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Guest Opinion

Making sense of adult vaccines


Adults over age 50 face increased risk of serious disease or death from a range of infectious diseases, much of which can be minimized by routine vaccination. The Center for Disease Control & Prevention (CDC) vaccine recommendations are only general guidelines, so it’s critical that you discuss your individual vaccine needs with your primary care health provider to customize vaccines to your specific particular health needs.

Influenza vaccine

During most seasons, people 65 years and older account for the majority of flu hospitalizations and deaths. In the United States, up to 85% of seasonal flu-related deaths and 70% of seasonal flu-related hospitalizations occur among people 65 years and older. Total flu-related deaths in the U.S. last year were approximately 21,000. In the U.S., Fluzone High-Dose Quadrivalent vaccine is approved only for people 65 years and older. Studies have shown that the high-dose vaccine was 24% more effective in preventing flu in adults 65 years and older relative to a standard-dose vaccine.

COVID-19 vaccine

According to the World Health Organization, of the more than 1.1 million U.S. deaths from COVID to date, approximately 80% were in adults over age 50. All adults, no matter the age, and especially people ages 50 and older, should be vaccinated against COVID-19 if they have conditions that put them at increased risk of hospitalization or death (eg, obesity, diabetes, cancer, immunocompromised conditions). The CDC recently recommended persons 65 and older should receive an additional dose of 2023–2024 Formula COVID-19 vaccine.

Respiratory Syncytial Virus (RSV) vaccine

RSV leads to as many as 160,000 hospitalizations and kills up to 10,000 people each year, most of them older, with infections peaking in November. In May, the FDA approved two RSV vaccines for older adults. The Pfizer vaccine, Abrysvo, was 89% effective at preventing lower respiratory symptoms (such as cough, shortness of breath or wheezing) in the first RSV season after vaccination, while the GSK vaccine, Arexvy, was 83% effective.

Shingles (herpes zoster) vaccine

The CDC recommends that everyone 50 and older get the Shingrix shingles vaccine, even if they had the earlier recommended vaccine, Zostavax — which was much less effective and more quickly wanes — and even if they’ve already had shingles. If you had chickenpox as a child, you harbor the varicella-zoster virus that causes shingles that remains in your system in perpetuity. Shingrix is given in two doses two to six months apart to prevent both shingles and its complications. Shingrix can protect 97% of people in their 50s and 60s, and 91% of those in their 70s and 80s.

Pneumococcal (pneumonia) vaccine

Pneumococcal disease, which can cause pneumonia, kills more people in the U.S. each year than all other vaccine-preventable diseases combined before COVID. Young children under 2 and those over 65 have the highest incidence of serious illness, and older adults are more likely to die from it. Healthy adults 65 years and older, or adults 19 to 64 with certain risk factors (smoking or health problems, such as chronic lung or heart disease, leukemia, lymphoma or alcoholism) should receive the pneumococcal vaccine. Adults who haven’t received a pneumococcal vaccine should opt for either the PCV15 (VAXNEUVANCE) or PCV20 (Prevnar). If PCV15 is used, it should be followed by a dose of PPSV23 (Pneumovax 23).

There are more than a dozen different adult vaccines included in the CDC Adult Immunization Schedule. I’ve highlighted here the ones that most national health organizations emphasize for adults over age 50. Again, speak with your health care provider about which of these (and others not listed) may be important for your particular health needs.

David Segarnick is chief medical officer at MedEvoke, an iNIZIO company, and an adjunct assistant professor of pharmacology, physiology and neuroscience at Rutgers/NJ Medical School. He lives in Upper Black Eddy.

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