Health – Page 4 – watercress words by Dr Aletha

The Surprising Benefits of Vaccines for Older Adults

In this post I share updates about the numerous off-target benefits of vaccinations for older adults, highlighting their potential to reduce risks of cardiovascular diseases and dementia. It emphasizes the importance of vaccinations like flu, shingles, and RSV, while noting that many older adults remain unvaccinated, missing out on these protective effects.

This information is current as of the date of original publication or update but may have changed by the time you read this. Do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with a qualified healthcare professional.

I think I am officially “older”. I qualify for Medicare and have reached my full retirement age. I receive the senior discount at restaurants. I remember many events that younger people have only heard about.

I find many advantages to having reached this age and in this article from KFF Health News I learned about more. The vaccines I have received to prevent infections may also protect me from cardiovascular disease and dementia.

I’m sharing this information with you here now, courtesy of KFF Health News.

VACCINE-PREVENTABLE DISEASES — This is not a complete list of all available vaccines.

Vaccines Are Helping Older People More Than We Knew

by Paula Span, January 14, 2026

Let’s be clear: The primary reason to be vaccinated against shingles is that two shots provide at least 90% protection against a painful, blistering disease that a third of Americans will suffer in their lifetimes, one that can cause lingering nerve pain and other nasty long-term consequences.

The most important reason for older adults to be vaccinated against the respiratory infection RSV is that their risk of being hospitalized with it declines by almost 70% in the year they get the shot, and by nearly 60% over two years.

And the main reason to roll up a sleeve for an annual flu, influenza, shot is that when people do get infected, it also reliably reduces the severity of illness. However, its effectiveness varies by how well scientists have predicted which strain of influenza shows up.

photo of a display at the Museum of Natural Science in Washington, DC, from Dr. Aletha

Off-Target Benefits

But other reasons for older people to be vaccinated are emerging. They are known, in doctor-speak, as off-target benefits, meaning that the shots do good things beyond preventing the diseases they were designed to avert.

The list of off-target benefits is lengthening as “the research has accumulated and accelerated over the last 10 years,” said William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center in Nashville, Tennessee.

Some of these protections have been established by years of data; others are the subjects of more recent research, and the payoff is not yet as clear. The first RSV vaccines, for example, became available only in 2023.

Still, the findings “are really very consistent,” said Stefania Maggi, a geriatrician and senior fellow at the Institute of Neuroscience at the National Research Council in Padua, Italy.

She is the lead author of a recent meta-analysis, published in the British journal Age and Ageing, that found reduced risks of dementia after vaccination for an array of diseases. Given those “downstream effects,” she said, “vaccines are key tools to promote healthy aging and prevent physical and cognitive decline.”

Dr. Aletha inspecting her arm after a COVID-19 shot

I rolled up my sleeve for a COVID vaccination.

Yet too many older adults, whose weakening immune systems and high rates of chronic illness put them at higher risk of infectious diseases, have not taken advantage of vaccination.

The Centers for Disease Control and Prevention reported last week that about 31% of older adults had not yet received a flu shot. Only about 41% of adults 75 and older had ever been vaccinated against RSV, or respiratory syncytial virus, and about a third of seniors had received the most recent COVID-19 vaccine.

The CDC recommends the one-and-done pneumococcal vaccine for adults 50 and older. An analysis in the American Journal of Preventive Medicine, however, estimated that from 2022, when new guidelines were issued, through 2024, only about 12% of those 67 to 74 received it, and about 8% of those 75 and older. (The pneumoccal vaccine protects against disease from the bacteria Streptococcus pneumonia. )

Prevalence of High Level Penicillin Resistance in Streptococcus pneumoniae, United States. — This image was produced, by the Centers for Disease Control and Prevention (CDC) in 1997, It lists the percentages of penicillin resistant S. pneumoniae infections, during 1987, 1991, and 1993-94, based on data collected by both the Morbidity and Mortality Weekly Report (MMWR), The Journal of Infectious Diseases. Note how over this 8-year period, there was a steady increase in the occurrence of high level penicillin resistance. public domain

Benefit for Heart Disease Prevention

The strongest evidence for off-target benefits, dating back 25 years, shows reduced cardiovascular risk following flu shots.

Healthy older adults vaccinated against flu have substantially lower risks of hospitalization for heart failure, as well as for pneumonia and other respiratory infections. Vaccination against influenza has also been associated with lower risks of heart attack and stroke.

Moreover, many of these studies predate the more potent flu vaccines now recommended for older adults.

Could the RSV vaccine, protective against another respiratory illness, have similar cardiovascular effects? A recent large Danish study of older adults found a nearly 10% decline in cardiorespiratory hospitalizations — involving the heart and lungs — among the vaccinated versus a control group, a significant decrease.

a preserved human heart, from a museum exhibit — photo by Dr. Aletha at the Denver Museum of Natural Science

Lowered rates of cardiovascular hospitalizations and stroke did not reach statistical significance, however. That may reflect a short follow-up period or inadequate diagnostic testing, cautioned Helen Chu, an infectious disease specialist at the University of Washington and co-author of an accompanying editorial in JAMA.

