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Posted: November 29, 2008

Vaccinations Against Illness Important in Old Age Too

Not Just Kid Stuff

Contrary to popular belief, vaccinations are not just for kids. The cold, hard fact is that literally thousands of illnesses and deaths among adults could be prevented each year, if more Americans were immunized.

The problem starts with a lack of knowledge: a survey by the federal Centers for Disease Control and Prevention (CDC) last summer suggests that many of us don’t even know adult vaccinations exist. The only one most of the 7,000 people surveyed could name was the flu shot. Vaccinations are especially important for seniors, caregivers to the elderly, and those who come into contact with them. Taking this one simple, preventive step can protect you and your loved ones.

The nation’s leading public health experts stress the importance of getting vaccinated. Often glossed over as kid stuff, they are equally and sometimes more vital to older adults. The immune system weakens as we age, making our bodies less effective at naturally warding off and fighting illness. In addition, older adults are more likely to have existing health conditions, which put them at higher risk for more serious illness and death.

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Still, in the face of this reality, too many older adults do not protect themselves. The death rate for influenza and pneumonia, for example, increases sharply with age. Each year, about 90% of the estimated 36,000 people who die from flu-related causes in the United States are age 65 or older. Yet, only 72% of this group received the flu shot last year and only 57% had ever received the pneumococcal vaccination. The government’s announced goal is to vaccinate 90% of this age group by 2010 for all recommended vaccinations.

Carrie Anne from Maine says her 91-year-old mother refuses to get a flu or pneumonia shot, even though her doctor recommends it. She says that about four years ago, her mother was diagnosed with pneumonia and spent six days in the hospital. “Believe it or not, to this day she says that she didn't have pneumonia,” Carrie Anne said. “Talk about being stubborn!”

Being stubborn is just one of several reasons older adults are not keeping up on their vaccinations. Some, as mentioned, are unaware that they even need to be vaccinated, while others believe that because they are in good health they don’t need vaccinations. Many seniors fear they will contract the very disease the vaccine protects against, and they are also concerned about side effects. High cost is yet another obstacle that stands between many seniors getting their vaccinations.

Rosie, in Australia, says she has no tolerance for those who balk at vaccinations like the flu shot, saying it will give you the flu. She says “I reckon if a person refuses to have the shots, then so be it, they can take the risk. I've had pneumonia once. I now have the shot, and I can tell you the shot is a darn sight more pleasant than pneumonia.”

The very real risk of spreading disease to her elderly parent is another reason for Rosie and others of caregiving age to vaccinate. The CDC recommends flu shots for those at high risk of complications from the flu, and urges those who live with or care for someone at high risk to get vaccinated early. Anyone who comes into contact with the elderly – such as health care workers, caregivers, and children -- should be vaccinated, because illness could be spread to them.

As we age, our immune system weakens. This makes us more vulnerable to infection and also reduces our ability to respond to vaccinations. Studies have challenged the effectiveness of flu and other vaccines in older adults, yet they are still highly recommended and can be life saving -- especially for this age group. Dr. Ann Falsey, an infectious disease specialist, says, “Without a doubt, the influenza vaccine, as it is today, is beneficial for everyone, including older adults, and we strongly encourage every older person, and every person with a chronic illness, to get vaccinated.”

Researchers are listening to these concerns and making efforts to improve vaccinations for the older population. Last month, Falsey presented the results of a study to improve the effectiveness of the flu vaccination on older adults by increasing its dose of antibodies. The results are very encouraging, showing increased protection in the most vulnerable individuals who had the lowest existing protective antibodies. Even more encouraging is seeing that researchers are making efforts to improve quality of life for seniors.

Though the CDC recommends the pneumococcal vaccine for all Americans 65 and older, as well as those with chronic ailments such as heart disease, it is often challenged. The controversy is that, like the flu shot, it is difficult to know if the vaccination actually decreases the risk of pneumonia. There have been cases where patients contracted the disease even though they had received the vaccination, but studies show that any post-vaccination illness will be less severe than if no vaccination was received.

A study in Canada suggests that the pneumococcal vaccine cuts the risk of heart attack by 50% two years later. This is actually consistent with a two-year-old study showing that those who received the vaccine were 40% to 70% less likely to die than those who were not vaccinated. There were also lower rates of heart attack, kidney failure, and other problems in the vaccinated group. Dr. David Fisman, who reported the study findings last month, said, “The important take-home message is that pneumococcal vaccine gets a bad rap. It saves lives. It is a lot safer to vaccinate people than to pull them back from the brink when they have a heart attack."

The herpes zoster vaccination is also recommended for people age 60 and older, even for those with no prior episode of herpes zoster. Only available since 2006, just 2% have received this vaccination, even though herpes zoster -- better known as shingles -- affects more than a million Americans each year. The vaccination can cut the risk of infection by half, but if you do contract it, the case will be less severe.

Whooping cough is turning up again in the senior population because the effectiveness of childhood vaccinations has worn off. “Tdap” is the combined tetanus, diphtheria, and pertussis vaccination recommended for all adults age 64 and younger whose last tetanus-diphtheria booster was at least 10 years ago. For those 65 and older, a tetanus-diphtheria booster shot is recommended, rather than the full Tdap.

Keep in mind that additional vaccinations may be recommended, depending on where you live, your health, lifestyle, and whether you plan to travel internationally. Check out the CDC Immunization schedule, and ask your doctor about routine vaccinations. This is one case where a little prevention clearly goes a long way.

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Lori Zanteson is a California-based freelance writer. She specializes in topics related to families and can be reached at lorizanteson@verizon.net.

Resources:

Centers for Disease Control and Prevention, Adult Immunization Schedule:
http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm

Centers for Disease Control and Prevention, Immunization Comprehensive Recommendations and Vaccine-Specific Recommendations:
http://www.cdc.gov/vaccines/pubs/acip-list.htm

Mayo Clinic Vaccines for Adults: Which ones should you get?
http://www.mayoclinic.com/health/vaccines/ID00016

AARP, Flu Shot Information:
https://www.aarpmedicarecomplete.com/members/immunization_sh.html

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