Vaccine-preventable diseases can lead to severe or prolonged illness, hospitalization, and death in older adults, particularly in those who have not received the appropriate vaccinations.

Vaccine-preventable diseases can lead to severe or prolonged illness, hospitalization, and death in older adults, particularly in those who have not received the appropriate vaccinations. The most common illnesses are influenza and pneumococcal disease, but older adults are at risk for other vaccine-preventable illnesses as well, including Herpes Zoster (shingles). Researchers estimate the cumulative costs of vaccine-preventable diseases in this population could be more than a trillion dollars over the next 30 years, and lead to over a million deaths.

Influenza (Flu)

The flu is an acute respiratory illness caused primarily by one of two influenza viruses — Influenza A or B. Influenza epidemics typically occur during late fall through early spring, and most cases are due to Influenza A infection. People aged 65 and older are especially vulnerable to serious complications, and most influenza-related deaths occur in this age group. People living in nursing facilities are at higher risk for complications because of chronic medical conditions, living in a closed environment and having less responsive immune systems.

Influenza is spread through close contact, droplet and sometimes air-borne transmission (e.g., sneezing, coughing and a runny nose). The incubation period is generally one to four days, but on average two days from the time of infection. People can be contagious up to 24 hours before symptoms begin, and for five to seven days after the onset of illness.

Immunization is the cornerstone of influenza control. Anyone living or working in a nursing facility should receive the flu vaccine each year, unless specifically contraindicated. Antiviral medications may be used to prevent infection and for treatment purposes; however, they are not a substitute for immunization.

Pneumococcal Pneumonia

Pneumococcal pneumonia is a common infection and a major cause of illness, hospitalization and death in people living in nursing facilities. It is especially common in winter and early spring when respiratory diseases are prevalent. Although Pneumococcal disease can cause many types of illnesses, pneumonia is the most common illness in adults. People aged 65 years and older as well as people who have certain conditions are at higher risk for Pneumococcal pneumonia. The organism that causes it, Streptococcus pneumoniae, is the most common cause of bacterial pneumonia in nursing facilities. Pneumococcal disease spreads from person to person by coughing, sneezing or close contact. The incubation period is one to three days.

The pneumococcal vaccine should be administered routinely to anyone living in a nursing facility, regardless of age. People whose vaccination status is unknown should be vaccinated as well. Specific recommendations and the vaccine used will depend on the age of the person, and any underlying health conditions.

Herpes Zoster (Shingles)

Around one in three people in the US will develop shingles, in their lifetime. Anyone who has had chickenpox is at risk for developing shingles. Other risk factors include advanced age, a weakened immune system, and even stress. While most people will get shingles only once, it is possible for it to recur.

Shingles develops when the dormant chickenpox virus reactivates later in life. Pain, itching, and/or tingling are often the first symptoms, followed by a rash and blisters. Most cases resolve within three to five weeks, but some people experience long-term complications such as post-herpetic neuralgia - severe pain that can impact their daily lives.

The Centers for Disease Control and Prevention (CDC) recommends the shingles vaccine for all adults aged 50 and older. The shingles vaccine can reduce the risk of developing the disease by 50% to 90%. If someone develops shingles after being vaccinated, their risk of developing post-herpetic neuralgia is reduced and generally the course of the disease is less severe.

Tetanus, Diphtheria and Pertussis

The CDC recommends everyone be vaccinated against tetanus, diphtheria, and pertussis, including people living in nursing facilities. Adults who have not been vaccinated previously should receive:

  • An initial dose of the Tdap
  • A Tdap or Td booster every 10 years thereafter

Boostrix® is recommended for the booster vaccinations for people over the age of 65, but any available vaccine may be used.


COVID-19 is a highly contagious respiratory illness caused by a novel coronavirus that emerged in 2019, leading to a global pandemic. The disease can range in severity from asymptomatic to mild, moderate, and severe. People aged 65 years and older as well as people who have chronic conditions or are immunocompromised are at higher risk for severe illness.

COVID-19 is spread through droplet and aerosol transmission, as well as through touching environmental surfaces contaminated with the virus, and then touching the mouth, nose, or eyes. The incubation period is between two to 14 days.

The CDC recommends primary vaccination for anyone aged 6 months or older and a first booster based on age, immune status and vaccine product. People aged 50 years or older are eligible for a second booster. Specific recommendations and schedules for each available vaccine can be found on the CDC's Use of COVID-19 Vaccines in the United States webpage.

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