Immune function wanes in all adults—whether healthy or sick—as they age into their fifth decade and beyond. Their bodies become less adept at recognizing and stopping pathogens, and the ability to develop and maintain immunity declines. Also known as immunosenescence, age-related decline in immunity significantly contributes to the susceptibility of older adults to serious conditions, including influenza, pneumonia, and shingles.
Patients often believe that by living a healthy lifestyle, they can avoid illness and disease. While exercising, getting recommended screenings, and eating right are important for staying healthy, they alone do not prevent older adults from acquiring vaccine-preventable diseases. For older adults who feel, and generally are, healthy, it can be difficult to recognize that immunosenescence is occurring or what impact it may have. Underappreciation for immunosenescence could at least partially explain why adult vaccines remain significantly underutilized, despite their ability to stimulate and heighten immune response and boost waning immunity in older adults. According to the National Center for Health Statistics, in 2015, only 57% of Americans aged 65 years or older received a tetanus vaccine in the prior 10 years, 64% had received a pneumococcal vaccine, and only 34% had ever received a herpes zoster vaccine. Among adults 50 years and
older, four vaccine-preventable diseases alone—influenza, herpes zoster, pneumococcal disease, and pertussis—cost the United States more than $26 billion annually.
Ensuring that adult patients receive recommended vaccines is an important way to prevent unnecessary infections and reduce health care costs. Health care professionals play a key role in this process, specifically, they should:
Assess their adult patient’s immunization status
Strongly recommend vaccination at every opportunity using the 4R approach: Recommend, Repeat, Remind, Review
Have a program that supports in-practice vaccine administration
Refer patients to a health care professional who administers vaccines if you do not
Document vaccine administration and submit to the immunization registry
Vaccination is a critical component of protecting the health of individuals as they age. Providing a strong recommendation for vaccination at each encounter increases the likelihood of an individual accepting a vaccine, reducing the risk for debilitating illness, and protecting quality of life.