“I don’t think RSV behaves differently from flu,” Chu said. “It’s just too early to have the information for RSV, but I think it will show the same effect, maybe even more so.”

Possible Dementia Prevention?

Probably the most provocative findings concern vaccination against shingles, aka herpes zoster. Researchers made headlines last year when they documented an association between shingles vaccination and lower rates of dementia — even with the less effective vaccine that has since been replaced by Shingrix, approved in 2017.

Nearly all studies of off-target benefits are observational, because scientists cannot ethically withhold a safe, effective vaccine from a control group whose members could then become infected with the disease.

That means such studies are subject to “healthy volunteer bias,” because vaccinated patients may also practice other healthy habits, differentiating them from those not vaccinated.

Although researchers try to control for a variety of potentially confounding differences, from age and sex to health and education, “we can only say there’s a strong association, not a cause and effect,” Maggi said.

But Stanford researchers seized on a natural experiment in Wales in 2013, when the first shingles vaccine, Zostavax, became available to older people who had not yet turned 80. Anyone who was 80 and older was ineligible.

Over seven years, dementia rates in participants who had been eligible for vaccination declined by 20% — even though only half had actually received the vaccine — compared with those who narrowly missed the cutoff.

“There are no reasons people born one week before were different from those born a few days later,” Maggi said. Studies in Australia and the United States have also found reductions in the odds of dementia following shingles shots.

In fact, in the meta-analysis Maggi and her team published, several other childhood and adult vaccinations appeared to have such effects.

Comparing a Healthy Brain with a brain affected with Alzheimer’s Disease; Credit: National Institute on Aging, National Institutes of Health

“We now know that many infections are associated with the onset of dementia, both Alzheimer’s and vascular,” she said.

In 21 studies involving more than 104 million participants in Europe, Asia, and North America, vaccination against shingles was associated with a 24% reduction in the risk of developing dementia. Flu vaccination was linked to a 13% reduction. Those vaccinated against pneumococcal disease had a 36% reduction in Alzheimer’s risk.

The Tdap vaccine against tetanus, diphtheria, and pertussis (whooping cough) is recommended for adults every 10 years, with vaccination among older adults often prompted by the birth of a grandchild, who cannot be fully vaccinated for months. It was associated with a one-third decline in dementia.

Other researchers are investigating the effects of shingles vaccination on heart attacks and stroke and of COVID vaccination on cancer survival.

Preventing Damage from Chronic Inflammation

What causes such vaccine bonuses? Most hypotheses focus on the inflammation that arises when the immune system mobilizes to fight off an infection. “You have damage to the surrounding environment in the body, and that takes time to calm down,” Chu said.

The effects of inflammation can far outlast the initial illness. It may allow other infections to take hold, or cause heart attacks and strokes when clots form in narrowed blood vessels. “If you prevent the infection, you prevent this other damage,” Chu said.

Hospitalization itself, during which older patients can become deconditioned or develop delirium, is a risk factor for dementia, among other health problems. Vaccines that reduce hospitalization might therefore delay or ward off cognitive decline.

Will Anti-Vaccine Public Policy Cause Missed Vaccinations in Adults?

Health officials in the Trump administration have assailed childhood vaccines more than adult ones, but their vocal opposition may be contributing to inadequate vaccination among older Americans, too.

Many will not only miss out on the emerging off-target benefits but will remain vulnerable to the diseases the vaccines prevent or diminish.

“The current national policy on vaccination is at best uncertain, and in instances appears anti-vaccine,” said Schaffner, a former member of the CDC’s Advisory Committee on Immunization Practices. “All of us in public health are very, very distressed.”

This story also ran in The New York Times
Shared without charge under a Creative Commons License by KFF Health News.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Dr. Aletha

Key Predictions about 2026 Health Policy from an Expert

In this post I review some 2026 healthcare predictions for likely continuation of partisan gridlock, minimal congressional action, and increased focus on health care affordability amid midterm elections. Key issues to watch include ACA enrollment responses, Medicaid work requirements, rising insurance costs, and the impact of AI on consumer health care navigation.

As we anticipate 2026, here is a look at what the federal government may do with healthcare in the United States.

This is a reprint of an article first published on KFF and shared here by permission.

The author is Drew Altman, President and Chief Executive Officer of KFF, a position he has held for over 30 years, founding the KFF organization in the 1990s. He is a leading expert on national health policy issues and an innovator in health journalism and the nonprofit field.

(Note: I have edited this article for length and readability. I linked to the original content so you can read the full sections. The photos are for illustration and are not affiliated with the original article on KFF. AO)

Health Policy in 2026

from Drew Altman, December 8, 2025

Forecasting the year ahead in health policy is always treacherous because events intervene and screw up even the best predictions. But my working theory is that the sharp partisan divide in Congress, and even sharper disagreement on health care policy, can produce only small-ball actions on health next year.

So, what should you watch for that will really matter for people, policy, and politics?

Voter Reaction to the ACA in the Midterms

First and foremost is the role that health care affordability will play in the midterms. Assuming there is no deal on the enhanced ACA (Affordable Care Act) tax credits, spiking premium payments in the Marketplaces will become the national symbol for voters of concerns about their health care bills.

