Aging and Immunity: The Important Role of Vaccines

We often focus on the immunity of children, but as patients age into adulthood and seniority, following recommended immunization guidelines is essential to their overall well-being. Vaccines for illnesses such as pneumococcal disease, tetanus, and shingles can help combat the deterioration of immunity that many patients will experience as they age.

In the 2016 National Health Interview Survey, more than one-third of adults 65 years and older did not report receiving a pneumococcal or tetanus and diphtheria vaccination, and nearly two-thirds did not report receiving a herpes zoster (shingles) vaccination.

The lower number of aging adults who are up to date on recommended immunizations can be an open door to preventable health problems. By actively engaging with aging patients, providers can help close that gap and ensure better lifelong health.

How do vaccines help support adults’ health as they age?

 As patients age, their bodies’ ability to respond to immune system challenges becomes less effective, according to research published in Frontiers in Immunology. These changes, known collectively as immunosenescence, is one reason why the severity of many infections is greater in elderly patients compared to younger adults. There are many preventative activities patients can participate in to strengthen their immune system. The most commonly needed vaccines for older adult populations include influenza, pneumococcal disease, tetanus and herpes zoster vaccines, according to the Advisory Committee for Immunization Practices (ACIP).  

Which vaccines are most critical for older patients? 

The Centers for Disease Control and Prevention (CDC) notes that booster shots are an important aspect of maintaining a patient’s immunity. The tetanus and diphtheria booster is recommended every 10 years for adults.

In addition to diseases for which childhood immunity can wear off, there are also several vaccine-preventable diseases that patients are at a higher risk of contracting later in life, including shingles and pneumonia. The CDC estimates that there are one million cases of shingles reported each year in the U.S., and nearly a third of all Americans will develop shingles in their lifetime.

Given these risks, the CDC now recommends that all adults over 50 receive the two-dose shingles vaccine Shingrix, while Zostavax may be used in particular cases for patients 60 years of age or older.

Aging patients should also be immunized against the major types of pneumococcal disease, which include pneumonia, bacteremia, and meningitis. Fortunately, recent ACIP recommendations reported by Healio indicate that herd immunity may play a role in helping to protect older patients. Previously, ACIP recommended all adults over 65 years old get the pneumococcal conjugate vaccine Prevnar13. As of late June 2019, ACIP voted to recommend that the vaccination decision be left to providers and patients jointly, as pediatric use of Prevnar13 has indirectly reduced cases in older adults.

How can providers help improve vaccine rates among aging patients?

From education to patient reminders, providers can play a critical role in improving and maintaining their patients’ immunity in later years. Below, we highlight a few ways providers can help improve vaccination rates amongst their adult patients: 

  1. Recommend: Provider recommendations have power. In a survey from the National Foundation of Infectious Diseases (NFID), 55% of respondents said that they would not receive a vaccination unless it were recommended by their doctor. Particularly with the new ACIP pneumococcal recommendations, it is important for providers to accurately assess older patients’ needs and give the best advice for their health.  

  2. Educate: Providers can alert patients to diseases they may be newly at risk of contracting due to their age. A NFID survey found that only 20% of respondents were extremely or very familiar with pneumococcal disease, and only 43% were extremely or very familiar with shingles. Patients are more likely to be immunized if they know about their potential risk of contracting these diseases.  

  3. Contact: Reach out to patients ahead of their scheduled appointments to let them know that it’s time for their vaccines, instead of asking them if they would like to be vaccinated during the appointment.

By offering the right education and support, providers can ensure that every patient is protected from vaccine-preventable illnesses throughout their lifetime.