Vaccines for adult and senior

Several preventable diseases cause significant illness and even death in unvaccinated seniors. Older adults and those with chronic medical problems are more susceptible to contracting and developing serious complications and possibly life-threatening infections from preventable diseases.

It is important for older adults to keep vaccines current as immunity may have faded. The most important vaccinations for seniors include the flu vaccine, pneumococcal vaccine to prevent pneumonia, shingles vaccine, and a tetanus-diptheria-pertussis vaccine (Tdap).

Influenza/Flu Vaccine

Influenza (“flu”) is a contagious disease that spreads every winter. However, in tropical countries, people can get the flu all year round. Flu is caused by influenza viruses, and is spread mainly by coughing, sneezing, and close contact. The risk of getting flu is highest among children and elderly. Symptoms come on suddenly and may last several days.

They can include:

fever/chills
sore throat
muscle aches
fatigue
cough
headache
runny or stuffy nose

Flu can make some people much sicker than others. These people include young children, people 65 and older, pregnant women, and people with certain health conditions — such as heart, lung or kidney disease, nervous system disorders, or a weakened immune system. Flu vaccination is especially important for these people, and anyone in close contact with them. Flu can also lead to pneumonia, and make existing medical conditions worse. It can cause diarrhea and seizures in children.

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Influenza vaccine is the best protection against flu and its complications. Vaccine also helps prevent spreading flu from person to person.

Treatment

You are getting an injectable flu vaccine, which is either an “inactivated” or “recombinant” vaccine. These vaccines do not contain any live influenza virus. They are given by injection with a needle, and often called the “flu shot.”

Flu viruses are always changing. Each year’s flu vaccine is made to protect against 3 or 4 viruses that are likely to cause disease that year. Flu vaccine cannot prevent all cases of flu, but it is the best defense against the disease.

It takes about 2 weeks for protection to develop after the vaccination, and protection lasts several months to a year. Some illnesses that are not caused by influenza virus are often mistaken for flu. Flu vaccine will not prevent these illnesses. It can only prevent influenza. Some inactivated flu vaccine contains a very small amount of a mercury-based preservative called thimerosal. Studies have shown that thimerosal in vaccines is not harmful, but flu vaccines that do not contain a preservative are available.

Some people should not get this vaccine

If you have any severe, life-threatening allergies or ever had a life-threatening allergic reaction after a dose of flu vaccine, or have a severe allergy to any part of this vaccine, including an allergy to gelatin, antibiotics, or eggs, you may be advised not to get vaccinated. Most, but not all, types of flu vaccine contain a small amount of egg protein.
People with a history of Guillain-Barré Syndrome (a severe paralyzing illness, also called GBS).
If you are not feeling well. It is usually okay to get flu vaccine when you have a mild illness, but you might be advised to wait until you feel better.

Mild problems following inactivated flu vaccine:

(usually begin soon after the shot and last 1 or 2 days)

soreness, redness, or swelling where the shot was given
hoarseness
sore, red or itchy eyes
cough
fever
aches
headache
itching
fatigue

Moderate problems following inactivated flu vaccine:

Young children who get inactivated flu vaccine and pneumococcal vaccine (PCV13) at the same time may be at increased risk for seizures caused by fever.
Tell your doctor if a child who is getting flu vaccine has ever had a seizure.

Inactivated flu vaccine does not contain live flu virus, so you cannot get the flu from this vaccine.

There is a very remote chance of a vaccine causing a serious injury or death.

Instruction before and after treatment /procedure

Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or behavior changes. Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination.

Td or Tdap Vaccine

Tetanus, diphtheria and pertussis can be very serious diseases, even for adolescents and adults. Tdap vaccine can protect us from these diseases.

