“Sarah,” a 68 year-old former smoker of 25 years was offered a pneumonia vaccine this week. Her response was, “I never had pneumonia and don’t need the vaccine.” Thankfully, we had the time to explain to her that as we age our immune systems weaken, making us more susceptible to not only getting pneumonia but also becoming sicker if we do. We explained that for people who have smoked for many years, the lining of the lungs that ordinarily helps filter germs causing pneumonia don’t work as well.
When we think about vaccines for seniors, we think about patients like “Sarah” and also about the overall statistics from the Centers for Disease Control (CDC). Since 2010, the CDC estimates that anywhere from 140,000 to 710,000 seniors were hospitalized from the flu, and about 12,000 to 56,000 seniors had flu related deaths.
These numbers could be drastically reduced through vaccination and prevention. We decided to answer a few common questions we receive from seniors or family members about which vaccines for older adults are necessary.
What vaccines do seniors need?
1. Influenza (flu)
The flu is a viral infection that is treatable, but deadly to vulnerable groups like seniors. There are different kinds of pneumonia shots for seniors, and the CDC recommends two pneumococcal vaccines for all adults 65 years or older:
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.
The CDC does not recommend one vaccine for seniors over the other. 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 manifestation of chickenpox. People with shingles may feel burning, numbness and sensitivity. Along with a rash, 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)
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. The vaccine is given in two doses, two to six months apart.
Diphtheria is an infection of the nose and/or throat. Bacteria from the infection attaches to the lining of the respiratory system and produces a toxin (poison) that can cause weakness, sore throat, fever and swelling in the neck. The infection makes it increasingly difficult to breathe and swallow.
For treatment options, there are two primary modes those afflicted with Diptheria should use via the CDC:
- An antitoxin, which stops the toxin produced by bacteria from damaging the body.
- Antibiotics that kill and get rid of the bacteria.
Complications from diptheria can have serious effects on seniors. For adults 50 and older, diphtheria can lead to permanent breathing problems, heart damage and nerve damage due to the spread of the toxin throughout the body.
A diphtheria vaccine is highly-recommended for seniors, and there are two options for seniors to get vaccinated per vaccines.gov:
- Tdap vaccine protects adults from tetanus, diptheria and whooping cough.
- Td vaccine protects adults from diptheria.
Tetanus is an infection that causes painful muscle spasms. As a bacterial infection, tetanus symptoms may appear anytime from a few days to several weeks after the bacteria has entered the body.
Some common symptoms of tetanus include spasms and 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 pulmonary embolism, a lung artery. If the infection is left untreated, muscle spasms can become so intense that it stops 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. Adult vaccines for tetanus include:
- Td vaccine
- Tdap vaccine
5. Whooping Cough
Whooping cough is a contagious respiratory tract infection. Once infected, it takes about seven to 10 days for the first signs and symptoms to appear. The symptoms may appear cold-like at first with symptoms that include:
- Runny nose
- Nasal Congestion
- Red, watery eyes
These symptoms worsen after about two weeks. 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.
While whooping cough is more common in children, seniors are still susceptible to it, 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 other infections as well. As mentioned before, the Tdap vaccine is a one-time booster that protects you from tetanus, diphtheria and whooping cough. Adults should then get the Td vaccine every 10 years to stay up-to-date on vaccines and healthy.
Pneumonia is an infection of the lungs that causes air sacs that may fill with fluid. 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 organs
- Pleurisy and Empyema: Inflammation of the lining of the lungs and infection of inflammatory fluids.
- 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. For adults, there are two vaccines that should be considered:
Protects against 13 strains of pneumococcal bacteria.
Protects against 23 strains of pneumococcal bacteria.
What are some common side effects of these vaccines?
For most of the above vaccines, you might experience redness/swelling from the shot, headache, chills, nausea, muscle aches and tiredness. Most of these are uncommon, but it’s important to talk to your doctor about preventable diseases and how it relates to your health goals as you age.
Sarah told me that no one had ever taken the time to explain the reasoning behind some of the recommended vaccines for seniors. After a discussion around which vaccines seniors need and how those aligned with her health goals, she said, “Well that makes sense,” and received a pneumonia shot.
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.
In your next appointment, be sure to ask your doctor which vaccines are right for you.