The Centers for Disease Control and Prevention estimates that between 50,000 and 60,000 adults in the United States die from vaccine-preventable diseases each year. We often think of shots as the province of childhood, a rite of passage for the young, but the immune system requires maintenance just as much as an old house or a vintage car.
As we age, our immune system naturally weakens, a process called immunosenescence, making us more susceptible to infections we once might have shrugged off. The good news is that modern medicine has provided us with powerful tools to defend ourselves.
A simple conversation with a doctor or a pharmacist can ensure that your defenses are up to date.
The Annual Influenza Vaccine
Influenza is not merely a bad cold. It is a serious respiratory illness that sends hundreds of thousands of people to the hospital annually. For adults over 50, the risk of complications rises significantly.
The CDC recommends that everyone six months and older get a flu vaccine every year, but for those over 65, the standard shot is often not enough. There are two preferred vaccines for this age group.
The Fluzone High-Dose Quadrivalent vaccine contains four times the antigen of the standard flu shot. The other option is the FLUAD Quadrivalent adjuvanted flu vaccine, which includes an ingredient to help create a stronger immune response.
Studies have shown that these specialized vaccines can reduce the risk of flu-related hospitalization by roughly 24 percent in older adults compared to standard-dose vaccines.
Protection Against Shingles
Almost one out of every three people in the United States will develop shingles in their lifetime. The risk increases sharply after age 50. Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox.
It lies dormant in the body and can reactivate years later, causing a painful rash that can last for weeks or even months. The CDC recommends two doses of the Shingrix vaccine for healthy adults 50 years and older.
Shingrix is a nonliving vaccine given in two doses, with the second shot administered two to six months after the first. Clinical trials demonstrated that Shingrix was 97 percent effective in preventing shingles in adults aged 50 to 69 years old.
It remains over 90 percent effective for those over 70. The previous vaccine, Zostavax, is no longer available in the United States as of November 2020.
Pneumococcal Disease Prevention
Pneumococcal disease refers to illnesses caused by the bacteria Streptococcus pneumoniae. It can lead to infections of the lungs, blood, and lining of the brain. Older adults are at greater risk for serious illness and death from this bacteria.
The guidelines for these vaccines changed in 2022 to simplify the process. Adults aged 65 or older now have two options. They may receive one dose of PCV20 alone, or they may receive one dose of PCV15 followed by a dose of PPSV23 one year later.
These vaccines protect against the most common and dangerous strains of the bacteria. Pneumococcal pneumonia alone causes about 150,000 hospitalizations each year. The bacteremia form of the disease kills about one in 20 older adults who contract it.
Vaccination remains the most effective method to prevent these severe outcomes.
Tdap and Tetanus Boosters
Many adults assume they are finished with tetanus shots after childhood, but immunity fades over time. The CDC recommends that all adults receive a booster dose of the Tdap vaccine once if they did not get it as an adolescent.
This vaccine protects against tetanus, diphtheria, and pertussis, also known as whooping cough. After that initial Tdap dose, adults should get a Td booster every ten years.
Tetanus enters the body through cuts or wounds and causes painful muscle stiffness. Pertussis is highly contagious and can be deadly for infants. Grandparents are often urged to ensure their Tdap vaccination is current to create a safety net for their grandchildren.
This practice, often called cocooning, helps protect vulnerable newborns who are too young to be fully vaccinated themselves.
The New RSV Vaccines
Respiratory syncytial virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. However, it can be dangerous for older adults. In May 2023, the Food and Drug Administration approved the first RSV vaccines for use in the United States for adults 60 years and older.
These are sold under the brand names Arexvy and Abrysvo. Clinical trial data showed that these vaccines were roughly 83 percent effective at preventing lower respiratory tract disease caused by RSV.
The CDC advises that adults 60 and older may receive a single dose of the RSV vaccine based on shared clinical decision making. This means patients should consult their doctor to see if their specific health risks make the vaccine a necessary precaution.
RSV causes between 60,000 and 160,000 hospitalizations annually among adults 65 and older.
COVID-19 Updated Boosters
The virus that causes COVID-19 continues to change. Protection from the vaccine decreases over time. Staying up to date with COVID-19 vaccination is crucial for preventing severe illness, hospitalization, and death.
The CDC recommends that everyone aged 5 years and older get at least one updated COVID-19 vaccine to protect against serious illness from COVID-19. Adults aged 65 and older who received one dose of the updated vaccine should receive one additional dose at least four months later.
This is particularly important because age remains the strongest risk factor for severe COVID-19 outcomes. Data from the peak of the pandemic showed that people aged 65 to 74 were 25 times more likely to die from COVID-19 than people aged 18 to 29.
The virus is still circulating, and the updated vaccines target the most recent variants.
Recommended Adult Vaccines by Age
| Vaccine | Age 50-64 | Age 65+ |
|---|---|---|
| Influenza | Annually | Annually (High-Dose preferred) |
| Shingles (Shingrix) | 2 doses | 2 doses |
| Pneumococcal | If risk factors exist | 1 dose PCV20 OR 1 dose PCV15 + PPSV23 |
| Tdap | Once, then Td every 10 years | Once, then Td every 10 years |
| RSV | Not recommended | 1 dose (shared decision making) |
Keeping track of these medical necessities does not require a degree in public health. It simply requires a willingness to ask questions. Most pharmacies keep these vaccines in stock and can administer them without a full doctor's appointment, though checking with your insurance provider is always wise to understand potential costs.
Carry a simple card in your wallet or use a health app to record the dates and types of vaccines you receive. This small act of organization ensures you receive the right booster at the right time.
A few minutes of prevention today can spare us weeks of misery tomorrow.
Sources
- Centers for Disease Control and Prevention, 'Recommended Vaccines for Adults,' (2023)
- U.S. Food and Drug Administration, 'FDA Approves First RSV Vaccine,' (2023)
- National Institute on Aging, 'Vaccines for Older Adults,' (2022)
- The New England Journal of Medicine, 'Efficacy of High-Dose Influenza Vaccine,' (2014)