This month with the start of a new academic year grade school, middle school, high school and college students have received or are about to receive important vaccinations. It is often forgotten that our need for vaccines does not end upon completion of our school years but persists throughout our lives. Individuals especially in need of ongoing immunizations are older individuals particularly senior citizens. Now, I am aware that many of you are not members of that group (or as in my case refuse to admit it despite the date on my driver’s license) but most of us have grandparents, parents, brothers (such as mine), sisters, aunts, uncles or friends who are so I thought that this month we should look at several important vaccinations for senior citizens.
Older adults are at greater risk of incapacitation and/or death from certain infectious diseases such as flu, pneumococcal disease, diphtheria, whooping cough (pertussis) and shingles. Fortunately, vaccines for each of these are available and can be safely administered to most older persons. (Any questions regarding applicability and safety for any individual patient should be discussed with that person’s physician. She/he will be able to provide appropriate guidance.) As we age our immune response tends to decline and individuals who are frail and undernourished or depressed are at particular risk of infectious diseases as are their caregivers. Although response to vaccines may not be as robust in older individuals as it was when they were younger it becomes even more important that they receive immunizations as advised. Another important consideration regarding vaccinations such as those previously mentioned is the phenomenon known as herd immunity. Vaccinating against certain infectious diseases protects not only the vaccinated individual but by reducing the incidence of the disease it confers a degree of protection to other people in the vaccinated person’s community be that family, friends or others with whom that person comes in contact. Over the past few years we have witnessed several outbreaks of whooping cough a disease that thanks to vaccines had become relatively rare in the latter half of the 21st century. Possible vectors of transmission of this potentially deadly disease are parents and grandparents previously vaccinated as children but without ongoing vaccinations as adults. It has been hypothesized that these individuals retain some immunity to whooping cough preventing them from becoming ill with it but not enough to completely eradicate it from their bodies. Hence they are able to pass it on to others particularly very young children. Obviously this would be one example where lack of appropriate vaccinations negatively impacts more than just one’s self. I am of the firm opinion that each of us must look out for our own health but we have an equal responsibility to society.
Let’s take a look at the Centers for Disease Control recommendations for vaccinations of adults for each of the diseases mentioned above:
- Influenza: One dose annually
Influenza (flu) can be a devastating disease particularly for individuals at the extremes of age (very young infants and the elderly). It can result in chronic respiratory problems, mental retardation, and other serious problems including death. The adult vaccination is not a live virus and will not cause one to get the flu. Many individuals get the vaccination during flu epidemics and have been exposed prior to the vaccination and before one develops the appropriate immune response and do develop the flu but not from the vaccine but rather from procrastination!
- Tetanus, diphtheria, pertussis (Td/Tdap): Substitute 1-time dose of Tdap for Td booster: thereafter boost with Td every 10 years
This vaccine protects against three diseases including whooping cough mentioned above. Each of these diseases is not pleasant to have so make sure you stay current. If you are into scary literature, Google “lockjaw” (tetanus) and read about it and its history. You will be camped out on the steps of your doctor’s office when it opens in the morning to make sure you are immunized!
- Pneumococcal polysaccharide: 1 or 2 doses prior to the age of 65 with 1 dose for those 65 or older
Pneumococcal disease particularly pneumonia is a common cause of debilitating disease and death in the elderly. This effective vaccine can markedly reduce the incidence of the disease and should not be neglected. See your physician should you have questions or concerns.
- Zoster (shingles): 1 dose at the age of 60 or as soon as possible thereafter.
Shingles is caused by the same virus that causes chickenpox. The virus lays dormant in spinal nerve roots for many years, even decades and reactivates resulting in a linear rash that is in most cases extremely uncomfortable and may result in ongoing pain. It is estimated that 1/3 of adults will develop shingles. The zoster vaccine does not prevent all cases of shingles (60%-70% effective) but evidence suggests that for the approximately 1/3 of those who develop shingles despite being vaccinated will experience outbreaks which are less frequent, shorter in duration and less uncomfortable.
If you would like more information regarding these or other vaccines, I suggest that you go to www.cdc.gov . This is the website of the Centers for Disease Control. You pay for it so take advantage of it. I think you will find it informative.
In closing, I recommend that everyone keep an up to date immunization record and frequently discuss with your physician vaccinations and boosters for you and your family.
Stay Well and Stay Safe!
Benton Baker III, M.D., FACS, FACOg
200 River Pointe, Suite 115
Conroe, TX 77304