By Courtney Schmidt, PharmD
October 14, 2020
Advertisement

When we hear about vaccines, we often think about babies and school-aged children. However, vaccines aren’t just for kids; they are also important for maintaining health and preventing illness as we grow older. 

Benjamin Kaplan, MD is an internal medicine physician and clinical associate professor at Florida State University College of Medicine. He explains, “It's important for people over the age of 65 to get all their vaccines because as we get older, our immune systems don't work as well. We become more susceptible to infections, then when we do get sick, we may not have the same reserve to overcome the illness that we once had as a younger adult.”

An illness that might have been no big deal in your 30s can be a really big deal in your 70s. If you have a chronic condition, such as diabetes or heart disease, the stakes are even higher. 

“If you can get a vaccine that can prevent sickness and death, you should get it,” says Dr. Kaplan.

Even if you haven’t reached retirement age, you may be caring for or advocating on behalf of an older parent or spouse. You may be able to help your loved one stay healthy by encouraging them to get vaccinated after age 65. 

Here are four vaccines everyone over 65 should consider:

Influenza vaccine

Each year beginning in October, you’ll see signs around your doctor’s office or at your local pharmacy advertising flu shots. You might be tempted to think, “Hey, what’s the big deal? I’ve had the flu before,” or “I never get the flu. I’m fine!” You aren’t alone; many people feel this way. 

Consider, though, that during the 2019–2020 flu season 38 million people got the flu, 400,000 became hospitalized, and 22,000 died, according to the Centers for Disease Control and Prevention (CDC). Of those who died of this preventable illness, 62% were older adults. 

While an annual flu vaccine can’t guarantee you’ll never get the flu, the CDC estimates that a flu shot decreases your chance of getting the illness by 40 to 60%. If you do contract the flu after receiving the vaccine, you’ll probably experience a less severe illness with less likelihood of complications, hospitalization, or admission to an intensive care unit. 

When should I get a flu shot?

“I am telling my patients, similar to the guidance of the CDC, that everyone should get their flu shot as soon as possible,” says Dr. Kaplan. “There is no reason to wait, especially now with the possibility of COVID-19. You don’t want to have the flu and COVID at the same time, and you want to know that you’re doing your part to protect those around you.”

Does Medicare cover the flu shot?

Yes, if you have Original Medicare, Medicare Part B covers one flu shot each year. You pay nothing as long as your health care provider accepts Medicare, and you can receive the flu shot at your doctor’s office or local pharmacy. 

If you have a Medicare Advantage plan, a flu shot is likely covered, but you may need to use an in-network provider. Contact your plan for details. 

Pneumococcal vaccine

The pneumococcal vaccine protects you from harmful bacteria that can cause serious infections throughout your body resulting in pneumonia (lung), meningitis (brain and spinal cord), or bacteremia (bloodstream). The consequences of this disease can be devastating, leaving lasting effects such as deafness, loss of limbs, brain damage, or death. More than 18,000 adults over 65 die from pneumococcal disease each year, and those with chronic diseases are most at risk for complications and death. 

There are two pneumococcal vaccines: Prevnar 13 (PCV13) and Pneumovax 23 (PPSV23).

When should I get the pneumococcal vaccine?

All adults over 65 should be vaccinated against pneumococcal disease. For most people, it is recommended to get Prevnar 13 at age 65, then receive Pneumovax 23 one year later. 

This schedule could vary if you have already received the PCV13 prior to age 65 or if you are immunocompromised. You should not receive both the Prevnar and Pneumovax vaccine at the same time. 

Does Medicare cover the pneumococcal vaccines?

Yes, if you have Original Medicare, Medicare Part B covers both pneumococcal vaccines. Medicare covers the PCV13 at any time, then the PPSV23 one year later. 

If you have a Medicare Advantage plan, pneumococcal vaccines are likely covered, but you may need to use an in-network provider. Contact your plan for details. 

Shingles vaccine

The same virus that causes chicken pox causes shingles. If you had chicken pox as a child, the virus can remain dormant in your body for many years, then become reactivated to cause shingles. The rash itself is debilitating and painful, but it can also leave long-lasting nerve pain after the rash has cleared. 

The CDC estimates that 90% of adults over 40 have had chicken pox (whether they remember it or not), but if you have never had chicken pox, this vaccine will protect you from that as well. 

When should I get the shingles vaccine?

All adults over 50 should get the shingles vaccine Shingrix. It is a two-part series, with the second dose given two to six months after the first. While another shingles vaccine is on the market, Shingrix has been shown to be more effective at preventing the illness. 

Does Medicare cover the shingles vaccine?

No, Original Medicare (Medicare Part A and Part B) does not cover the shingles vaccine. However, Medicare prescription drug plans (Part D) cover all commercially available vaccines needed to prevent illness. 

If you are enrolled in a Part D prescription drug plan or a Medicare Advantage plan, review your plan for details.

Tetanus, diphtheria, and pertussis vaccine

The Tdap vaccine is a combination shot that protects against tetanus, diphtheria, and pertussis. Tetanus is an infection caused by bacteria often found in soil and associated with wound contamination. Diphtheria is a severe infection of the nose and throat, and pertussis is a severe respiratory infection known as whooping cough.

When should I receive the tetanus, diphtheria, and pertussis vaccine?

You should consider the Tdap if you have never received this routine vaccine (known as the DTaP in children), which is usually given around 11–12 years of age and to pregnant women during each pregnancy. Whooping cough is especially dangerous for infants, so new parents, grandparents, and caregivers are encouraged to vaccinate to protect babies who are not yet able to receive the vaccine. 

Does Medicare cover the tetanus, diphtheria, and pertussis vaccine?

No, Original Medicare (Medicare Part A and Part B) does not cover the Tdap. However, Medicare prescription drug plans (Part D) cover all commercially available vaccines needed to prevent illness. 

If you are enrolled in a Part D prescription drug plan or a Medicare Advantage plan, review your plan for details. 

The takeaway 

Receiving vaccinations as an adult is an important way to protect and prolong your health as you age. Whether you’ve reached retirement age, are the caregiver of an older adult, or are simply concerned for an elderly family member, knowing which vaccines are recommended will help you or your loved one make important decisions. If you have questions or concerns about these vaccines, talk to your doctor or pharmacist.

Courtney Schmidt is a medical communications professional and clinical pharmacist with pediatric and adult hospital experience.