Vaccines for the Elderly

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While the bulk of vaccination in the UK is performed on young children through the childhood vaccination programme, there are instances where vaccination is performed on older people. This article looks at why some elderly people need additional support through these extra vaccinations, and which ones are provided on the NHS.

Why are vaccines needed amongst elderly people?

The NHS’ childhood vaccination programme confers immunity against a range of extremely contagious diseases for life, and through it there has been over a 90% decrease in deaths from preventable diseases in the UK.

As we age our body’s ability to defend itself can suffer, becoming less efficient at protecting you from the myriad of different bacteria and viruses we encounter every day. Our natural defences are referred to as the immune system, and over time it responds less quickly to invading disease bearing agents.

This chance occurs because as we age our bodies tend to undergo a number of changes, and generally speaking, become less efficient at various different roles. Ultimately the net result of all these changes is that we can find it harder to fend off relatively common infections like the flu. Because of this particular care is taken when treating elderly patients, as they can be particularly susceptible to conditions like influenza and pneumonia. Not only are these conditions more likely to strike elderly patients, but once the infection has taken hold they can also pose a more serious threat.

An example of bodily changes that ultimately result in a weakened immune system is in the thymus, a small organ found in your chest. The thymus is an extremely important immune organ, responsible for generating a class of immune cells called T-lymphocytes or T-cells. Normally these cells are produced in our bone marrow and sent to the thymus to mature and become the disease fighting machines that protect us from infection.

As we grow older our thymus actually becomes smaller and smaller, eventually becoming a staggering 5% of the original size by the time we reach the age of 60. The result of this is a decline in the number of our T-cells our body can field in response to an infection, and ultimately this means that the immune system is less able to deal with invading bacteria and viruses.

As we age our skin undergoes a number of changes that actually impact our immunity. Many people are surprised to find that our skin is actually an important part of our immune system, providing a first line barrier defence against organisms around us. As we age and our skin thins and loses its integrity, bacteria find it easier to make their way into our systems.

These changes mean that it becomes more important to take steps to prevent infections from happening in the elderly community, as they can pose a more significant threat then they would in younger people.

How is infection prevented amongst the elderly?

There are a number of steps that can be taken to protect elderly people from potentially nasty infections. These include good hygiene to prevent the inadvertent transmission of disease, and regular hand washing is an excellent example of that. Similarly avoiding people with the flu or any other particularly infectious condition which may pose a risk to an elderly person is a good step.

Diet and a healthy fitness regime are two absolutely critical factors when it comes to protecting against infections, both amongst the elderly and the wider public. A balanced diet that is rich in all the nutrition your body needs and free of too many sugars, fats, and artificial components can do wonders for the general health and workings of the human body.

Finally regular vaccination is a key step in preventing the spread of disease amongst the elderly community, and this is discussed in more detail in the following section.

Vaccinations for older people

A number of different vaccinations are provided for older people with the purpose of bolstering their immunity. At present the NHS provides two key vaccines to this end, the first is a single dose against pneumococcal infections given at the age of 65, and the second is a yearly fly booster injection given at the start of the flu season (around October). This simple injection programme saves countless lives every year and is an invaluable service offered by the NHS.

Vaccinations against chickenpox isn’t a regular provision in the UK, but can be offered to elderly patients who have not previously suffered from the infection. Chickenpox is harmless when it affects children, but infections afflicting older people can become quite severe.

Shingles Vaccinations are offered, as well as booster injections for conditions vaccinated against as part of the routine childhood vaccination programme. There is evidence to indicate that immunity against conditions like diphtheria can decrease as we grow older, making it prudent to effectively top up the elderly’s immunity against such conditions.

Finally travel vaccinations are offered to elderly adults travelling abroad, and can include injections against hepatitis (A and B) and BCG (the tuberculosis vaccine).

While vaccinating the elderly is a powerful preventative tool, some older people don’t react very well to existing vaccines, simply because of the gradual decrease in their immune systems’ ability to respond to infections. Because of this, research into new vaccination techniques that would meet the needs of the elderly population is always underway.

What Vaccinations are Available to Elderly People?

While most of us benefit from the protective effects of childhood vaccinations, the elderly population can find themselves vulnerable to particular illnesses and conditions. As we age our body’s immune system can start to work less efficiently, meaning that we are less able to combat infections and stay healthy. Because of this a number of vaccinations are offered to elderly people to provide their immune systems with the support needed to fight off everyday infections like the flu.

Seasonal flu vaccine for the elderly

This vaccination is offered to elderly patients at the age of 65 and above on a yearly basis. While younger people can usually fight off the flu, and if infected, recover within a few days, many elderly patients face serious risks and complications if exposed to influenza.

The flu vaccine is an injection offered at around October, the start of the flu season when infection is quite likely. This injection needs to be supplied yearly because the flu virus is constantly changing its structure. This is a mechanism by which the virus tries to evade the immune system, and so new vaccines need to be developed and administered to vulnerable populations.

PPV for the Elderly

PPV stands for pneumococcus polysaccharide vaccine, another injection offered to elderly patients that offers immunity against a class of bacteria called Streptococcus, also referred to as pneumococcus. There are a very large number of different pneumococcal bacteria, and this vaccine can immunise against about a third of them with an efficiency rate of about 50-70% against pneumonia, sepsis, and other conditions.

Pneumococcus can pose a serious risk to elderly patients, many of who died from pneumonia before this vaccine was offered by the NHS to people aged 65 and over. The PPV injection only needs to be administered once, and that single dose is enough to protect elderly patients for the rest of their lives.

Varicella (chickenpox) and Shingles vaccinations for the elderly

Chickenpox is a harmless childhood infection that, once it strikes, confers immunity against the causative varicella zoster virus. Unfortunately this virus causes a more serious threat if infects adults and the elderly, posing the risk of complications like encephalitis. Hence a chickenpox vaccine is offered to adults and elderly people who did not contract the condition when they were children, giving them much needed protection against the disease.

The varicella zoster virus also causes another condition called Shingles, which occurs in adults when the virus is re-activated. Individuals suffering from Shingles have usually previously suffered from chickenpox, and usually have the virus in their system for some time before its reactivation. The vaccination can prevent the onset of a very severe condition which can cause debilitating long term pain. At present you will probably have to pay for this particular vaccine, but the hope is that a routine vaccination for Shingles will be offered to 70-79 year olds in the future.

Childhood boosters

As mentioned earlier in his article, we are provided with a number of injections during our childhood that provide immunity against a broad range of diseases. Recent evidence indicates that the immunity conferred by childhood vaccination may diminish as we age, and so it is now possible to receive a supplementary booster injection for the conditions the NHS vaccinates against during childhood (e.g. whooping cough or diphtheria).

Other vaccinations offered to elderly people

Older people who travel frequently or are at risk of exposure to particular infections through their occupation are offered vaccinations relevant to their situation. For example some elderly people are prone to travelling extensively, and in these cases vaccines against hepatitis A and B, tuberculosis, and yellow fever can be obtained.

Vaccinations are an important means by which elderly people can retain their quality of life and avoid illnesses that can often be severe, if not life threatening. New vaccines are constantly being developed with elderly people in mind, and the hope is that as time goes on a more rigorous system of adult vaccination will be implemented against a broader range of diseases known to afflict the elderly population.

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