Vaccines That Protect Older Lungs

Why vaccines matter more with age

With age, the immune system responds less strongly to infections and to vaccines, and chronic conditions such as COPD, asthma, diabetes, heart failure, kidney disease and cancer add to the risk. Respiratory infections can trigger COPD and asthma flare-ups, heart attacks, strokes, confusion and falls. Prevention is easier than recovery. Vaccines also protect others: a vaccinated family reduces the chance of bringing infection to a vulnerable parent.

Influenza (flu) vaccine

• What it protects against: seasonal influenza, which can cause pneumonia and complications in older adults. The virus changes each year, so the vaccine is updated and given every year.
• Who: doctors generally advise it for adults over sixty-five or sixty, and for people of any age with chronic lung, heart, kidney or metabolic disease, those in care settings and their carers and household contacts.
• When: typically before the flu season in your area. In India, flu peaks vary by region, with surges around the monsoon and in winter, so ask your doctor for the best timing. Older adults may be offered a higher-dose or adjuvanted vaccine in some countries; availability in India may vary.
• Effectiveness: it reduces the risk of illness, hospital stay and death, though not completely, and protection fades, hence the yearly dose.
• Egg allergy: most people with egg allergy can still be vaccinated under medical advice; tell the doctor.

Pneumococcal vaccines

• What they protect against: infection by the pneumococcus bacterium, a leading cause of bacterial pneumonia, as well as blood infection and meningitis.
• Types: there are conjugate vaccines and a polysaccharide vaccine, with different numbers of included types. Schedules differ between countries and have changed over time; some adults receive one dose of a newer conjugate vaccine, others receive a conjugate followed by a polysaccharide vaccine after a gap.
• Who: commonly recommended for adults over sixty-five or sixty, and for younger adults with chronic lung disease, heart disease, diabetes, kidney disease, no spleen, smoking and some other risk factors.
• When: usually not every year. Ask the doctor which vaccine your parent should get and whether earlier doses count.

COVID-19 vaccines

• Why: older adults have the highest risk of severe illness from COVID-19.
• What: vaccines and boosters updated for circulating variants. Recommendations on timing and the products offered have changed, and differ by country and over time.
• Who: doctors usually prioritise older adults and people with long-term conditions for primary doses and periodic boosters.
• Practical: if your parent had COVID-19, ask the doctor about the timing of the next dose.

RSV vaccine

Respiratory syncytial virus (RSV) causes cold-like illness in most adults but can lead to pneumonia, worsening of COPD, asthma and heart failure in older people. Vaccines for older adults have become available in several countries in recent years, with recommendations focusing on adults aged around sixty and above, particularly those with chronic conditions. Availability and policy in India may differ and are evolving. Ask your doctor whether it is appropriate and available.

Tetanus, diphtheria and whooping cough (pertussis)

Adults are advised to keep tetanus and diphtheria protection up to date, typically with a booster every ten years, and a booster after a dirty wound if more than five years have passed. A combined vaccine that includes whooping cough protection may be offered; pertussis can cause prolonged coughing and is a risk for infants in the family. Ask the doctor.

Other vaccines the doctor may discuss

• Shingles vaccine: protects against herpes zoster and its painful aftermath, and is commonly advised for older adults in many countries. Shingles is not a lung illness, but it is a serious cause of illness in older age.
• Hepatitis B, hepatitis A, typhoid and others: depending on risk, travel and chronic conditions.
• Travel vaccines: if your parent is going abroad or on pilgrimage; see travel with an elderly parent checklist.

Your doctor will tailor the list. A written vaccine record is useful: see keeping a health record at home.

Getting vaccinated: practical points

• Where: a family doctor's clinic, a hospital vaccination centre, a government facility or a trusted private provider. Ensure vaccines are stored and handled properly, and the product is genuine; check batch and expiry. If a vaccine is bought outside, only a qualified person should give it.
• Before: tell the doctor about allergies, previous reactions, fever or acute illness, bleeding disorders or blood thinners, immunosuppressive treatment, and recent vaccines. Carry the medicine list. Eat normally and drink water.
• Timing: postpone for a moderate or severe acute illness or a fever; minor colds are usually not a reason to delay. Ask the doctor.
• Multiple vaccines: several can often be given at the same visit in different arms or sites, if the doctor advises.
• Blood thinners: the doctor may advise a thin needle and firm pressure for a few minutes.
• After: stay for 15 to 30 minutes for observation, keep the vaccination card, and note the date and next due dates.

Side effects

Most are mild and short-lived:

• Soreness, redness or swelling at the injection site.
• Mild fever, tiredness, headache, body aches or chills for a day or two.
• Occasionally, dizziness or fainting during or just after the injection.

Use only the measures the doctor suggests for comfort, such as a cool cloth for the arm. Ask the doctor or pharmacist before giving any fever or pain medicine, particularly if your parent takes blood thinners or has kidney or stomach problems.

Rare but serious reactions include a severe allergic reaction, usually within minutes to an hour: difficulty breathing, swelling of the face or throat, hives all over, fast heartbeat or collapse. Call 112 immediately if any occur. Seek medical advice for high fever, severe pain or swelling, or any symptom that worries you in the days after. Report adverse events to the doctor or the vaccination programme.

Myths

• "The flu vaccine gives you flu." The injected vaccines do not contain live virus and cannot cause influenza; mild symptoms after the injection are the immune response.
• "My parent is too old." Older age is a reason for vaccination, not against.
• "A vaccine means no precautions." Vaccines reduce but do not remove risk; keep up with hand hygiene, clean air, healthy habits and medical care.
• "Natural immunity is enough." Immunity from past infection wanes and the virus changes.
• "Vaccines are only for children." Many adult vaccines exist for good reasons.

Other ways to protect the lungs

• Stop smoking and avoid smoke; see COPD at home guide.
• Hand hygiene and cleaning shared surfaces; see infection control for home caregivers.
• Avoid close contact with sick people, and ask visitors with colds to stay away or wear masks.
• Good dental and mouth care, which reduces germs.
• Clean air: see indoor air quality for older lungs: dust, smoke and damp and a pollution season plan for older adults.
• Good nutrition and exercise; see pulmonary rehabilitation exercises at home.
• Prompt treatment of symptoms and an action plan for chronic lung disease; see building a COPD action plan with your doctor.
• Safe swallowing to avoid aspiration pneumonia; see swallowing problems (dysphagia) in older adults.
• Household vaccination: family members who are vaccinated reduce the chance of passing infection.

See also pneumonia in older adults: prevention and recovery.

Costs and access in India

Some vaccines are provided free in government programmes for certain groups, and others are available privately, at costs that vary. Ask the doctor, the local health authority or the hospital about availability, schedules and any senior citizen programmes. Check whether health insurance covers vaccination; see health insurance for senior citizens in India.

When to ask a professional

Ask the doctor which vaccines your parent should have, when and in which order, and whether any should be avoided. Ask about timing around illness, surgery and medicines that lower immunity. Ask a pharmacist or nurse to record doses. Seek medical help for fever, cough, breathlessness or chest pain after exposure to infection. Call 112 for a severe allergic reaction or severe breathlessness.