Immunization Guidelines for Older Adults
A vaccine is a medication given to produce antibodies against a certain infection to prevent that infection from occurring. The vaccination program in the US has dramatically reduced the prevalence of once-common diseases, including measles , mumps , and polio . Today, many vaccines are administered during childhood and adolescence, but some are necessary in adulthood. Many adults are not aware that they could still benefit from new vaccinations and “booster” doses of previously administered vaccinations.
Why Get Vaccinated?
Older adults are particularly susceptible to some of the infections that can be prevented by vaccination. In fact, complications from influenza (the flu) and pneumonia —both diseases that can be vaccinated against—are a leading cause of death in older adults. Fortunately, getting the recommended vaccines can greatly reduce the risk of vaccine-preventable infections.
Another reason for getting recommended immunizations is to protect your family, friends, and others around you from becoming ill. Many vaccine-preventable infections can be spread from person to person, so getting vaccinated helps protect anyone who comes in contact with you from contracting these diseases.
Recommendations
If you are an older adult, you may need to get some or all of the following vaccines:
Influenza
Like many diseases, the flu is usually mild in younger people, but can be life-threatening in older adults. Symptoms of the flu may include fever, chills, dry cough, sore throat, congestion, headache, muscle aches, and fatigue.
Since the flu virus changes all the time, the US Centers for Disease Control and Prevention (CDC) recommends a yearly influenza vaccine for all adults age 50 and over. You should get the vaccine before the flu season starts—October or November.
Pneumococcal Disease
Most people associate pneumococcal disease with the lung disease pneumonia, but it can also cause meningitis , infections of the blood and middle ear , and sinus infections .
The CDC recommends that people age 65 and older get the pneumococcal vaccine . Most people need only a single dose. But if you received the shot more than five years ago and were younger than 65 when you received it, you may need a second, or “booster” dose. It is generally not necessary to receive more than two doses of the current vaccine.
Tetanus and Diphtheria
Tetanus (lockjaw) is caused by a bacterium that can enter the body through a scratch or wound. Symptoms of tetanus include headache, jaw stiffness, neck stiffness, difficulty swallowing, muscle spasms, sweating, and fever. Tetanus is a serious disease that can result in death.
Diphtheria is also caused by a bacterium, and it can be spread from person to person. Signs of diphtheria include a severe sore throat, fever, enlarged lymph nodes, and/or sores on the skin. Diphtheria can lead to breathing problems, heart failure, paralysis , and even death.
Most people received a series of diphtheria-tetanus-pertussis (DTaP) vaccines as children. They will need to receive a Td booster every 10 years throughout their lives and when they experience a severe cut or puncture wound and have not had a booster in the past 5-10 years. Adults who have not received the DTaP series will need to have a series of three doses of DTaP.
Varicella (Chickenpox)
Varicella (chickenpox) is a very contagious viral infection that can be spread through the air or by touching a chickenpox sore. Chickenpox is a relatively mild disease in children, but it can be serious—even life-threatening—in older adults. Symptoms of chickenpox include aching, tiredness, fever, and sore throat, followed by a widespread, itchy, blister-like rash.
People who have had chickenpox are protected from getting it again. But for adults who never had chickenpox, two doses of the varicella vaccine are recommended, 4-8 weeks apart.
Shingles
The shingles vaccine is the new kid on the block for older adults. Shingles is a painful and sometimes severely debilitating flare-up of chickenpox .
Older people are susceptible to getting shingles, as well as certain high-risk groups (eg, those with compromised immune systems). Severe complications include vision problems or blindness, pneumonia, brain inflammation, and hearing problems. The CDC now recommends that adults aged 60 and older get the shingles vaccine. Research is still being done to determine whether booster vaccines are necessary.
Measles, Mumps, and Rubella (MMR)
While they were once very common diseases, measles, mumps, and rubella (MMR) are now very rare, thanks to widespread immunizations against them. Measles is a viral respiratory disease that may lead to diarrhea , ear infections, pneumonia, swelling of the brain, seizures, and death. Mumps is a viral disease of the lymph nodes that can cause meningitis, inflammation of the testicles, ovaries, or pancreas, and permanent deafness. Rubella is a viral respiratory disease that can cause birth defects, including deafness, cataracts , heart defects, mental retardation , and liver and spleen damage.
Everyone born in the US after 1957 should have received an MMR vaccine sometime after age one. People born before 1957 who have never had measles, mumps, or rubella should talk to their doctor about getting the vaccine.
In addition to the vaccines listed above, people who experience unexpected exposures to a virus, are traveling abroad, are employed in certain occupations, or who have certain medical conditions may need additional vaccines. Some people should not receive certain vaccines, either due to allergies or due to a medical condition. Talk with your doctor to see if you should be considered for any other vaccines.
Paying for Vaccines
Medicare , which is the health insurance program that covers almost all Americans age 65 and older, pays 100% of the cost of influenza and pneumococcal vaccines. If you are not covered by Medicare, check with your state health department to see if they offer free vaccines.
RESOURCES:
Centers for Disease Control and Prevention
http://www.cdc.gov/
National Institute on Aging
http://www.nia.nih.gov/
CANADIAN RESOURCES:
Healthy U
http://www.healthyalberta.com/
Insurance-Canada.ca
http://www.insurance-canada.ca/index.php/
References:
McCoy K. Influenza vaccine. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated February 2008. Accessed August 27, 2008.
Recommended adult immunization schedule. October 2007-September 2008. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/recs/schedules/downloads/adult/07-08/adult-schedule.pdf. Accessed August 27, 2008.
Recommended Adult Immunization Schedule - United States, 2010. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/mmwr/PDF/wk/mm5901-Immunization.pdf. Updated January 2010. Accessed June 22, 2010.
Shots for safety. National Institute on Aging website. Available at: http://www.niapublications.org/agepages/shots.asp. Updated February 2008. Accessed August 27, 2008.
Vaccine-preventable childhood diseases. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nip/diseases/child-vpd.htm. Updated January 2007. Accessed August 27, 2008.
Why should older adults be immunized? 100% Immunization Campaign website. Available at: http://www.immunizeseniors.org/website/o1_why.htm. Accessed July 3, 2006.
Last reviewed June 2010 by Brian P. Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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