ByDebbie Gardner
dgardner@thereminder.com
Vaccines have, of late, become a very personal choice, with many Americans exercising their right to choose, or not choose immunization for themselves and their families.
But for those of retirement age – 65 and older– vaccines are more than just a personal choice. They are a way to prevent severe illnesses, hospitalizations and in the case of one vaccine, the potential to face a dementia diagnosis.
To get an expert’s perspective on this season’s vaccines, and any other vaccines elders should consider, Prime spoke with Dr. Kawsar Talaat, associate professor of international health at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.
Cases of measles are on the rise. Should people over 65 be concerned about their immunity status?
“If you were born before 1957, it’s pretty much guaranteed that you had the measles and immunity is lifelong [ after exposure] Talaat explained, adding that in the pre-Salk vaccine era, nearly every child had the common, and highly contagious, illness.
Having undergone an organ transplant, however, might mean measles immunity needs to be revisited, as does anyone who received a measles vaccine between 1963 and 1966. Back then, there was a vaccine that used a killed virus, and one with a live virus, but neither formulation has proven to provide long-term immunity, Talaat said.
“If you don’t know if you got the killed vaccine or the live vaccine, have a titer done” to determine your immunity and any possible next step in gaining measles immunity, Talaat advised.
RSV — Respiratory Syncytial Virus — is another childhood illness that can affect elders. Is the RSV vaccine something people over 65 should consider?
According to information from the American Medical Association, the RSV season coincides with COVID-19 and the seasonal flu, with cases beginning to appear in the fall and peaking in the winter.
For elders, the danger is that the illness, which resembles a common cold in healthy individuals, can result in hospitalization for pneumonia.
Talaat said because the immune system naturally weakens as we age, everyone over the age of 75 should receive the RSV vaccine, as at that point, age alone “is a risk factor.”
“Other high-risk individuals are people over 60 who have comorbidities [such as heart disease, lung disease or a weakened immune system] … people who are at high risk should talk to their doctor,” Talaat said.
This step is important because Talaat said the immunity offered by the vaccine “probably only lasts a few years,” and the shot can only be administered once.
Speaking of pneumonia, there is a new vaccine that’s been advertised in the media. Is this something elders should ask about?
Talaat said the newest pneumonia vaccine “covers the strains of [pneumonia] that are available,” but that revaccination is not necessary if you received the vaccine that covers 20 strains recently.
However, earlier pneumonia vaccines covered fewer strains, 13 and 15, respectively and if you were immunized against pneumonia some time ago, it might be worth getting the newer vaccine.
“You should talk to your doctor about it,” Talaat stressed.
Is the Shingles (Herpes Zoster) vaccine really a necessity for elders?
It’s a vaccine that’s been described as sometimes having painful side effects that have left individuals feeling ill for a few days after the shot. But that shouldn’t deter individuals from getting immunized.
As was mentioned with the measles, people born in 1957 or before most likely had chicken pox, which is the virus that can reemerge and cause shingles later in life.
Because this exposure puts everyone in that group at risk of what Talaat called a “horrible disease that only gets worse as you get older,” the recommendation is that everyone who was exposed to chicken pox should get the vaccine.
“My mother-in-law had it two years ago on her face. She still has pain and a nose that constantly drips because of damage from the shingles outbreak,” Talaat shared.
“If you haven’t gotten [the shingles vaccine] you should get it,” Talaat said. “The vaccine also decreases the risk of dementia and the risk of heart attack and stroke.”
What about this season’s COVID-19 booster?
Talaat said that the CDC recommendation is for everyone 65 and older to get a COVID-19 booster this fall, but getting that shot may be determined by where you live.
“Some states you can walk in and get the shot at your local pharmacy, other states require a prescription, and in some states, you can’t get it at all,” Talaat said.
Insurance coverage may also affect who gets the shot at what cost, as Talaat said, “Medicaid may not cover the shot, and some insurance companies may not cover it, it depends on the state.”
In Massachusetts, the State Department of Health has mandated that the COVID-19 booster be available to all residents 5 years of age and older, and that all health insurance carriers cover the cost.
As of Sept. 17, Connecticut was following the Advice of the CDC’s Advisory Committee on Immunization Practices, which provides for individuals over the age of 65 and younger individuals with certain illnesses to receive the booster. The state is also working on making sure insurance companies cover the cost for qualifying individuals.
It’s flu season. When should individuals get their annual immunization?
“I would wait until October, maybe early November, but if flu cases start spiking in your area, get the shot,” Talaat said, adding that of all the vaccines, the flu is not always the best match to circulating strains and annual immunity “only lasts a few months.”
“If the flu season is in January and February, you want [the vaccine] in November; if the season is in March or April, you want to get it later,” Talaat said.
The flu shot is “very safe” to get with other vaccines, Talaat added.
One last vaccine to consider
Talaat said if you haven’t received a tetanus shot in the past 10 years, it is time to get a booster.
“If you are having a new grandchild, consider the tetanus and pertussis vaccine, called the DTaP,” Talaat advised, to help protect the new one from pertussis infection.