Let’s be clear: The main reason to get the shingles vaccine is to get at least two doses. 90% protection It’s about confronting a painful and extreme disease that one-third of Americans will experience in their lifetime. This disease can cause persistent nerve pain and other unpleasant long-term consequences.
The most important reason older adults get vaccinated against respiratory infection RSV is Reduces your risk of being hospitalized. It increased by almost 70% in the year the shot was given and by almost 60% in the second year.
And the main reason to prepare for an annual flu shot is that it also reliably reduces the severity of the disease if people get infected. But its effectiveness depends on how well scientists predicted which strains of influenza would appear.
But other reasons are emerging for older people to get vaccinated. The shots are known for their off-target benefits, doctors say. This means that the shot does more good than prevent the disease it is designed to prevent.
“As research has accumulated and accelerated over the past decade, the list of off-target benefits is growing,” said William Schaffner, an infectious disease expert at Vanderbilt University Medical Center in Nashville, Tennessee.
Some of these protections have been established through years of data. Others are the subject of recent research, the results of which are not yet clear. For example, the first RSV vaccine was only released in 2023.
Nonetheless, the findings are “very consistent,” said Stefania Maggi, a geriatrician at the National Research Council’s Institute of Neuroscience in Padua, Italy.
she is Recent meta-analysisA study published in the British journal Age and Aging found that the risk of dementia was reduced after vaccination against a variety of diseases. Considering these “downstream effects,” she said, vaccines are “a key tool to promote healthy aging and prevent physical and cognitive decline.”
However, older people, who have weakened immune systems and a higher incidence of chronic diseases, are at increased risk of infectious diseases, so vaccinations are underutilized.
that Centers for Disease Control and Prevention report Last week, it was found that about 31% of older adults had not yet received a flu shot. Only about 41% of adults ages 75 and older have ever been vaccinated against respiratory syncytial virus (RSV), and about a third of older adults have received their most recent dose of a COVID-19 vaccine.
CDC recommends a one-time pneumococcal vaccine for adults age 50 and older. However, an analysis in the American Journal of Preventive Medicine found that calculation From 2022 to 2024, when the new guidelines were published, only about 12% of people ages 67 to 74 received them, and about 8% of people ages 75 and older.
The strongest evidence for off-target benefits dates back 25 years, showing a reduction in cardiovascular risk after a flu shot.
Healthy elderly people who have received the flu vaccine Reduced risk of hospitalization for heart failureThis also applies to pneumonia and other respiratory infections. Influenza vaccination is also relevant. reduced risk of heart attack and stroke.
Moreover, many of these studies predate the stronger flu vaccines currently recommended for older adults.
Could RSV vaccines that prevent other respiratory diseases have similar cardiovascular effects? recent large Danish study on older adults A nearly 10% reduction in cardiopulmonary hospitalizations involving the heart and lungs was found between the vaccinated and control groups. This is a significant decrease.
However, the reduction rates in cardiovascular hospitalizations and strokes did not reach statistical significance. This may reflect a short follow-up period or inadequate diagnostic testing, warned Helen Chu, an infectious disease expert at the University of Washington and co-author of the paper. accompanying editorial In JAMA.
“I don’t think RSV behaves any differently than the flu,” Chu said. “It’s too early to know about RSV, but we think it will show the same effect, maybe even more.”
Vaccination against COVID-19, another dangerous respiratory disease, has been linked to: Reduce the risk of developing long-term COVID-19It has detrimental effects on physical and mental health.
Perhaps the most provocative discovery concerns vaccination against shingles, also called shingles. Researchers made headlines last year when they documented a link between shingles vaccination and lower rates of dementia. This was true even with the less effective vaccine, which was replaced by Shingrix, approved in 2017.
Almost all studies of off-target benefits are observational. Because scientists cannot ethically withhold a safe and effective vaccine from a control group whose members may become infected with the disease.
This means that such studies are subject to “healthy volunteer bias” because vaccinated patients may practice different healthy habits that distinguish them from unvaccinated patients.
Although researchers try to control for a variety of potentially confounding differences, ranging from age and gender to health and education, “we can say there is a strong association, not cause and effect,” Maggi said.
However, Stanford researchers Wales’ natural experiment In 2013, when the first shingles vaccine, Zostavax, was made available to older people who were not yet 80 years old, anyone who got the vaccine was ineligible.
Over a seven-year period, the incidence of dementia among participants who were eligible for the vaccine was reduced by 20% compared to those who narrowly missed the deadline, even though only half of them actually received the vaccine.
“There is no reason why someone born a week ago would be any different from someone born a few days later,” said Maggie. research in australia and USA Additionally, the probability of developing dementia has been shown to decrease after vaccination against shingles.
In fact, a meta-analysis published by Maggi and her team found that several other childhood and adult vaccinations also seemed to have that effect. “We now know that many infections are associated with the development of Alzheimer’s disease and vascular dementia,” she said.
In 21 studies involving more than 104 million participants across Europe, Asia, and North America, shingles vaccination was associated with a 24% reduced risk of developing dementia. Flu vaccination was associated with a 13% reduction. People who were vaccinated against pneumococcal disease had a 36% reduced risk of Alzheimer’s disease.
The Tdap vaccine for tetanus, diphtheria and whooping cough (whooping cough) is recommended every 10 years for adults, and for older adults, it is often triggered by the birth of grandchildren who may not be fully vaccinated for several months. This was associated with a one-third reduction in dementia.
Other researchers are investigating the effects of: Shingles vaccine for heart attack and stroke and Corona vaccination for cancer survival.
What causes such vaccine bonuses? Most hypotheses focus on the inflammation that occurs when the immune system is mobilized to fight infection. “There is damage to the body from the surrounding environment, and it takes time to calm down,” Chu said.
The effects of inflammation can last much longer than the initial disease. If a blood clot forms in a narrowed blood vessel, it can lead to other infections or heart attacks and strokes. “If you prevent infection, you can prevent other damage,” Dr. Chu said.
Hospitalization itself, which can cause elderly patients to deteriorate or develop delirium, is a risk factor for dementia, among other health problems. Therefore, vaccines that reduce hospitalizations may delay or prevent cognitive decline.
Health officials in the Trump administration have attacked vaccines for children more than vaccines for adults, but their vocal opposition may contribute to inadequate vaccinations even among older adults.
Not only will many people miss out on emerging off-target benefits, but they will also remain vulnerable to the diseases that the vaccine prevents or reduces.
“Current national policy on vaccinations is uncertain at best and, in some cases, appears anti-vaccination,” said Schaffner, a former member of the CDC’s Advisory Committee on Immunization Practices. “All of us in public health are very distressed.”
“‘The New Old Age’ is produced in partnership with . new york times.
