Not just for kids

Older adults fall short in vaccination rates for shingles, flu

Vaccination is a lifelong health concern. DOs can use wellness visits to discuss vaccines with seniors.


Some things, like a school yearbook found tucked under the bed, can bring up fond memories from childhood. A red rash or stripe of painful blisters, however, is not the way many would care to remember the chickenpox virus that’s been lying dormant for years. Despite the availability of a shingles vaccine, the Centers for Disease Control and Prevention found that roughly three-quarters of seniors do not get it.

And that’s not the only vaccination older adults are skipping. Just 65% of senior adults get the flu vaccine, and only 60% were vaccinated for pneumococcal disease, according to a 2015 report from the Alliance for Aging Research. The target goals are 90%.

In July, the AOA House of Delegates established policy encouraging physicians to treat patients’ vaccination history as an integral part of their health record. The new policy also urges DOs to take all reasonable steps to ensure patients are fully immunized against vaccine-preventable illness regardless of their age.

Physicians need to focus on prevention, says Randy Shuck, DO, director of medical education at St. Petersburg (Florida) General Hospital. Older adults might wait until they or someone they know gets shingles before they would consider getting vaccinated.

“We have no idea who’s going to get shingles; that is why we have to vaccinate everyone,” Dr. Shuck says.

Wellness visits are a great opportunity to discuss vaccinations with patients, says Donald Noll, DO. He especially advocates for the shingles vaccine because the disease could lead to neuralgia and require long-term pain management.

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“I explain to patients that vaccinations prime their immune system so it is ready to attack illness or infection if they are exposed,” says Dr. Noll, a professor at the Rowan University School of Osteopathic Medicine (RowanSOM) in Stratford, New Jersey. “Some patients change their minds, but some just won’t do it.”

It’s not uncommon for adults to lose vaccination records. If patients are unable to verify which vaccines they have received, Jennifer Caudle, DO, an assistant professor of family medicine at RowanSOM, recommends talking with their physician about repeat vaccination.

“For the vast majority of patients, there is no harm in receiving additional vaccination doses,” Dr. Caudle says.

Five tips to improve vaccination rates

Trying the following during appointments with older patients could encourage more of them to get vaccinated:

  • Let patients know if Medicare covers a vaccination because cost might be a concern to seniors on a fixed income.
  • Get to know your patients and their medical histories. “The more you know about a patient, the more you’ll know about what diseases they need protection from,” says Dr. Shuck. “For example, anyone with pulmonary issues or advanced age should be vaccinated for pneumonia.”
  • Use seasonal cues to start the conversation. Late summer and early fall, for instance, are good times to discuss the flu shot.
  • Educate patients about the benefits of vaccination in disease prevention.
  • Set realistic expectations with patients. “People are afraid they’ll get the flu anyway or they will get sick from the shot. They can still get flu, but it could be milder if they are vaccinated,” Dr. Noll says.

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