Adult immunizations: don’t leave home without them

The last thing that you and I want to know is that aging brings a deterioration of the immune system to the point that we are at significant risk of serious infections. Bummer!  Can we combat this problem? You bet we can with immunizations!  However, you need to understand that because the immune system is weaker, immunization may not prevent the infection but often will decrease its severity and reduce the likelihood of it causing death.

Unfortunately, in Canada many seniors have not received appropriate adult immunizations because they tend not to be a priority for primary care practitioners who have many other things to worry about. Although routine childhood immunizations such as whooping cough, and tetanus should be up kept to date “the big 3”, influenza, pneumococcal pneumonia, and shingles are the most important immunizations for seniors. It is estimated that 4000 Canadians die each year from pneumonia related to influenza, of whom the vast majority are over the age of 65.

Therefore, for you and I, influenza is not just a sore throat and runny nose but rather a severe infection that can finish us off earlier than we had planned.  Influenza vaccine, free in Ontario, must be given annually because the viruses tend to change each year.

Bacterial pneumonia, frequently caused by the pneumococcus bacterium, is another leading cause of lung infections in the elderly; 30 to 50% of those who survive hospitalization with community acquired pneumococcal pneumonia will die within 5 years. Those with underlying health problems such as diabetes, chronic lung disease, heart disease, and cancer are at greatest risk from both influenza and pneumococcal pneumonia. Recent studies have shown that both of these infections can increase the risk of heart attack and stroke; vaccination has been shown reduce these risks substantially.

The chickenpox virus (Herpes zoster) acquired in childhood, remains dormant until immune dysfunction with age leads to its reactivation in nerves causing ‘shingles’.   This infection is actually on the rise and will affect 30-50% of seniors in their lifetime. Often accompanying shingles is severe nerve pain that can go on for months to years, especially in the elderly. The chronic pain of shingles can be so devastating that patients lose their independence because of loss of normal function .The shingles vaccine, available for the past 5 years, is about 66% effective in preventing shingles in those 60 to 69 years of age and is 35% effective in those over 70. However, both groups benefit from a 66% reduction in nerve pain in those who developed shingles after being vaccinated.

Vaccines are not just for kids. They are the safest and most convenient way to prevent significant illness and death. Don’t suffer because you procrastinated …be vaccinated! Tell your family doctor that I sent you.

Jay S. Keystone  MD FRCPC

Director, Medisys Travel Health and Immunization Clinic, Toronto

Professor of Medicine, University of Toronto