Ask a Medcan registered nurse: Which vaccines do I need when I am 50 or older?

Boosters for boomers

During a consultation with a patient over the age of 50, we typically recommend the following vaccines:

Tetanus, Diptheria and Pertussis

It is important to make sure you’ve had a tetanus shot within the last 10 years, as that’s something that is easy to lose track of. We will typically give an Adacel vaccination, which includes tetanus, diptheria and pertussis (whooping cough).  In recent years, we have seen an increase in whooping cough incidence in Ontario, therefore we want to ensure clients have at least one dose of pertussis in their adult life.

Coverage against pertussis is especially important if you are around infants and young children who are not fully protected against whooping cough. After receiving an Adacel vaccine, you should receive a Tetanus-Diptheria (Td) booster vaccination every 10 years.

Shingles

Our newest and most popular vaccine at Medcan is the Shingrix vaccine to prevent the shingles virus. Shingles is a viral infection, also known as herpes zoster, caused by the chicken pox virus. The virus remains in the nerve cells of your body and may re-activate in adulthood, commonly resulting in a very painful, blistering rash. Currently, there are two shingles vaccinations on the market: the Zostavax vaccine and the Shingrix vaccine. Both immunizations are available to anyone 50 years of age or older. If you’ve had an episode of the shingles, it is recommended to wait a minimum of one year before receiving the Shingrix or Zostavax vaccine.

The two shingles vaccines differ slightly in their efficacy and composition. Both vaccines are still newer to the preventive health market, therefore data is limited to four to five years. Using the comparison chart below, you can consider which shingles vaccine is most suitable for you.

Zostavax Shingrix
Live vaccine

  • Subcutaneous injection
Non-live recombinant adjuvanted vaccine

  • Intramuscular injection
1 dose required

  • Unknown if booster is required
2 doses required at 0, 2-6 months

  • Unknown if booster dose is required after primary series
Cost: $245 for one dose

  • OHIP covered for anyone 65-70 years of age.
Cost: $200 per dose ($400 total for series)

Reduces the risk of shingles overall by 51% and PHN (post-herpetic neuralgia) by 67% in people 50 and over.

Efficacy of preventing zoster declines as age at time of vaccination increases:

  • 50-59 yrs 70% effective
  • 60-69 yrs 64% effective
  • 70-79 yrs 41% effective
  • ≥80 yrs 14% effective
Efficacy at over 90%, regardless of age at time of vaccination (50 and over).
Effective for about 5 years, with a considerable decrease in effectiveness after year 1, and by year 4, effectiveness down to less than 35%. Efficacy of over 87.9% maintained for 4 years post vaccination and continues to be monitored.
Common side effects include: pain, swelling, hard lump, itchiness and redness at the site, lasting up to 3 days.

  • 1 in 3 people who receive the vaccine will experience these side effects

Common side effects include: pain, redness, swelling at the injection site, headache, stomach and digestive complaints, muscle pain, tiredness, chills and fever.

There tends to be an increased number of complaints of pain at injection site that lasts an average of 3 days.

Contraindicated for people who are immuno-compromised or on immunosuppressive medication. Although there is limited data on giving Shingrix to someone who is immuno-compromised, immunosuppression is not a contraindication for the vaccine.
Adults vaccinated before age 60 years might not be protected later in life when the risk for shingles and its complications are greatest. While Shingrix looks promising in providing excellent coverage against shingles, the effectiveness past 4 years is unknown.

Pneumonia

For anyone over the age of 65, we will consider vaccinating against pneumonia. Pneumococcal bacteria can be spread from person to person through talking, coughing and/or sneezing. Pneumococcal disease can lead to various potentially life-threatening disease such as pneumonia, sepsis and meningitis. There are two immunizations currently available: the Prevnar 13 vaccine and the Pneumovax23 vaccine. We recommend receiving both vaccines to have a broad range of coverage against bacterial pneumococcal pneumonia. If you have certain medical conditions such as chronic lung disease (asthma, COPD etc.), heart disease or diabetes, you may be eligible to receive your pneumonia vaccine before the age of 65.

Influenza

Every fall, Medcan offers publicly-funded influenza vaccinations for people of all ages. Each year, the flu shot is created based on which influenza strains were most prevalent the previous year, in hopes to optimize its efficacy. It is best to receive your annual flu shot before flu season begins. The influenza vaccine is typically available at the end of October or beginning of November. The influenza vaccine not only protects yourself from infection but helps to protect your friends and family. In addition to receiving your annual flu shot, the best way to prevent transmission of influenza is good hand hygiene!

An ounce of prevention … 

Vaccines are a great preventive measure to maintain good health. Unsure if your vaccines are up to date? Consult with your family physician or a nurse to see if there are any vaccines you could benefit from receiving.

If you have questions or would like to book your booster at Medcan, please email YearRoundCare@medcan.com.

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