The Pandemic Stopped Many Things but don’t Let it Stop Your Routine Healthcare

Many older adults are skipping out on their shots, against advice from professionals. 

As we get older our immune systems get weaker. This is why people over a certain age are highly recommended to get the flu shot and why it’s so important for older adults to stay up on their vaccinations. We usually find out about our vaccinations from routine doctor’s visits, so what happens when you aren’t going to the doctor anymore? Many people have not seen their Primary Care Physician (PCP) for months if not a year, as with Covid, no news is good news. We’ve all been avoiding exposure and riding the “well if I don’t need to go to the doctor that’s a good sign right?” Well, not quite… 

Many older adults have been foregoing their necessary vaccinations including flu shots, shingles, and others that we only find out about from routine visits. We are playing a game of chicken by thinking that we are saving ourselves by not getting vaccinated because with Covid-19 filing our hospitals, you don’t want to end up in the hospital for a vaccine-preventable illness like Shingles, yet people are afraid or uninformed of the vaccinations they need to keep up with. Every year, older adults are encouraged to get the flu shot as influenza kills 12,000-61,000 people every year, most of which are over the age of 65. Healthcare workers are encouraging prevention now more than ever, not just for Covid-19, but for preventable illnesses as well. 

According to the New York Times, “the nation has long done a better job of vaccinating its children than its elders. The most recent statistics, from 2017, show that about one-third of adults over 65 had not received a flu shot within the past year. About 30 percent had not received the pneumococcus vaccine.” In 2018 we saw only 34.5% of qualified older adults receive a shingles vaccine. (nytimes.com) 

Another common theme to our realizations of 2020 are healthcare disparities between races. A disproportionate number of Black and Hispanic older adults receiving significantly less vaccinations than their white counterparts. For example, Black and Hispanic people are vaccinated 20% against shingles as compared to their white counterparts at 40%. (nytimes.com) 

Health officials say they understand the fear of the Coronavirus vaccination because of it’s novelty, but there’s no excuse to bypass the others. Especially for a generation that saw polio, whooping cough and more, older adults are expected to understand why vaccinations are so important. So why is it happening?

Vaccinations are simply not as well advertised to older adults by their PCPs as with Pediatricians and children. Older adults often have multiple doctors and therefore have a hard time keeping track of what they got and didn’t.

Fear of cost can’t be a barrier as Medicare Part B covers influenza, pneumococcal and Hepatitis B vaccinations completely. Part D covers Tdap and shingles, which you can get at a pharmacy if you don’t make it to the doctor’s office. If that doesn’t work you can get your vaccinations at supermarkets, health departments and clinics. Not only will this protect older adults, but it will protect everyone else. 

Here’s what the CDC recommends for your vaccinations in 2020/2021:

Influenza An annual shot in the fall — and it’s still not too late, because flu season peaks from late January into February. Depending on which strain is circulating, the vaccine (ask for the stronger versions for seniors) prevents 40 to 50 percent of cases; it also reduces illness severity for those infected.

Thus far this year, flu activity has remained extraordinarily low, perhaps because of social distancing and masks or because closed schools kept children from spreading it. Manufacturers shipped a record number of doses, so maybe more people got vaccinated. In any case, fears of a flu/Covid “twindemic” have not yet been realized.

Nevertheless, infectious disease experts urge older adults (and everyone over six months old) to get flu shots now. “Flu is fickle,” Dr. Schaffner said. “It could take off like a rocket in January.”

Tetanus, diphtheria, pertussis. A booster of TD vaccine every 10 years, to prevent tetanus and diphtheria. If you’ve never had the Tdap vaccine — which adds prevention against pertussis — that’s the one you want. Although pertussis, better known as whooping cough, occasionally shows up in adults, newborns are particularly at risk. Pregnant women will ask expectant grandparents to get a Tdap shot. Because it is covered under Part D, a pharmacy is the best bet.

Pneumococcus. “It’s a pneumonia vaccine, but it also prevents the most serious consequences of pneumonia, including meningitis and bloodstream infections,” Dr. Koppaka said.

People over 65 should get the polysaccharide formula — brand name Pneumovax — but there are certain circumstances, such as immune-compromising conditions, to discuss with a health care provider.

Those over 65 may choose, again in consultation with a provider, to also get the conjugate pneumococcal vaccine (brand name Prevnar), which provides some additional protection. If so, C.D.C. guidelines specify which vaccine to take when.

Shingles. Social distancing won’t ward off this disease; anyone who had chickenpox, which is just about every senior, still carries the virus.

“If you live to be 80, you stand a 35 to 50 percent chance of having an episode,” Dr. Schaffner said. “And the older you are when you get it, the more apt you are to get the most serious complication” — lingering nerve pain called post-herpetic neuralgia.

The C.D.C. recommends Shingrix, the highly effective shingles vaccine the F.D.A. approved in 2017, for everyone over 50. The previous shingles vaccine has been discontinued. Get Shingrix even if you had the earlier vaccine, Zostavax, and even if you’ve had shingles — it can recur.

The two required shots, given two to six months apart, can total $300 out of pocket. But Medicare Part D beneficiaries will pay an average of $50 for the pair, said a spokesman for the manufacturer GlaxoSmithKline, and people with private insurance even less.

Hepatitis A and hepatitis B. These aren’t age-related; the vaccines are recommended for people with certain health conditions, including chronic liver disease and H.I.V. infection, or for travelers to countries where the diseases are widespread.

The hepatitis B vaccine is also recommended, at a provider’s discretion, for diabetics over 60 who haven’t been previously vaccinated. Talk to a health care professional about your risks.

Source: https://www.nytimes.com/2020/12/28/health/coronavirus-elderly-vaccines.html