Ageing gradually reduces immunity in individuals. As one ages, the cells degenerate and the body’s immunity is lowered. This reduces the body’s capacity to fight infections. Hence, doctors recommend vaccines for the elderly, especially those over 65 years of age, to protect them from developing various infections.
Older people: A population survey
In 2007, the US National Institute on Ageing reported that by 2030, one in every eight individuals worldwide will be an older adult at or over the age of 65, amounting to nearly one billion people. These people have a higher life expectancy too, points out Dr Adesh K Agrawal, geriatric psychiatrist, All India Institute of Medical Sciences, Deoghar, Jharkhand. With the percentage of older adults increasing, vaccination becomes important to reduce the disease burden.
Why should the elderly take vaccines?
On Apr 23, 2021, the US National Council on Ageing reported that 11 per cent of older adults suffer from chronic obstructive pulmonary disease (COPD). Also, a 2021 report by the Centres for Disease Control and Prevention (CDC) shows that chronic lower respiratory diseases, influenza (flu) and pneumonia were some of the leading causes of mortality among older adults in the US in 2019. In India, Dr Rahul Tambe, senior consultant, Internal Medicine, Nanavati Max Super Specialty Hospital, Mumbai, adds, “Influenza and pneumonia are highly prevalent among the elderly.” However, these illnesses can be easily prevented through vaccines.
Since the older populace is more vulnerable to severe infection, they were prioritised for the Covid vaccine against SARs-CoV2 during the pandemic.
Who is eligible?
“Most older people, including those with comorbid conditions such as diabetes, hypertension or respiratory diseases, should get vaccinated to prevent severe illnesses or health complications,” emphasises Dr Tambe. Adding to this, Dr J Harikishan, senior general physician, Kamineni Hospitals, Hyderabad, warns that the elderly can have multiple comorbidities, allergies, immune disorders or ongoing medical treatments. Hence, expert medical advice regarding details such as precautions and vaccine schedules becomes mandatory before one gets vaccinated.
Vaccines for the elderly
Flu vaccine: “Quadrivalent influenza vaccine (against four influenza viruses) must be taken by older adults,” says Dr Shobha Naidu, Consultant, Internal Medicine & Geriatric Medicine, Sagar Hospitals, Jayanagar, Bengaluru. “The flu vaccine is best taken in autumn (September to November) before flu season starts, allowing time to develop immunity,” Dr Harikishan. This should be taken once every year irrespective of age, say experts.
Pneumococcal vaccine: This vaccine prevents pneumococcal infections, which can lead to serious illnesses such as pneumonia, bronchopneumonia, meningitis and bloodstream infections. Doctors recommend pneumococcal vaccination based on age and health conditions. Dr Naidu points out that for those above 65 years of age, only one dose of this vaccine is sufficient.
Shingles (herpes zoster) vaccine: Shingrix is a lesser-known vaccine crucial for the elderly. It protects them against shingles, a viral infection that causes a painful rash. In India, veteran actor Amitabh Bachchan has begun raising awareness regarding this condition. Shingles is caused by the reactivation of the varicella-zoster virus. CDC recommends that adults 50 years and older get two doses of Shingrix (recombinant zoster vaccine) to prevent shingles and its complications. There should be a gap of two to six months between the doses.
Tetanus, diphtheria and pertussis (Tdap) vaccine: The CDC report identifies pertussis (whooping cough) as one of the leading causes of mortality in their 2021 report. “The Tdap vaccine is a booster shot that helps protect against pertussis as well as tetanus and diphtheria,” explains Dr Hairkishan. These boosters should be taken every 10 years.
Hepatitis B vaccine: This vaccine prevents the severe liver infection caused by Hepatitis B virus. Chronic Hepatitis B infection can lead to liver failure; hence, doctors recommend the vaccine to older people who haven’t been immunised against it or those at risk of infection. “The frequency of doses and duration of protection against Hepatitis B can vary. One must always follow the latest recommendations,” Dr Tambe adds.
Measles, mumps, rubella (MMR) vaccine: MMR vaccine, once taken, provides lifelong immunity. “In case an older adult has not received it, they should consider getting vaccinated, especially during measles, mumps or rubella outbreaks,” advises Dr Harikishan.
How to travel safely and stay protected?
Vaccines are also recommended for older adults who travel to different countries. Dr Naidu advises, “This is to be taken based on individual requirements, such as age, allergies and comorbidities”.
Dr Naidu explains, “Anybody travelling to any other country must take prophylaxis to protect against traveler’s diarrhea (more than three bouts of loose, watery stools in a day).” She adds, “Older people travelling to African countries and South America, must take the yellow fever vaccine after medical consultation.”
Side effects of vaccines
Vaccines can sometimes have side effects. Older people can experience body pain, fever, redness or swelling at the site of the prick, a sore arm and fatigue, among others. But these symptoms are minor. They usually subside after a few days of rest, say experts.
However, the risks outweigh the side effects. Doctors suggest that one must be aware of the known side effects of each vaccine and discuss the same with their doctor before the jab.
Staying abreast of your vaccination history
Dr Harikishan strongly recommends that the elderly stay updated with their immunisation record. “The duration of protection differs based on the various vaccines and the individual’s immune response,” he adds. “So, while certain vaccines such as measles offer lifelong immunity, others like tetanus and diphtheria need periodic boosters.”
Takeaways
- Vaccines are highly recommended for the elderly to protect them from illnesses and hospitalisation.
- They are also recommended for older people when they travel to different countries.
- Most vaccines can show minor side effects, such as body pain, fever, sore arm, fatigue and others. But, they will subside in a few days.
- Older people must stay updated with their vaccination history.
