Kim Beckham, an insurance agent living in Victoria, Texas, in the US, had seen friends suffer so badly from shingles that she wanted to receive the first approved shingles vaccine as soon as it became available, even if she had to pay for it out of pocket.
After her Zostavax shot, she said, “I felt really relieved.” She has since received the newer, more effective shingles vaccine, as well as the pneumonia shot, the respiratory syncytial virus vaccine, annual flu shots and all the recommended vaccinations for Covid.
Some older people are really eager to be vaccinated.
Robin Wolaner, 71, a retired publisher in Sausalito, California, US, has been known to badger friends who delay getting recommended vaccine shots, sending them relevant medical studies. “I’m sort of hectoring,” she acknowledged.
Deana Hendrickson, 66, who provides daily care for three young grandsons in Los Angeles, US, sought an additional MMR shot, though she was vaccinated as a child, in case her immunity to measles was waning.
For older adults who express more confidence in vaccine safety than younger groups, the past few months have brought some welcome research. Studies have found important benefits from a newer vaccine and enhanced versions of older ones, and one vaccine may confer a major bonus that nobody had foreseen.
The phrase “Vaccines are not just for kids anymore” has become a favourite of Dr William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center in the US.
“The population over 65, which often suffers the worst impact of respiratory and other disease-causing viruses, now has the benefit of vaccines that can prevent much of that serious illness,” he said.
Take influenza, which annually sends from 1,40,000 to 7,10,000 people to hospitals, most of them older than 65. It is fatal to 10 per cent of hospitalised older patients.
More good news: vaccines to prevent respiratory syncytial virus (RSV) in people older than 60 are performing admirably.
RSV is the most common cause of hospitalisation for infants, and it also poses significant risks to older people. “Season in and season out,” Dr Schaffner said, “it produces outbreaks of serious respiratory illness that rivals influenza.”
In analysing electronic health records for almost 8,00,000 patients, the researchers found the vaccines to be 75 per cent effective against acute infection, meaning illness that was serious enough to send a patient to a healthcare provider.
The vaccines were 75 per cent effective in preventing emergency room or urgent care visits, and 75 per cent effective against hospitalisation, both among those aged between 60 and 74 and those older.
Immunocompromised patients, despite having a somewhat lower level of protection from the vaccine, will also benefit from it.
People older than 65 express the greatest confidence in vaccine safety of any adult group, a survey by non-profit KFF found in April. More than 80 per cent said they were “very” or “somewhat confident” about MMR, shingles, pneumonia and flu shots. Although the Covid vaccine drew lower support among all adults, more than two-thirds of older adults expressed confidence in its safety.
Even sceptics might become excited about one possible benefit of the shingles vaccine. This spring, Stanford University, US, researchers reported that over seven years, vaccination against shingles reduced the risk of dementia by 20 per cent.
The Stanford team took advantage of a “natural experiment” when the first shingles vaccine Zostavax was introduced in Wales, UK. Health officials set a strict age cutoff — people who turned 80 on or before September 1, 2013, weren’t eligible for vaccination, but those even slightly younger were eligible.
In the sample of nearly 3,00,000 adults whose birthdays fell close to either side of that date, almost half of the eligible group received the vaccine, but virtually nobody in the older group did.
“Just as in a randomised trial, these comparison groups should be similar in every way,” Dr Pascal Geldsetzer, a public health researcher at the Knight Initiative for Brain Resilience at Stanford and lead author of the study, explained. A substantial reduction in dementia diagnoses in the vaccine-eligible group, with a much stronger protective effect in women, therefore constitutes “more powerful and convincing evidence,” he said.
The team also found reduced rates of dementia after the shingles vaccine was introduced in Australia and other countries.
How a shingles vaccine might reduce dementia remains unexplained. Scientists have suggested that viruses themselves may contribute to dementia, so suppressing them could protect the brain. Perhaps the vaccine revs up the immune system in general or affects inflammation.
“I don’t think anybody knows,” said Dr Paul Harrison, a psychiatrist at Oxford, UK, and a senior author of the study. But he added, “I’m now convinced there’s something real here.”
NYTNS