Vaccines: A few minutes now could spare you misery later

What are you looking forward to this fall and winter?

Getting together with friends to cheer for your favorite teams? Halloween parties? Going to concerts or that new restaurant you want to try? Family holiday traditions? Maybe a trip somewhere warm?

But wait!

Unless you act now, you could instead be looking at a week or two lying on the couch, miserable. A potential trip to the emergency room. Using up your sick time at work, or going without pay because you don’t get sick time. Excruciating pain. Long-lasting fatigue. Or maybe weeks in the hospital.

No thanks.

But every fall and winter, millions of adults get sick and miss work and fun  because they didn’t get the vaccines that could have protected them from infectious diseases.

If you’re over 50, you’re especially vulnerable.

That’s why now is a perfect time to get the vaccines that could mean the difference between a great fall and winter, and a terrible one.

Even if you do get infected, vaccines will make your illness shorter and less awful.

Kahli Zietlow, M.D., is a University of Michigan Health geriatrician, or doctor who specializes in the care of older adults.

Every winter, she encounters patients who regret missing out on recommended vaccines, as they as they realize they could have stayed out of the hospital if they had gotten a simple shot.

“They say ‘I wish I’d known,’ or ‘I wish I’d gotten around to getting that vaccine,’” she said.

She also talks to patients who are on the fence about vaccination because they worry that getting a shot will make their arm sore or make them feel tired.

“I tell them one day of feeling a little under the weather after getting a vaccine is much better than being out of commission for weeks, or ending up on a stretcher in a windowless emergency room hallway, or lying in a hospital bed for weeks and realizing you could have avoided it,” she said.

What vaccines should you get, when should you get vaccinated, and which ones should come first?

The updated COVID-19 vaccine and the updated flu vaccine are important to get right away, for everyone over the age of 6 months, says Preeti Malani, M.D., an infectious disease specialist at U-M Health.

Then, if you qualify for an RSV vaccine because you’re over 60 or pregnant, get that one this fall too.

After that? Catch up on the other vaccines recommended for your age and health status, listed below in this article. (If you have kids, make sure they’re up to date too.)

“The main thing is to start now, and keep going, because each vaccine takes a couple of weeks to reach full effectiveness,” said Malani.

“Get ahead of the fall and winter respiratory virus waves and avoid missing the things you love most.”

Zietlow and Malani recommend older adults check out vaccination information prepared by the American Geriatrics Society, and take a quick vaccine-advice quiz for adults from the Centers for Disease Control and Prevention.

 

Where should you get vaccinated?

Go to the place where you can get your shots soonest.

That may mean the pharmacy down the street or the public health clinic downtown, rather than your usual doctor’s office.

And that’s OK – the important thing is to get vaccinated. You can search for COVID-19 and flu shot locations near you at vaccines.gov.

The rise of pharmacy-based vaccination during the pandemic has made it much more convenient for many people.

Churches and temples, senior centers and other locations often offer flu shots too.

But it can still be hard for some older adults to get to a vaccination place or book an appointment online. Reach out to older neighbors, friends and relatives to see if you can help them.

 

Key adult vaccines you should get

Updated COVID-19 vaccine

Designed to protect you against an ever-mutating coronavirus, this may become an annual fall vaccine just like the flu vaccine.

You can get vaccines made by Pfizer, Moderna or Novavax.

Insurance covers the entire cost for almost everyone, and if you don’t have insurance you can get it for free.

While some people had trouble finding it in the first weeks, it should be widely available now, especially at pharmacies.

If you have Medicare Advantage, or other types of insurance with narrow networks, make sure the pharmacy or clinic where you want to get vaccinated is in-network for your plan.

People over 50, and especially people over 65 or so, have a much higher chance of getting seriously sick if they get COVID-19. And while past vaccinations do offer some protection, it wanes over time.

In fact, data presented when this year’s COVID-19 vaccine was approved showed that the vast majority of older adults hospitalized for COVID-19 in the first half of 2023 had not gotten an updated bivalent booster vaccine (That’s the one rolled out last September; the new COVID-19 vaccines replace it and the original vaccines.)

Also, most older people who got sick enough to hospitalize for COVID-19 had multiple underlying health conditions – including obesity, heart disease, diabetes, and chronic lung diseases.

If you’ve already got some health issues, you really need to make time to get the updated vaccine as soon as possible.

You can also reduce your risk of long COVID if you get your updated vaccine.

If you had COVID this summer, you have some added immunity from it – but you can still get protection from a COVID vaccine this fall.

