Vaccines? Me?

If you’ve ventured out at all lately, you know it’s that time of year: Crisper air, turning leaves and oh yes, roll-up-your-sleeve time. It’s flu shot time, and a host of billboards, radio and TV messages and other gentle nudges are likely surrounding you, pushing you towards action.

While the flu vaccination is top of mind now—experts advise getting it by the end of October—that trip to the doctor or the drugstore is also a good chance to see what else you might need.  Vaccines aren’t just kid stuff, and seniors who bypass vaccines  can jeopardize their health. (Just ask Oprah, who didn’t realize she needed the pneumonia vaccine). Vaccine hesitancy, as the experts call it, is viewed by the World Health Organization as one of the top 10 threats to public health.    

So does it really work?

In a recent survey by the National Foundation for Infectious Disease(NFID), 60%  of U.S. adults polled said they think vaccination is the best preventive measure against death and hospitalization from flu, but only 52% said they planned to get the shot; another 18% said they weren’t sure. Some said they didn’t think it worked.

True, it’s not perfect. Each year, scientists make up the seasonal vaccine using their best guess about which flu strains will be out to get us. However, even if you get the shot and come down with the flu, ”you are likely to have a less severe illness,” says William Schaffner, MD, NFID’s medical director and professor of preventive medicine at Vanderbilt University Medical Center. 

And, you have choices. If you are 65-plus,the CDC recommends either the high-dose trivalent shot (it has a higher dose of the antigen, which the immune system develops antibodies against) and produces a stronger immune response. There’s also a trivalent flu shot made with adjuvant, which helps create a stronger immune response.

Younger people can get the standard dose quadrivalent made with egg, the quadrivalent with virus grown in cell culture, or the nasal spray.

While You’re There

Ask for a vaccine update/checkup. You may need protection against pneumococcal disease—lung and blood stream infections. 

About 1 in 3 people in the U.S. will get shingles, marked by a painful, sometimes debilitating rash. Recommended for those 50-plus, Shringrix is the CDC-preferred vaccine, given in two doses two to six months apart. Ask about it even if you had Zostavax, the original vaccine, in the past.

Updating other shots may be needed. Ask about Tdap vaccine (tetanus, diphtheria and pertussis or whooping cough), especially if there are new grandkids or other newborns around. They can’t be vaccinated right away.

With the measles outbreaks, consider asking your doctor to run a blood test to see where you stand on immunity. The results can guide you. Even if you had all the recommended vaccines, ”you can lose your immunity after age 50,” says Len Horovitz, MD, and internist and pulmonologist at Lenox Hill Hospital, New York City. He prefers a simple blood test to measure antibodies rather than simply vaccinating again without knowing that status.

Overcoming Resistance

People’s willingness to get vaccines aren’t always logical, as the survey suggests and Dr. Horovitz knows. He has had patients skip the flu shot but beg him for the shingles shot. They’ve often seen those commercials showing a person with shingles writhing in pain. Yet facts about the death toll from flu don’t always change their mind, even with the CDC reporting from 12,000 to 79,000 deaths annually from flu from 2011 through 2018.

Check, Please

Will health insurance and/or Medicare cover all these shots? Often. Original Medicare (fee-for-service) Part B covers most vaccines you need, Medicare says. Part D, the prescription drug plan, covers commercially available vaccines, except those covered by Part B, when they are reasonable and necessary to prevent illness.

Part B covers flu vaccine and the pneumococcal vaccine. Shingles vaccines aren’t covered by Medicare A&B, but are typically covered by Part D prescription drug plans.  Part D may also cover Tdap.

Health insurance plans vary in coverage, but often do cover for little or no cost.  

Extra Credit

For more on various flu vaccine options, FAQs and other details, see the CDC influenza page.

‘Fess Up

Did something change your mind about getting a vaccine you used to decline? For Oprah, coming down with a nasty case of pneumonia led her to urge people to get that shot when she recently appeared on the Ellen show. What’s your story? Tell us in the comments!

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