adults need.

“Outside of the last three years where we usually start-and you can probably guess-is that annual flu shot,” said Jonathan Marquess, PharmD, CDCES, FAPhA, who with his wife owns more than a dozen independent pharmacies. He is also the Georgia Pharmacy Association Vice President of the Academy of Independent Pharmacy.

Flu vaccine

And similar to COVID-19, health experts sound the alarm when it comes to older adults and the flu. According to the CDC, it’s estimated that in recent years, 70% to 85% of seasonal flu deaths have occurred in people ages 65 and above.

The National Institute on Aging says older adults are in the crosshairs both because of weakened immune systems that come with age and with a greater likelihood of chronic conditions that can set the stage for serious complications.

“Anywhere between 30 and 50 thousand Americans die each year due to the flu,” Bennett said. “So getting a shot is critical to preventing complications, hospitalizations and death.”

Older adults have gotten a boost in fighting off the smart and adaptable virus.

Several different types of flu vaccine are available, but the CDC recommends that people age 65 and older specifically get a higher-dose flu vaccine or an adjuvanted vaccine such as Fluzone High-Dose Quadrivalent, which has a higher amount of antigen that helps create a more robust immune response.

Branstetter says the optimum time to vaccinate for the flu is in the fall.

“Thinking about timing every fall I call it the ‘boo flu’ so around Halloween (so) make sure you get your influenza vaccination done. The other thing to remember is that it takes about two weeks after the final dose before you get full protection.”

That fall target time gives older adults optimum protection well ahead of the traditional heart of the flu season, which medical professionals say peaks between December and February.

Shingles vaccine

Shingles can be a painful malady for older adults. Cleveland Clinic says it’s caused by the varicella-zoster virus, which is the same one that causes chicken pox. It’s ugly, appearing as a raised rash that turns into fluid-filled blisters.

One preventative shingles vaccine is authorized for use in the United States: Shingrix. It’s given to adults 50 and over, as the risk of developing the condition increases as one gets older. Doctors administer two doses of the shot, typically two to six months apart.

Pneumococcal and Tdap vaccines

In what by now seems a familiar litany, older adults need to keep up with the pneumococcal vaccine because while it’s fairly common in young children, the risk of serious illness and death is greatest in adults over 65. Two varieties of pneumococcal vaccines are approved for use in the U.S.: conjugate vaccines and polysaccharide vaccines. The timing of dosing is dependent on several factors, including what variety of the vaccine an older adult might have gotten previously, according to the CDC.

The Tdap vaccine, which according to the CDC is able to prevent tetanus, diphtheria, and pertussis, is also a key to older adults’ continued health. The vaccine is recommended for adults, once each decade. That’s a long gap, so how can older adults keep track of those effectively — and other needed shots?

As Bennett puts it, “really the first thing is to collect as much information as possible. You can get some information from a prior group provider or pharmacies. Pharmacies are required to keep data for an extended period. When in doubt we give the vaccine again.”

Marquess backs that up, saying that “it’s certainly one that can slip by.”

He and other medical officials say that the great majority of any side effects are mild and are limited to things such as headache, mild fever, and muscle aches as well as pain at the injection site. Serious side effects from flu vaccines are exceedingly rare, says the CDC. For example, the risk of Guillain-Barre Syndrome, which can sometimes cause paralysis, is estimated at fewer than 1 or 2 cases per million shots. The agency also says that anyone with such symptoms as difficulty breathing, swelling around the eyes or lips, or weakness should seek medical attention.

Branstetter says that said more vaccines you get at once, the greater the possibility that that reaction will arise.

Of utmost importance, Marquess said, are trust and a good relationship.

“It is very important having that personal relationship with your doctor. And I put the same importance on having a personal relationship with your pharmacist.”

He said among the reminders they employ are calling people on their birthdays to remind them of pending immunizations.