 

Flu vaccine

Another vaccine to get immediately – on the same day as your COVID vaccine if you want to – is the tried-and-true flu shot.

It’s updated every year, and while it doesn’t give you a guarantee against catching the flu, you’ll get less sick if you do catch it.

If you’re over 65, you can get a high dose version that really ramps up your immune response. Both this version, and the regular flu vaccine, are available at no cost.

Zietlow says many people don’t realize that in older adults, the flu can lead to the lung infection called pneumonia, which is a top reason for ER visits and hospitalizations, and a top cause of death.

Other viruses and bacteria can cause pneumonia too – but we don’t yet have vaccines against all of those.

“These things that we think of as benign aren’t actually that benign, especially in older adults,” she said.

“The flu can send you to the emergency department with pneumonia. You could end up hospitalized. And, especially for our oldest adults, that all too often becomes the entry point to a nursing facility, and never coming home.

“Or you could get vaccinated.”

 

RSV vaccines

New this fall for people over 60, these vaccines can prevent another top cause of illness and pneumonia in older adults: the respiratory syncytial virus or RSV.

Babies, toddlers and anyone in their last months of pregnancy can also get protection against RSV now.

Both the youngest and the oldest Americans face the worst threat from RSV, which infects the lungs.

Last fall, RSV led to a massive surge in hospitalizations on top of a COVID wave.

That’s why the new vaccines are so exciting to doctors like Malani and Zietlow.

It’s not every day that they can offer their patients a new way to prevent a potentially serious illness.

Malani and her colleagues at the National Poll on Healthy Aging asked older adults across America this summer about the RSV vaccine, and found widespread interest, but also a lack of awareness.

A single dose of RSV vaccine is covered by insurance for everyone in the recommended age groups, in consultation with a health care provider.

For now, it’s best to get it on a different day than your COVID-19 or flu shots. After you get it, you may have a sore arm or some fatigue for a short time.

Just think of that as the ounce of prevention that’s worth a pound of cure.

Shingles vaccine

If chickenpox made you miserable when you were a kid or teen, shingles is even worse.

It’s what happens when the same virus rises like a zombie from its hiding places inside your body, and attacks your nerves.

It causes merciless, piercing pain that can last weeks or months.

Zietlow has seen some horrible cases in older adults, whose genitals, eyes, face or large patches of skin get taken over by shingles rash.

It can even affect vision or leave lasting nerve damage.

“I’ve heard so many people wishing they had gotten this vaccine, after it’s too late,” she said.

“We can treat the rash, but the medications we need to use can increase a person’s risk of a fall, or damage their kidneys.”

Everyone over age 50 can get the shingles vaccine, whether or not they know that they had chickenpox earlier in life. It’s a two-dose vaccine.

When you get your first dose, book an appointment to return two to six months later for the second.

New this year, Medicare covers the full cost of the vaccine, unlike in past years when some older adults had to pay for it.

Pneumococcal vaccine

Viruses like COVID, flu and RSV aren’t the only things that can cause pneumonia – bacteria can too. That’s why people over 65 should also get the vaccine that can help you fight off the most common bacterial forms of pneumonia. It’s called the pneumococcal vaccine.

These vaccines are covered by Medicare and other forms of insurance.

It’s especially important for people who live in nursing homes and assisted living facilities, and people with heart problems, diabetes, asthma or lung disease to get this vaccine.

Zietlow says it’s best to talk with a doctor, pharmacist or nurse practitioner to figure out your personal schedule for getting the multiple doses of this vaccine needed for full protection, depending on your age and health status.

Tetanus and Tdap

What’s the last time you got a tetanus shot?

Can’t remember? It’s probably time for another one – you should get it every 10 years.

You can get it by itself or as part of a “combo platter” vaccine called Tdap.

That one also protects you against pertussis, commonly called whooping cough.

If you’re likely to be around babies or toddlers, who can get really sick from pertussis and can also give it to you, it’s important to get a Tdap vaccine if you haven’t had one in the last decade.  A bout of pertussis in an older adult can lead to a cough that lasts for months, Zietlow says.

Other adult vaccines

Depending on your age and circumstances, you can get vaccinated against Hepatitis B (especially if you’re under 59), measles, mumps and rubella (if you were born after 1957 and aren’t sure if you got vaccinated as a child, or you are planning an overseas trip).

Not sure you want to get all these vaccines?

Talk to a health care provider you trust, such as a primary care doctor or nurse practitioner, or the pharmacist at the place you go regularly.

“You won’t hurt anyone’s feelings by having questions,” said Zietlow.

“It makes us all better if we question with an open mind and discuss options.”