In
the 1920s, the respiratory disease diphtheria was one of parents’
biggest fears for their children. In the United States, an estimated
100,000-200,000 cases of diphtheria per year caused 13,000-15,000
deaths, mainly children, in that decade (Wikipedia).
Today, diphtheria vaccines have largely eradicated the disease from the
United States. In fact, if diphtheria is remembered at all today, it’s
because of the celebrated story of a relay by sled dogs and their
mushers to deliver diphtheria antitoxin 674 miles away to Nome, Alaska,
to prevent a predicted epidemic. The initial relay in 1925 became
today’s Iditarod Trail Sled Dog Race.
Today,
vaccines have curbed the development of many diseases that were once
considered fatal, especially in older adults. While some vaccines have
side effects, health experts say that the benefits typically outweigh
the possible complications of certain illnesses in seniors. Except for
people with certain health problems, such as cardiovascular disease,
lung disease, diabetes, kidney problems or a condition that weakens the
immune system, getting vaccinated is a safer choice than risking illness
to obtain immune protection. Consult with your healthcare provider to
discuss the advantages and disadvantages of each vaccine for you.
Vaccines
work by exposing you to dead or weakened disease-causing
microorganisms, which causes your body’s immune system to produce
antibodies that fight the microorganisms, helping to make you immune to a
specific disease. Most vaccines are given through a simple injection,
usually in your arm, although some are administered by mouth or nasal
spray.
Experts recommend four vaccinations for seniors: flu, pneumonia, shingles and a combined tetanus-diptheria-pertussis.
Flu
The
most prevalent vaccine is for influenza, commonly called the flu, a
contagious illness caused by viruses. Older people are at the highest
risk of developing serious flu complications that require
hospitalization; in some cases, the flu can be fatal. Ninety percent of
flu-related deaths and more than half of flu-related hospitalizations
occur in people age 65 and older. As you age, your immune system
weakens, which makes you more susceptible to the flu.Health
experts recommend that those 50 or older should receive one dose of
influenza vaccine every year, preferably in October or November, before
the winter flu season starts. Flu season usually peaks in January or
February, but it can occur as late as May. Early immunization is most
effective, but it is not too late to get the vaccine in December,
January or later. Flu vaccines are needed every year because immunity is
short-lived and vaccine manufacturers make updates every year to combat
current strains of the virus.
If
you get the flu vaccine, you are 60 percent less likely to need
treatment for the flu by a healthcare provider. Vaccination may also
reduce illness, antibiotic use, time lost from work, hospitalizations
and deaths.
Although
the flu vaccine is meant to protect you for one flu season, evidence
supports that immunity declines more quickly in older people. Therefore,
another flu vaccine option is available—one that contains a higher dose
of antigen, the part of the vaccine that prompts the body to make an
antibody. Designed specifically for people 65 and older, this
alternative is intended to create a stronger immune response.
For those worried about the possible dangers, seasonal flu vaccines have a good safety track record (vaccines.gov).
The Centers for Disease Control and Prevention (CDC) and the Food and
Drug Administration (FDA) closely monitor their safety. As with any
drug, mild side effects, such as soreness, headaches and fever, are
common. Less common and more serious are severe reactions such as
difficulty breathing, hives or facial swelling; for these, seek medical
attention immediately.
Shingles
Shingles
is an extremely painful and contagious blistering rash, which is
activated by the varicella zoster virus, the same virus that causes
chickenpox. After a person recovers from chickenpox, the virus stays in
the body in a dormant state but can reactivate years later, for reasons
not fully known. At least 1 million people a year in the United States
get shingles.
The
zoster vaccine, which scientists developed in 2006, is not guaranteed
to prevent shingles, but it can decrease your risk by about 50 percent,
or at least minimize its severity. Vaccines.gov recommends that anyone
60 years of age or older get the shingles vaccine, regardless of whether
they recall having had chickenpox or not. Studies show that more than
99 percent of Americans ages 40 and older have had chickenpox, even if
they don’t remember. Shingles is far more common in people 50 years of
age and older than in younger people, and increasing age can result in
more severe effects.
