In the U.S., more than 1/3 of U.S. deaths are preventable. Pneumonia and influenza remain in the Top Ten causes of death for people 65 and above.¹

Now is the time to encourage older adults to get a flu shot and make sure they are up-to-date on other immunizations. Immunizations are one of the most effective means to reduce the risk of illness for older people.Deadly diseases such as influenza and pneumonia are largely preventable by vaccination. Older people who lived through the 1918 flu epidemic that killed countless people all over the world will tell you that the flu shot is a miracle life saver!

Most of us have experienced the loss of a patient or loved one to pneumonia or associated complications that, perhaps, could have been prevented through immunization. In addition to flu and pneumovax vaccines, many health professionals are recommending patients get the shingles vaccination to ward off the severe nerve pain flare up that may attack anyone who has had chickenpox.

Even though immunization is available, recommended by health professionals, and payment is often covered by Medicare, there remain countless numbers of older people who do not receive the immunization.

The 2007 CDC report State of Aging and Health in America reports our nation’s progress in meeting the target indicators developed by the CDC Healthy People 2010 and provides a state-by-state comparison of progress.² The states of Ohio, Kentucky and Indiana rank in the bottom half of all states for both the flu and pneumovax vaccine. Based on 2004 data, only about 60 to 65% of older adults in these states have received vaccinations compared to the Healthy People 2010 target immunization rate of 90%. The immunization rates for minorities are even worse. The report indicates that only 50% Hispanics and 43% of African Americans obtain vaccinations for the flu and pneumonia. Additional research is needed as no conclusive factors explain the significant ethnic disparities.

Review of Best Practices in Clinical Settings:

1. Screen for an individual’s immunization history and educate about vaccination
2. Offer immunization for individuals (Fair evidence indicates health professionals motivate individuals in health behaviors)
   • Annual flu shot for individuals >65, one-time pneumococcal vaccination, and
   • Tetanus-diphtheria toxoid booster. (See resources below for more details)
   • 60 years of age and older against shingles (herpes zoster), (immunized individuals experience lower rate of herpes zoster and associated neuralgia, 61% and 67%, respectively)
3. Screen health care staff or those caring for others and offer immunization at recommended intervals (dependent on care-giving status)³

Although a recent report in Lancet Infectious Diseases (October 2007) indicates flu shots may not be as effective as believed for seniors, this study authors recommended that while awaiting more conclusive evidence, older adults continue to be immunized. An article in the October 4, 2007 New England Journal of Medicine indicates that the flu vaccine is highly effective and even cost saving for older people.⁴

Immunization for disease prevention is one of the scientific miracles available today to prevent illness or reduce its complications. Promoting healthy behaviors for older people and all of us includes educating, motivating and providing immunizations as needed.

The Centers for Disease Control and Prevention provides the recommended adult immunization schedule for the United States. This schedule and extensive footnotes include the recommended age groups and medical indications for routine administration of currently licensed vaccines for adults as of October 1, 2006 – September 2007.

These recommendations are approved by the Advisory Committee on Immunization Practices, The American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the American College of Physicians.

Resources:

1. Immunizations for Adults, Centers for Disease Control and Prevention.
2. The State of Aging in America, Centers for Disease Control and Prevention, 2007. 
3. Try this: Best Practices in Nursing Care to Older Adults, Issue No. 21 in a series. The Hartford Institute for Geriatric Nursing. Retrieved October 2, 2007.
4. Nichol., K. et al (2007). New England Journal of Medicine, 357:1373-1381, 1439-1441.

Compiled from Dr. Evelyn Fitzwater’s Gero Gems, which is a monthly publication of the Center for Aging with Dignity and is intended to raise awareness of aging and related issues affecting health care and social service professionals, and our society as a whole.

For more information:

Go to the Senior Health health topic.