The Health Section

5 vaccines (and 3 health screens) adults need as they age

Vaccines and health screenings are not just for kids. In fact, they are just as critical for older adults.

Some may be needed every year, such as the flu shot, or every 10 years, such as tetanus shots. Vaccines can protect a person from a disease, while screenings can allow a health professional to check for certain conditions or cancers that are more common with age. When older adults have annual checkups with their primary care physicians, they should discuss screenings and vaccines they may need in the near future, according to John Moore, DO, FAAFP, Aetna’s medical director for the U.S. Northeast Region.

Vital vaccines

In early 2016, the U.S. Centers for Disease Control and Prevention (CDC) released a recommended adult immunization schedule, which shows how many doses of a certain vaccine specific age groups should receive. If a person has risk factors for a condition, the schedule also details when they should receive a vaccine. Five of the recommended vaccines are particularly important, notes Moore.

The influenza vaccination, or flu shot, is an “absolute necessity” for older adults.

The influenza vaccination, or flu shot, is recommended annually for everyone starting with babies at the age of 6 months. “You are never too old to get a flu shot,” Moore says. “In fact, the flu shot is an absolute necessity for older adults because the immune system weakens with age.”

The CDC recommends adults over 65 receive one dose each of two different vaccines to prevent pneumococcal bacteria, which is a common cause of pneumonia, bacterial infections in the blood (sepsis) and meningitis. These two vaccines are more effective when given separately, typically at least six months apart. Ask your doctor if you are at risk and should get the pneumococcal vaccines before age 65.

Older adults should also receive a dose of tetanus, diphtheria, pertussis vaccine. This shot, which can be referred to as a Tdap, will take the place of a tetanus booster which is normally given every 10 years. The vaccine is used to prevent pertussis, commonly known as whooping cough. You likely received the vaccine as a child, but the antibodies in the body wane over time.

“The antibodies wear off and don’t stay there, so we need to be boosted — especially if we’re going be around newborn babies,” Moore said. “You can put a newborn baby at risk for whooping cough. A serious case could send the baby to intensive care.”

Adults who are 60 or older should also receive the Zoster vaccination. The vaccine prevents shingles, a painful rash which is a reactivation of the chickenpox virus in adults. Some managed care plans, such as Aetna, cover this vaccine starting at age 50. For non-Aetna members, check with your health insurance provider to determine if a vaccine at age 50 is covered.

Importance of health screenings

Health screenings are recommended according to age and certain risk factors. For example, colonoscopies are recommended once someone turns 50. However, due to a higher incidence of colon cancer, African American adults should get a colonoscopy starting at age 45, according to Moore. Other adults with a strong family history of colon cancer need to start screenings at an even younger age. Moore suggests talking with a primary care physician to determine when to receive a colonoscopy screening.

Screenings are also important for older adults if they’re overweight because it can check for any chronic conditions related to weight.

For more information, the U.S. Preventive Services Task Force (USPSTF) offers a useful overview of recommendations for different screenings.

Screenings for women

About 1 in 8 women in the United States will develop breast cancer during their life, according to the American Cancer Society. Excluding skin cancer, breast cancer is the most common form of cancer found among women.

Many government and societal organizations have differing recommendations on when to start mammograms, how frequently to get them and if mammograms should continue after age 75. In general, Moore says, many physicians feel strongly about starting an annual screening at age 40 for women with an average risk of breast cancer. The screening should continue past age 75 if the woman is in good health and a good candidate for treatment if breast cancer is discovered. Moore recommends women speak to their primary care physician or OB/GYN about timing and frequency of mammograms. 

The American Cancer Society estimates 246,660 new diagnoses of breast cancer in 2016.

Depending on their age, women should also be screened for cervical cancer. Cervical cancer, or cancer of the cervix, will affect 12,990 new patients in 2016, according to the American Cancer Society. The organization also estimates about 4,120 women will die from cervical cancer, but it also emphasizes early detection can lead to treatment and cure.

The USPSTF recommends women between the ages of 21 and 65 be screened with cytology, or a pap smear, every three years. Women older than 65, who are also not at high risk of cervical cancer, do not need to be screened, according to the USPSTF.

Screenings for men

About 1 in 7 men will be diagnosed with prostate cancer during their lifetime, according to the American Cancer Society. As with mammograms, the recommendations for screenings for prostate cancer differs between several organizations and agencies. The general recommendation is to start exams and blood testing at age 50. Men who are African American or who have a family history of prostate cancer might need to be tested earlier.

Roughly 6 in 10 cases of prostate cancer are diagnosed in men aged 65 or older.

The frequency of prostate exams for men will depend on their prostate-specific antigen levels. For example, men with high levels should receive a screening every two years or every year. A primary care physician can determine how early and often prostate screening is advised for specific individuals.

Men can also be at risk for testicular cancer, which can develop in one or both testicles. About 1 out of 263 men will develop testicular cancer during their life. While many men are diagnosed at a younger age, the American Cancer Society reports about 7 percent of cases occur in men older than 55. Men can perform a self-examination for testicular cancer. For information, visit the American Cancer Society, which provides information on how to conduct a self-examination.