TETANUS (Lockjaw) causes painful muscle tightening and stiffness, usually all over the body. It can lead to tightening of muscles in the head and neck so you can’t open your mouth, swallow, or sometimes even breathe. Tetanus kills about 1 out of 5 people who are infected.
DIPHTHERIA can cause a thick coating to form in the back of the throat. It can lead to breathing problems, paralysis, heart failure, and death.
PERTUSSIS (Whooping Cough) causes severe coughing spells, which can cause difficulty breathing, vomiting and disturbed sleep. It can also lead to weight loss, incontinence, and rib fractures. Up to 5 in 100 adults with pertussis are hospitalized or have complications, which could include pneumonia or death.

These diseases are caused by bacteria. Diphtheria and pertussis are spread from person to person through coughing or sneezing. Tetanus enters the body through cuts, scratches, or wounds.

Treatment

Tdap vaccine can protect adults from tetanus, diphtheria, and pertussis.

One dose of Tdap is routinely given at age 11 or 12. People who did not get Tdap at that age should get it as soon as possible. Tdap is especially important for health care professionals and anyone having close contact with a baby younger than 12 months.
Pregnant women should get a dose of Tdap during every pregnancy, to protect the newborn from pertussis. Infants are most at risk for severe, life-threatening complications from pertussis.
A similar vaccine, called Td, protects from tetanus and diphtheria, but not pertussis. A Td booster should be given every 10 years. Tdap may be given as one of these boosters if you have not already gotten a dose. Tdap may also be given after a severe cut or burn to prevent tetanus infection.
Tdap may safely be given at the same time as other vaccines

Risk and side effect of treatment

With any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own, but serious reactions are also possible.

Brief fainting spells can follow a vaccination, leading to injuries from falling. Sitting or lying down for about 15 minutes can help prevent these. Tell your doctor if you feel dizzy or light-headed, or have vision changes or ringing in the ears.

Mild problems following Tdap

(Did not interfere with activities)

Pain where the shot was given (about 3 in 4 adolescents or 2 in 3 adults)
Redness or swelling where the shot was given (about 1 person in 5)
Mild fever of at least 100.4°F (up to about 1 in 25 adolescents or 1 in 100 adults)
Headache (about 3 or 4 people in 10)
Tiredness (about 1 person in 3 or 4)
Nausea, vomiting, diarrhea, stomach ache (up to 1 in 4 adolescents or 1 in 10 adults)
Chills, body aches, sore joints, rash, swollen glands (uncommon)

Moderate problems following Tdap

(Interfered with activities, but did not require medical attention)

Pain where the shot was given (about 1 in 5 adolescents or 1 in 100 adults)
Redness or swelling where the shot was given (up to about 1 in 16 adolescents or 1 in 25 adults)
Fever over 102°F (about 1 in 100 adolescents or 1 in 250 adults)
Headache (about 3 in 20 adolescents or 1 in 10 adults)
Nausea, vomiting, diarrhea, stomach ache (up to 1 or 3 people in 100)
Swelling of the entire arm where the shot was given (up to about 3 in 100).
Severe problems following Tdap

(Unable to perform usual activities; required medical attention)

Swelling, severe pain, bleeding and redness in the arm where the shot was given (rare).
A severe allergic reaction could occur after any vaccine (estimated less than 1 in a million doses).

Some people should not get this vaccine

If you ever had a life-threatening allergic reaction after a dose of any tetanus, diphtheria, or pertussis containing vaccine, OR if you have a severe allergy to any part of this vaccine, you should not get Tdap.
If you had a coma, or long or multiple seizures within 7 days after a childhood dose of DTP or DTaP, you should not get Tdap, unless a cause other than the vaccine was found. You can still get Td.
Talk to your doctor if you: – have epilepsy or another nervous system problem, – had severe pain or swelling after any vaccine containing diphtheria, tetanus or pertussis, – ever had Guillain-Barré Syndrome (GBS), – aren’t feeling well on the day the shot is scheduled.

Pneumococcal Vaccine

Pneumococcal disease is caused by Streptococcus pneumoniae bacteria. Anyone can get pneumococcal disease, but some people are at greater risk than others:

People 65 years and older
The very young people with certain health problems
People with a weakened immune system
Smokers

Pneumococcal disease can lead to serious infections of the:

Lungs (pneumonia),
Blood (bacteremia), and
Covering of the brain (meningitis).