Democrats will prosecute the issue to the fullest, and Republicans will generally try to shift the subject and fight on other issues. Health care affordability will be in the spotlight, but how important it is as a vote-and-turnout driver remains to be determined.

Photo by Edmond Dantu00e8s on Pexels.com

How ACA Enrollment Might Change

Second, again assuming there’s no deal on the tax credits, we’ll see how enrollees actually respond in the Marketplaces. What share of the 24 million enrollees switch to cheaper high-deductible plans? What is the impact of doing that on their financial security and health-seeking behavior? What happens to older and sicker enrollees who need better, more comprehensive coverage? How many millions choose to be uninsured in 2026 and who are they?

Medicaid Work Requirements

Third, states that have expanded Medicaid will be gearing up for Medicaid work requirements, which kick in in 2027.

Red states may be looking for flexibility to implement the toughest possible requirements and reduce their Medicaid rolls and spending.

Blue states will be looking for nooks and crannies in the law and the rules to lessen the impact in the hopes that Democrats seize control again in 2028 and reverse the requirements.

Having implemented state welfare work requirements myself, I know there is always some ability to shade implementation depending on the goals of a state.

In our case in New Jersey, we had little interest in kicking people off welfare (and into homelessness or deep poverty, which we’d also have to address). We did have a big interest in providing job training, childcare, transportation, and a pathway to jobs.

More Expensive Health Insurance

Fourth, after years of moderate increases, health costs will increase more sharply again. Employer premium increases may not touch double digits but could come close.

The average cost of a family policy for employers could approach $30,000. Cost-sharing and deductibles will likely rise again after plateauing for several years.

Employers and public payers are increasingly skittish about the costs of GLP-1s for weight loss. It’s possible GLP-1s could turn from today’s dilemma to a technology-diffusion success story of sorts. (Glucagon-Like Peptide-1)

Costs are coming down, pills are on the horizon, and payers are developing more sensible guidelines for their initial and long-term use.

In a country where the dam breaks on every effective new medical technology and it’s rapidly disseminated at high costs, GLP-1s could emerge as a more balanced and sensible example of technology diffusion. Like most new medical technologies, it still increases costs.

Drug and Hospital Costs Increase

Fifth, the Trump administration has put pressure on drug prices through a variety of initiatives. Probably the most important is Medicare drug price negotiations, which began in the Biden years, but together they are putting pressure on drug prices.

Still, retail drug spending is only 9% of overall health spending (16% for employers) and there is growing awareness that hospitals gobble up the single largest share of the health care dollar.

Proposals to cap hospital prices or put hospitals on a budget seem to be coming back into fashion again but are non-starters with Republicans in charge, as of course is single payer.

For 2026, we can look generally for greater attention being paid to hospital prices and possibly greater action at the state level, where several states have established hospital cost targets with varying degrees of teeth.

Prior Authorization Review

Sixth, people (and providers) hate prior authorization review. Will the administration’s voluntary effort to work with industry to streamline and pare back prior authorization result in any concrete relief for patients when it kicks in this year?

MAHA and Vaccinations

Seventh, four in 10 Americans say they identify with the MAHA agenda. We’ll learn more in the coming year about which tenets of this loose movement have staying power. (Make America Healthy Again)

Everyone is for exercise and for healthier food for kids (although I do still miss those Hostess Cupcakes and Twinkies that I had as a kid).

But people who have serious illnesses may grow tired of the central MAHA notion that they are personally responsible for disease and may increasingly make the connection between their own need for medical care and cuts in Medicaid and ACA coverage.

President Trump and Secretary Kennedy at the MAHA commission meeting, public domain photo

There is some overlap between MAHA and the anti-vax movement. Another thing to watch: will vaccination rates continue to decline as the administration chips away at universal vaccination and trust in vaccines?

Patients Using AI for Health

Eighth, AI means a lot for physicians, researchers, hospitals, insurance companies, and investors, with profound implications in some areas of medicine, such as radiology. But when will AI start having real meaning for the things people care about most: their costs and their ability to navigate the health system? (AI-Artificial Intelligence)

The implications and practical applications for consumers receive far less attention, as generally does the relatively low level of trust in AI. Possibly, 2026 will be the year when attention shifts more seriously to the consumer side of AI in health.

Conclusion

All told, it will be a big year ahead in health policy. And this list only just scratches the surface. (Others include the CDC, NIH, FDA, and Medicare.)

But there probably won’t be a lot of significant action in Congress. Still, every incremental change is a big fight in health care, and hard won, and in a hyper-partisan Congress, 2026 will be no different.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Subscribe to KFF Health News’ free Morning Briefing.

This article first appeared on KFF Health News and is republished here under a Creative Commons license.

How health policies may affect you.

Based on what you know now, how likely are these predictions correct?

Which of these issues are most important to your healthcare?

How will you respond to health policy changes that affect you? What information do you need?

How do you and your family contribute to “making America healthy again”?

Cover Photo

The cover image was created by the AI feature of Jetpack. (affiliate link)

Exploring the HEART of Health

I’d love for you to follow this blog. I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.