Immunization Update for Older Adults
Vaccines aren't just for children. Every year, thousands of American adults become ill, are disabled, or die of diseases that could have been prevented by vaccines.
Although infectious diseases are no longer the most common causes of death for older Americans, pneumonia and influenza remain among the top causes of death for seniors, according to the CDC.
The following guide can help you determine if you need to be immunized. If you have a chronic health condition or a disease that affects your immune system, you may need to follow a different schedule from the one listed below. Check with your health care provider about which immunizations you might need.
An annual flu shot is recommended for anyone 6 months or older. Because adults who have diabetes or chronic heart, lung, or kidney disease, or live in nursing homes or other long-term care facilities may be at higher risk for complications of the flu, it's especially important for them to get a vaccination. People who are in close contact with someone at high risk for complications of the flu also should get vaccinated.
Although a nasal spray flu vaccine is now available as an alternative to a vaccine given by injection, the nasal spray vaccine is not approved for people younger than 2 years or older than 49.
The best time to get vaccinated is when the vaccine becomes available in your community. If you miss getting a vaccination at that time, getting the vaccine in December or later may still be beneficial, according to the CDC. Talk with your health care provider if you have questions about the flu shot.
The CDC recommends the pneumococcal vaccine for all adults 65 and older, and for younger adults who have HIV or diabetes, are alcoholic, or have chronic liver, heart, lung, or renal disease. Adult smokers also should be vaccinated. If you are 65 or older, you should get a booster if you received your first vaccination before age 65 and more than five years have elapsed. Adults with certain medical conditions should also receive a one-time booster five years after the first vaccination. Talk with your health care provider before getting this vaccination if you have a chronic health problem. The CDC says that people vaccinated at or after age 65 don't need additional doses.
Tetanus, diphtheria, and pertussis
For adults ages 19 to 64, the CDC recommends a one-time booster of tetanus-diphtheria-pertussis. Adults 65 and older who have close contact with an infant and have not previously received Tdap should receive one dose. All other adults 65 and older need only a tetanus-diphtheria booster every 10 years. This booster is especially important for older adults because they have thinner skin and may be more vulnerable to tetanus-infected cuts and puncture wounds. Call your health care provider if you have a puncture wound or injury that breaks the skin and you haven't had a tetanus immunization or booster in five years.
Most older adults don't need a polio vaccine because they were vaccinated as children. The CDC recommends that you talk with your health care provider about the polio vaccine:
If you travel to areas of the world where polio is common
If you are a laboratory worker who might handle the polio virus
If you are a health care worker who deals with patients who could have polio
If you are in one of these groups, your health care provider may recommend that you get a polio booster even if you have had three of more doses of the vaccine in the past. If you did not receive at least three doses of the vaccine, your provider may recommend that you get the doses you are lacking.
Hepatitis A is a liver disease caused by the hepatitis A virus (HAV), which triggers temporary liver inflammation. The virus is spread through food or water contaminated by stool from an infected person. HAV vaccine is recommended for these high-risk groups:
Children older than 2 living in states with particularly high rates of HAV infection
Travelers to areas of the world where HAV is common
People with chronic liver disease
People who use illegal drugs
Men who have sex with men
The CDC recommends at least two doses of the vaccine for lasting protection; these doses should be given at least six months apart.
Hepatitis B is a liver disease caused by the hepatitis B virus (HBV). It can lead to chronic liver inflammation that can cause scarring of the liver (also called cirrhosis) or liver cancer. HBV is transmitted through contact with the blood of an infected person. It can also be transmitted sexually or from mother to infant during childbirth. HBV vaccine is recommended if you are at increased risk for exposure to hepatitis B. These are circumstances that increase your risk:
You have had sex with more than one person in the last six months, you've had a sexually transmitted disease, or you're a man who has sex with other men
You are treated with clotting factor products
You have chronic liver disease
You are a dialysis patient
You are in a nursing home or other institution
You are a health care worker or work in a health care setting
You travel abroad
You used injected drugs
You are exposed to hepatitis B through a family member or live-in friend
Measles, mumps, and rubella (MMR)
Adults born before 1957 are considered immune to measles and mumps. Adults born during or after 1957 should receive at least one dose of the MMR vaccine unless they have a medical condition that makes it inadvisable, or have had measles or mumps, or have had a blood test that shows they have immunity.
The varicella, or chickenpox, immunization is recommended for all adults who never had chickenpox or never received the chickenpox vaccine. They should get one dose.
If you are older than 60, a vaccine to prevent shingles is available. The CDC recommends one dose of the vaccine. Shingles is a disease caused by the varicella-zoster virus, the same virus that causes chickenpox. After an attack of chickenpox, the virus lies dormant in certain nerve tissue. As people age, it is possible for the virus to reappear in the form of shingles, which is estimated to affect two in every 10 people in their lifetime. Shingles is characterized by clusters of blisters, which develop on one side of the body. The blisters can cause severe pain that may last for weeks, months, or years after the virus reappears. Studies show that the vaccine reduces the occurrence of shingles by 50 percent or more.
For more information
Visit the CDC website for a handy immunization guide.
- Foster, Sara, RN, MPH
- newMentor board-certified, academically affiliated clinician