A
shingles rash usually appears on one side of the face or body and lasts
from two to four weeks. Its main symptom is pain, which can be severe.
Other symptoms include fever, headache, chills and upset stomach. Very
rarely, a shingles infection can lead to pneumonia, hearing problems,
blindness, brain inflammation (encephalitis) or death.
For
approximately 20 percent of people, severe pain, called post-herpetic
neuralgia (PHN), can continue long after the shingles rash clears up.
Its repercussions are more widespread in seniors, affecting up to half
of untreated people who are 60 years of age and older. Although the pain
from PHN may be debilitating, it usually resolves in a few weeks or
months.
While
any vaccine can carry risks, no serious problems have been identified
with the shingles vaccine. Mild reactions can include headache and
redness, soreness, swelling or itching at the site of the injection.
Pneumonia
Infection
from pneumococcal bacteria is one of the leading causes of death in the
United States from a vaccine-preventable disease. Seniors, especially,
are susceptible to pneumonia, which is responsible each year for 60,000
deaths among those over 65. The CDC recommends that people age 65 and
older receive a one-time dose of pneumococcal vaccine; those who were
vaccinated more than five years ago and were younger than 65 at the time
should get a one-time repeat vaccination.
Pneumococcal
infections, which include pneumonia, blood infections (bacteremia),
brain infections (pneumoccocal meningitis) and middle-ear infections,
are spread through respiratory secretions, like coughing and sneezing.
The disease comes from a type of bacteria called Streptococcus
pneumoniae (pneumococcus) found in many people’s noses and throats.
Pneumonia
symptoms include fever, cough, shortness of breath and chest pain. In
addition to redness, pain and swelling at the injection site, vaccine
side effects may include mild fever, fatigue, headache, chills or muscle
pain.
Tetanus-Diphtheria-Pertussis
Tetanus,
diphtheria and pertussis, all caused by bacteria, can be very serious,
for adolescents as well as adults. Before vaccines, the United States
saw as many as 200,000 diptheria and pertussis cases annually and
hundreds of tetanus infections. Since vaccination began, tetanus and
diphtheria have dropped by about 99 percent and pertussis by roughly 80
percent (CDC). The Tdap vaccination covers all three diseases.
The
tetanus bacteria enters the body when cuts, scratches or wounds come
into contact with contaminated soil, dust or manure. Tetanus, also known
as lockjaw, affects the nervous system, causing painful muscle
tightening and stiffness, usually all over the body. In some cases, you
can’t open your mouth, swallow or even breathe. It can be deadly,
particularly for older people, killing approximately one out of five
people who are infected. Because the immunity from past tetanus shots
eventually fades, ask your doctor if you are due for another
vaccination.
Diphtheria
is a respiratory bacterial infection that spreads from person to person
through coughing or sneezing. If left untreated, it can cause airway
obstruction, coma and death. Although both tetanus and diphtheria are
rare in the United States today, people who become infected often have
severe complications.
Pertussis,
also known as whooping cough, produces severe coughing spells, which
can cause difficulty breathing, vomiting and disturbed sleep. The
illness can also lead to weight loss, incontinence and rib fractures
from coughing. Up to 2 percent of adolescents and 5 percent of adults
with pertussis are hospitalized or have complications, which could
include pneumonia or death. Seniors are increasingly getting pertussis,
possibly due to dwindling immunity.
You should get the Tdap vaccination as a one-time booster, regardless of when you received your last tetanus-diphtheria vaccine. Side effects include redness or swelling at the injection site, headache, fatigue, fever, nausea, vomiting, diarrhea and stomach ache.
You should get the Tdap vaccination as a one-time booster, regardless of when you received your last tetanus-diphtheria vaccine. Side effects include redness or swelling at the injection site, headache, fatigue, fever, nausea, vomiting, diarrhea and stomach ache.
Sources
“Senior Immunizations,” John Muir Health
Vaccines.gov
“Vaccines for Seniors,” Everyday Health
View this article in the May 2014 Senior Spirit newsletter.
Blog posting provided by Society of Certified Senior Advisors
www.csa.us