Vaccines older adults need

By Emily Cheshire, DNP, MS, BS ~

Did you skip your flu shot last year? You are not alone.

The Centers for Disease Control and Prevention (CDC) report that about 30% of people 65 and older chose not to get a flu shot last year. And that’s just the tip of the proverbial vaccination iceberg. Flu is not the only vaccination that older adults are neglecting. According to the CDC, 43% of those 65 and older are not current on tetanus shots, and two-thirds didn’t receive the recommended shingles vaccine.

Vaccines are important for seniors as it protects them from a variety of illnesses including pneumonia, whooping cough, shingles, and the flu. Don’t be laid low this year because you forgot or didn’t have time to schedule an annual shot or booster.

As we age, our immune systems weaken, leaving us more susceptible to contracting these illnesses. So for many of us, the benefit of receiving a vaccination outweighs the disadvantages.

If you are vaccinated and still get the flu, or shingles, etc., your illness is probably going to be much milder than it would have been without the vaccine.

Keep in mind, no matter what your age, vaccines don’t necessarily provide complete protection. For instance, the flu shot reduces your risk of getting influenza by about half.

Flu Vaccine – why it works some years and not others
Influenza is a variety of viruses, not just one strain. So, every year scientists predict which strains will circulate in a given flu season and match the vaccine to what they think the flu viruses will be for that year. It’s a guessing game. Some years the scientists are right, and other years they are not.

Even though it can be hit or miss, the once-a-year shot is a “must” for older adults. According to the CDC, up to 85% of seasonal flu-related deaths occur in those who are 65 and older. In 2017, older adults made up about 58% of people hospitalized for the flu.

Can the flu shot give you the flu?
As the CDC states, the flu shot cannot cause the flu virus. However, the vaccine can trigger an immune response from your body causing you to have a few mild symptoms like achy muscles or low-grade fever. Or, you might have been exposed to the common cold or a rhinovirus immediately prior to receiving the vaccine. Because the timing is so coincidental, people often mistake the cause. Is there a better flu shot for seniors?
To improve your chances of escaping the flu, consider a vaccine created for seniors. Three vaccines are currently available that fit that bill.

• Flublok Quadrivalent and Fluzone High-Dose vaccines both appear more effective in older adults than the standard vaccine. Fluzone contains four times the amount of antigen than regular flu shots — making it 24% less likely for those vaccinated to catch the flu than those who received a standard shot. A New England Journal of Medicine study found that people 50 and older who received Flublok were 30% less likely to get the flu than those who received the standard vaccine.

• Fluad works on the immune system, prompting a stronger response than the traditional flu shot.

Flu season usually starts in late October, so early fall is the best time to receive your shot, which will provide adequate time to build immunity. Flu usually peaks in February and can circulate into April. Last year, Colorado saw an especially prolonged season with illness lingering into May.

Pneumococcal Vaccine
Pneumonia and influenza are two of the top killers of the elderly in the United States. Pneumococcal disease kills about 18,000 adults 65 + each year. Older adults are more at risk of having life-threatening complications from a pneumonia infection, so it’s important to get vaccinated around the age of 65. If you have a chronic illness such as asthma, diabetes, or kidney, heart or liver disease, talk to your physician or nurse practitioner about earlier vaccination.

Two vaccines protect against pneumococcal disease – Prevnar 13 and Pneumovax 23. The CDC recommends that all adults 65 and older have both shots, a year apart, with Prevnar first. Less than 20% of older adults get both. Check to see if you have received both vaccines.

Shingles Vaccine
Shingles, or herpes zoster, occurs when the chickenpox virus reactivates later in life. The condition often brings a blistering, painful rash, which usually scabs over in 10 days and clears up within a month. But for 20% to 25% of those infected, they continue to experience nerve pain for months or even years.

A new shingles vaccine developed at the University of Colorado Anschutz Medical Campus called Shingrix is more than 90% effective at preventing shingles. But you must get the two recommended doses (spaced two to six months apart) for protection. Because of high demand, there have been shortages. So, make sure to call ahead to ask if your pharmacy or provider has it in stock.

Tdap Booster
Making sure you’ve had the Tdap (tetanus, diphtheria, and pertussis) booster is especially important if you will be spending time with an infant. Pertussis, or whooping cough, is a highly contagious respiratory-tract infection that can be life threatening for babies. Even if you were vaccinated against whooping cough as a child, protection fades over time. If you had a Tdap 10 or more years ago, get a booster against tetanus and diphtheria, called Td.

What to do if you cannot track your vaccinations
Sometimes it’s hard to keep track of vaccinations we’ve received and those we have not. Because pharmacists, nurse practitioners and physicians can all vaccinate, we might not always remember when a vaccination was given.

If you’re unsure if you have been vaccinated or when, there’s no harm in being vaccinated again. If the idea of getting a shot bothers you, you can also request that the provider titer or test your blood to determine if you have the antibodies in your system. That will tell you if you ever received it or still have an immunity to the illness or not. Be aware, though, that you will have to return to get your results and/or get the shot if the results show you are not protected and need a booster.

Dr. Emily Cheshire is an assistant professor and clinical director at CU Family Health Clinic at Belleview Point, a University of Colorado College of Nursing nurse-led clinic in Parker. Emily holds a DNP, MS, BS, and presents in the community on a variety of topics that affect the elderly.

References:
CDC: https://www.cdc.gov/flu/prevent/misconceptions.htm


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