Communications: Patient Education

Patient Education: Caring for Older Adults - Vaccinations Should Be A Life-Long Priority

Wednesday, February 11, 2015  
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Preventive care with a trusted physician is just as important for adults as those well-checks are for children.  Family physicians provide preventive services to help patients avoid health problems or to identify and treat them early.  As a person ages, health issues tend to increase which is why older patients should make continued care a top priority – this includes getting all vaccinations that are recommended by experts.

Vaccinations prevent disease by giving the body immunity.  The U.S. Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians recommend an adult immunization schedule annually. 

“Patients should make sure to review the latest vaccination recommendations with their family doctor,” said James Struve, M.D., a Bloomington family physician and member of the Minnesota Academy of Family Physicians (MAFP).  “What a patient over 60 will need is dependent upon their health status, what immunizations they’ve had in the past, who they will have close contact with and any travel plans they may have on the books.”

Here are some vaccination basics to discuss with your family physician:

All adults should get an influenza vaccination every year unless there is a history of an allergic reaction or a known egg allergy.  The nasal spray flu vaccine (FluMist) should not be given to anyone older than 49 years old.  A high-dose flu shot, which can be given to patients 65 years of age or older, may offer added protection.  Also, many suppliers are transitioning from a vaccination which protects against three flu viruses to one which protects against two types of both A and B influenza viruses.  This type of quadrivalent vaccination should be widely available in coming years.

“People 65 years of age or older are at greater risk for hospitalization or death from influenza so this recommendation should be taken seriously,” said Dr. Struve. 

All adults need a tetanus and diphtheria (Td) booster shot every 10 years throughout their life.  This protects against tetanus and diphtheria.  At least one Tdap shot is also recommended at age 65 if a person will be caring for or spending time with grandkids or other young children.  The Tdap shot provides added protection against pertussis, also known as whooping cough. 

The pneumococcal vaccine helps protect against pneumococcal disease, including pneumonia, bacteremia (infection of the bloodstream) and bacterial meningitis. There are two different types of pneumococcal vaccine, PCV13 and PPSV23.  Within the last year, ACIP issued new recommendations for older adults changing the timing and the order of the vaccines to make them more effective.

“The new recommendations can sometime be confusing for patients,” said Dr. Struve.  “Seniors should talk to their doctor to find out if they need one or both of the vaccines and when they need them.”

He says it’s important to note that Medicare only pays for one pneumonia vaccination at or after age 65.  Until Medicare reviews its policy, patients will have to pay for any additional pneumonia vaccinations.

A herpes zoster vaccination is needed once after age 60 to protect against shingles.  Shingles is a viral infection that causes a painful rash.  Although shingles can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso.  A shingles vaccination is recommended even if a patient has had shingles before.

There are other immunizations that may be needed on a case-to-case basis.  If patients will be traveling, they should plan on visiting their family physician 4-6 weeks before departure.  Vaccination considerations for travel include typhoid, booster for polio, hepatitis A, hepatitis B, and rabies. Meningococcal polysaccharide and yellow fever vaccinations are required for entry into certain countries.  A Japanese encephalitis vaccination is recommended for travelers to Asia who will be staying in rural areas for at least a month.  Patients can search the Centers for Disease Control website (www.cdc.gov) by destination to find specific vaccination recommendation.
 

The Minnesota Academy of Family Physicians is a professional association of approximately 3,000 family physicians, family medicine residents and medical students organized to assist family physicians in providing quality medical care in Minnesota. The MAFP is the largest medical specialty organization in Minnesota and is a state chapter of the American Academy of Family Physicians, one of the largest national medical organizations in the United States with more than 103,000 members.


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