Vaccinations Archive

Ask the doctor

Q. I heard there is a high-dose flu vaccine that could work better in older people. Is it safe even if a man has a medical problem like cancer or heart disease?

A. The high-dose flu vaccine is very similar to the standard flu vaccine but appears to provide slightly better protection against influenza. Both vaccines target three different strains of the flu virus, selected from the most common strains predicted to be circulating that year. The viruses are inactivated, or killed, so they cannot cause the flu, even in people with weakened immune systems. Finally, both vaccines can cause mild symptoms of arm pain, redness, muscle aches, or low-grade fever. Although most people have minimal to no symptoms, the high-dose vaccine may slightly increase the side effects.

Adults need an annual flu shot and a Tdap booster every 10 years. People over 60 need a shingles shot, and those over 65 should have two pneumonia vaccines.

If you got the flu shot last year and it didn't work, don't reject vaccination.

During last year's battle of The People vs. Influenza, the virus gained the upper hand. Early in the 2014–15 flu season, a new strain of the virus emerged against which the existing vaccine offered virtually no protection. Hospitalizations for flu in older adults spiked to the highest level in a decade.

Vaccines are the best protection people have when it comes to certain illnesses. Older adults should get a flu shot every year.

Findings from a major clinical trial show that a new type of vaccine for shingles is much more effective than the existing vaccine in older people, although the new shot comes with more side effects.

I had shingles in 2005 and haven?t had a shingles shot. I haven?t been able to find any studies that indicate whether a shot is feasible for people who have already had shingles. What do you recommend?

Q. I'm 68, and I had the pneumonia vaccine a few years ago. Now I hear that I need to have two different ones. Do I really need to do this?

A. For many years, men who turned 65 were told that they needed a single pneumonia shot, called Pneumovax. Now the CDC suggests that older adults get an additional vaccination with a different vaccine, called Prevnar. The combination stimulates the immune system more effectively than either alone.

The two vaccines build immunity against different types of the bacterium, known as pneumococcus, that causes pneumonia. Pneumovax (PPSV23) protects against 23 common types of pneumococcus. Prevnar (PCV13) protects against 13 types.

If you're over 65, be sure to follow the latest pneumonia vaccine guidelines.

Each year, about a million people in the United States end up in the hospital with pneumonia, a serious lung infection that can be caused by an array of different viruses, bacteria, and even fungi. New research suggests that older people hospitalized with pneumonia face four times their usual risk of a having a heart attack or stroke or dying of heart disease in the month following the illness.

A study published in the Aug. 14, 2014, New England Journal of Medicine indicates that a high-dose version of the flu vaccine is more effective than the standard dose in preventing the flu for people over 65. The vaccine manufacturer, Sanofi Pasteur, had been required by the FDA to demonstrate that the high-dose version, which contains four times the dose of immune-stimulating antigens, actually works better than the standard dose.

About 32,000 people over 65 were randomly assigned to get either the standard flu vaccine or the high-dose version. All were asked to report any flulike illness they got over the next few months.