Pneumococcal pneumonia kills about 1 out of 20 people who get it. Bacteremia kills about 1 person in 5, and meningitis about 3 people in 10. People with the health problems described in Section 3 of this statement may be more likely to die from the disease.

There are two kinds of pneumococcal vaccines available:

Pneumococcal conjugate vaccine 15-valent (PCV15)
Pneumococcal polysaccharide vaccine or PPSV23

Treatment

All adults 65 years of age and older.
Anyone 2 through 64 years of age who has a long-term health problem such as:

1. heart disease

2.lung disease

3.sickle cell disease

4.diabetes

5.alcoholism

6.cirrhosis

7.leaks of cerebrospinal fluid or cochlear implant

Anyone 2 through 64 years of age who has a disease or condition that lowers the body’s resistance to infection, such as:

1.Hodgkin’s disease

2.lymphoma or leukemia

3.kidney failure

4.multiple myeloma

5.nephrotic syndrome

6.HIV infection or AIDS

7.damaged spleen, or no spleen

8.organ transplant

Anyone 2 through 64 years of age who is taking a drug or treatment that lowers the body’s resistance to infection, such as: – long-term steroids

1.certain cancer drugs

2.radiation therapy

Any adult 19 and above who:

1.is a smoker

2.has asthma

Risk and side effect of treatment

Anyone who has had a life-threatening allergic reaction to the vaccine should not get another dose.
Anyone who has a severe allergy to any component of a vaccine should not get that vaccine.
Anyone who is moderately or severely ill may be asked to wait until they recover before getting the vaccine. Someone with a mild illness can usually be vaccinated.
While there is no evidence that pneumococcal vaccine is harmful to either a pregnant woman or to her fetus, as a precaution, women with conditions that put them at risk for pneumococcal disease should be vaccinated before becoming pregnant, if possible.

What are the risks from pneumococcal vaccine?

About half of people who get the vaccines have mild side effects, such as redness or pain where the shot is given.
Less than 1% develop a fever, muscle aches, or more severe local reactions.
The risk of a vaccine causing serious harm, or death, is extremely small.

Instruction before and after treatment /procedure

Zoster Vaccine

Shingles, also known as zoster or herpes zoster, is a painful skin rash resulted from being repeatedly infected with the same virus that causes chickenpox, Varicella-Zoster Virus (VZV). Anyone who has had chickenpox or received chickenpox vaccine in the past may develop shingles, which can result in development of painful blisters, sores and rashes on the skin.

After recovering from chickenpox, VZV still remains within the infected body, locating along the end of the nerve pathways. When the body’s immune system is weakened, the virus can multiply, resulting in development of herpes zoster attack. Shingles will only occur along the nerve pathways such as around the hip, coccyx, eyes and face and will not spread to the rest of the body. A person with weak immune system such as an elderly, long term use of immunosuppressive medications such as steroids, having leukemia or Acquired Immunodeficiency Syndromes (AIDS) has higher risk of developing shingles.

Alternative treatment

Administering Herpes Zoster Shingrix Vaccine
Shingrix (recombinant zoster vaccine) should be administered to adults age 50 years and older as a two-dose series, 2 to 6 months apart.

Some people should consult the doctor before getting the vaccine.

A person who has ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of herpes zoster vaccine.
A person who has a weakened immune system because of:
- HIV/AIDS or another disease that affects the immune system,
- treatment with drugs that affect the immune system, such as steroids,
- cancer treatment such as radiation or chemotherapy, or
- cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma.
Women who are or might be pregnant. Women should not become pregnant until at least 4 weeks after getting herpes zoster vaccine.

Risk and side effect of treatment

Redness, soreness, swelling, or itching at the site of the injection and headache
Rarely, live shingles vaccine can cause rash or shingles.
Tell your doctor if you feel dizzy or have vision changes or ringing in the ears.
As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death

Risk and side effect of treatment

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