Many patients are vaccinated as children, but it's important that they remain up-to-date with routine vaccinations into adulthood. As patients age, their vaccine protection may weaken over time, making older adults more susceptible to infections and heightened symptom severity. To ensure patients of all ages are protected against preventable diseases, here is an overview of vaccines recommended for patients 50 and over.
Shingles
Shingles comes from the varicella-zoster virus, the same virus that causes chickenpox. If a patient has previously been infected with chickenpox, the virus can remain dormant in their body and reactivate later in life. The strongest method for preventing shingles is receiving the recombinant zoster vaccine (Shingrix). The Center for Disease Control (CDC) recommends that all patients over 50 receive the vaccine to protect themselves against the disease. Patients should receive two doses of the vaccine, separated by two to six months.
Measles, Mumps, and Rubella (MMR)
A dose of the measles, mumps, and rubella (MMR) vaccine is recommended for patients who are over 50 and born after 1957. Any patients born before 1957 do not need to receive the MMR vaccine because measles was so prevalent during their adolescence that they have presumed evidence of immunity.
Pneumococcal Disease
Due to the increased risk of pneumococcal disease complications, it’s recommended that patients over 65 receive the pneumococcal vaccine. As patients age, the side effects, symptoms, and risk of complications from pneumococcal disease escalate. There are two types of vaccines: pneumococcal conjugate vaccines (PCV13, PCV15, or PCV20) and pneumococcal polysaccharide vaccines (PPSV23). The CDC recommends that patients receive either PCV15 or PCV20, but if vaccinated with PCV15, it should be followed by a dose of PPSV23.
COVID-19
According to the CDC, older patients are at a heightened risk for COVID-19-induced complications. As of April 2022, adults over 65 accounted for 11.6% of COVID-19 cases, yet made up 75% of COVID-19-related deaths. The COVID-19 vaccine schedule includes an initial dose followed by the appropriate boosters, which depend on your vaccination history and age. An updated vaccine has just been approved to target prevalent variants and is recommended for patients over five years old as of September 2023.
Influenza
While all eligible patients should receive their influenza (flu) vaccine annually, older adults are strongly encouraged to receive their flu shot. Flu symptoms such as fever, respiratory distress, headaches, and muscle pains can be more severe and even fatal in older patients, making vaccination an important component of leading a healthy lifestyle for adults. Flu vaccination is most effective when administered in September or October.
Diphtheria, Tetanus, and Whooping Cough (Tdap)
All patients who have received the Tdap vaccine should receive the Tdap booster every ten years. The Tdap vaccine protects against diphtheria, tetanus, and whooping cough. Since older patients have a higher risk of complications, it’s important that providers ensure they remain up-to-date with their Tdap vaccination through routine boosters.
Respiratory Syncytial Virus (RSV)
The most recent immunization added to the list of recommended vaccines is RSV, offered as Arexvy or Abrysvo. The vaccine was approved by the FDA in the spring of 2023 and is recommended for patients over 60.
Addressing Vaccine Hesitancy in Adults
While adult immunization is a critical part of a healthy lifestyle, older patients can also exhibit greater vaccine hesitancy than younger generations. Common barriers to immunization for older adults include low health literacy, a lack of concern, and distrust in vaccine efficacy. Studies suggest that there is an opportunity for providers to engage their patients in conversations about immunizations by acknowledging and talking through their concerns and leveraging data that demonstrates the risk of falling behind on vaccination schedules.