5 after 65: Vaccines for Those Over 65 Years of Age

Vaccination is one of the most effective tools for helping older adults stay healthy. As people age, their immune systems become more vulnerable, putting them at an increased risk for certain diseases. Fortunately, the COVID-19 vaccine, flu vaccine, shingles vaccine, pneumonia vaccine and Tdap vaccine are available to protect those over 65.

According to the World Health Organization (WHO), around 3.5-5 million lives are saved every year because of vaccinations. Vaccines are biological products that work by creating a protective immune response when a person is exposed to an infection or disease. To do this, vaccines contain antigens, substances or toxins which can cause the body to produce antibodies, proteins that help provide protection.

Traditional vaccines are classified as live or non-live, depending on whether they include a live weakened replicating strain of a pathogen. Newer developments have led to other types of vaccines including viral vector vaccines and nucleic acid-based RNA and DNA vaccines.

Studies indicate that vaccines are safe and effective. In fact, some diseases, including smallpox, measles, mumps, and polio have been eradicated or nearly eradicated thanks to vaccines.

In order for vaccines to get approved, they must pass a tightly regulated and carefully documented process, including three phases of clinical trials. Once vaccines are licensed, they are continuously monitored and studied to ensure they are safe.

Any common side effects are documented during clinical trials and published when a vaccine is licensed. For most people, vaccine side effects are mild compared to the severe outcomes of the diseases they protect against. Seniors should consult with their medical care provider to determine the appropriate vaccine schedule for their needs.

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1. The COVID-19 vaccine:

Adults over 65 years of age are more vulnerable to severe effects from COVID-19, including hospitalization and death. The COVID-19 vaccine is associated with a 90% reduction in risk of needing a ventilator (IMV) and death.

In the United States, approved vaccines include Pfizer-BioNTech, Moderna, Novavax, and Johnson & Johnson’s Janssen. The WHO reports that a phase 3 trial found Novavax has a 90% efficacy against mild to severe COVID-19. Johnson & Johnson’s Janssen can also be considered in certain situations, but the CDC advises to review safety concerns.

Additionally, the WHO recommends wearing a properly fitted mask, avoiding poorly ventilated areas, and staying home if you are sick. While vaccines greatly reduce severe COVID outcomes, a systematic review suggests long-COVID is still a risk.

2. The flu vaccine

The flu (also known as influenza) is more likely to lead to health complications in those over 65, including severe illness, pneumonia, or death. Those with conditions including asthma, diabetes, and kidney disease, and those with heart disease or who’ve had a stroke, are also at increased risk.

Flu vaccines for 2022-2023 are quadrivalent vaccines that are designed to protect against two influenza A viruses and two influenza B viruses.

Available vaccines for those over 65 include Flucelvax Quadrivalent, a cell-based egg-free flu shot; Flublok Quadrivalent, a recombinant egg-free flu shot; Fluzone High-Dose Quadrivalent, a high-dose egg-based flu shot; and Fluad Quadrivalent, an egg-based adjuvanted flu shot.The CDC estimates that in 2019-2020,105,000 flu-associated hospitalizations and 6,300 flu-associated deaths were avoided thanks to vaccination.

3. The shingles vaccine

Anyone who has had chickenpox can get shingles, which occurs when the virus that causes chickenpox, varicella zoster virus (VZV), becomes reactivated. According to the CDC, around 1 out of 3 people will develop shingles in their lifetime.

Shingles can cause burning, pain, itching, tingling, rashes, and blisters. Up to 18% of people who get this disease will also experience postherpetic neuralgia (PHN), severe pain around the shingles rash. Additionally, 1-4% of people who get shingles may need hospitalization.

The CDC reports that Shingrix is over 90% effective at preventing shingles and PHN. This vaccine can help reduce risk of health complications.

4. The pneumonia vaccine

Older adults have an increased risk of serious outcomes from pneumonia, an infection that can affect one or both lungs, causing air sacs to fill with liquid or pus. Symptoms may include cough, fever, sweating, chills, chest pain, and difficulty breathing. Pneumonia is also one of the leading causes of mortality for those over 65.

There are four types of pneumococcal vaccines used in the United States, but a person’s medical provider can help determine which ones are the best fit. Vaccines available include Prevnar 13, Prevnar 20, Vaxneuvance, and Pneumovax23.

According to the CDC, studies show that PCV7 and PPSV23 are highly effective in protection from pneumonia in adults with healthy immune systems. PCV15 and PCV20 are newer vaccines that were approved based on results that show a similar immune response to PCV13 in clinical trials.

5. The Tdap vaccine

The Tdap vaccine protects against tetanus, diphtheria, and pertussis.

Tetanus (T) can enter the body through wounds, causing health problems including painful stiffening of muscles and difficulty breathing or swallowing. Diphtheria is spread from person to person and can result in breathing issues, heart failure, and paralysis. Pertussis (aP), which causes severe coughing that can lead to rib damage, loss of bladder control, and passing out, is also referred to as whooping cough. All three diseases can result in death.

Tdap vaccines licensed in the U.S. include Adacel and Boostrix. Studies indicate that Tdap is over 97% effective in protecting against diphtheria and tetanus, for about 10 years. When it comes to whooping cough, Tdap fully protects around 7 in 10 people in the first year after vaccination.