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“As humans, our greatest enemies are the smallest organisms and particles on the planet,” says Krista B. Ellow, Pharm.D., author of Not Another Prescription for My Chronic Condition. Furthermore, as we age, our immune system weakens, making us more vulnerable to illnesses we encounter in daily life, at work, or on vacation. Most people were immunized against common diseases in childhood, but many don’t realize their protection for some illnesses has worn off by the time they reach middle age.
“When I think about immunizations for older adults, I approach it with a very common sense perspective,” says Dr. Ellow. “We have the tools to combat one of our longest and most formidable enemies and we as a community need to make sure we’re actually utilizing them.”
Despite available vaccines that can prevent disease, every year thousands of people suffer from long-term illness, are hospitalized, or even die from vaccine-preventable diseases; the statistics reported by the Centers for Disease Control and Prevention (CDC), the leading national public health institution in the U.S., are staggering. A booster shot, or repeat vaccination, in adulthood can keep you from getting sick unnecessarily and from infecting others.
While vaccines are important for the general population, health professionals recommend that those who are midlife-plus boost their immune systems against the following illnesses.
1. Flu
The CDC recommends that all adults get a flu shot every year, especially older adults. Since 2010, the flu has resulted in up to 56,000 deaths and 710,000 hospitalizations. Those 65-plus are even more at risk: About 50%-70% of seasonal flu-related hospitalizations occur in people over the age of 65. If you are 65 or older, you will likely receive a high-dose version of the flu vaccine.
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2. Whooping cough
Pertussis, also known as whooping cough, is a highly contagious respiratory infection that causes severe, uncontrollable coughing fits that leave you gasping for air. Infections can last for 10 weeks or longer. Globally, there are 24.1 million cases of pertussis each year and more than 160,000 deaths.
Older adults who weren’t vaccinated in childhood should get the Tdap (tetanus, diphtheria, and pertussis) vaccine, followed by a booster shot every 10 years—especially when spending time with infants who have not been immunized.
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3. Pneumonia
Pneumonia is an infection of the lungs that can be caused by bacteria, viruses, or fungi. Even with treatment, there can be complications. For example, if bacteria enter the bloodstream, it can spread to organs and lead to organ failure. Annually in the United States, pneumococcal pneumonia has resulted in 320,000 infections, 150,000 hospitalizations, and 5,000 deaths, mostly among older adults.
Health officials recommend pneumococcal vaccines for all adults over 65, and some adults with certain chronic health conditions. Current vaccination recommendations for people 65 years of age and older are one dose of PCV20 (Prevnar 20) or one dose of PCV15 (Vaxneuvance) followed by PPSV23 (Pneumovax 23) at least one year later.
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4. Shingles
Shingles is a viral infection that can cause a skin rash and burning pain, which can last for months, or even years (this long-lasting burning pain is called PHN, or postherpetic neuralgia). It is caused by herpes zoster, the same virus that causes chickenpox; if you have had chickenpox, you can get shingles. “Shingles is actually very scary because technically we already have it,” Dr. Ellow says. “It’s just waiting for you to let your guard down. I’ve seen multiple patients struggling to move without pain because [even] the touch of their clothing on the rash is agony.”
The CDC recommends that healthy adults age 50 and older get vaccinated against shingles, even if you already had shingles (wait until the rash is gone!) or are unsure if you ever had chickenpox. Almost one in three people in the United States will develop shingles during his or her lifetime, and the risk increases with age. Shingrix is the preferred vaccine, with over 90% efficacy in preventing shingles and PHN. Adults should receive two doses—the second dose is given two to six months after the first. Be sure to set a reminder for your second dose, and/or ask the pharmacy or your doctor if they provide reminders.
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5. COVID-19
The CDC currently recommends that everyone older than 6 months of age stay up to date on their recommended COVID-19 vaccinations. For children ages 6 months to 4 years, this includes the primary series. For all individuals 5 years and older, that means a primary immunization series plus the appropriate booster.
According to the FDA, anyone older than 50 is eligible to receive a second booster shot of Pfizer-BioNTech COVID-19 Vaccine or Moderna COVID-19 vaccine 4 months or more after receiving a booster shot of any approved COVID-19 vaccine.
Individuals in this age range with underlying medical conditions including but not limited to cancer, lung disease, heart disease, liver or kidney disease, diabetes, dementia, and HIV are most likely to benefit from the extra dose due to their increased risk of severe illness and hospitalization from COVID-19.It’s important to remember that every immunization isn’t right for every person. Use the CDC’s Adult Vaccine Assessment tool as a guideline, and be sure to always speak with your doctor about which vaccines are best for you.
