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. It may have changed by the time you read this. I invite you to fact-check what you read here.

Please do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with your physician or other qualified healthcare provider.

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.

Exploring the HEART of Health

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From common colds to COVID-19-Respiratory infections update 2020

This year’s cold/flu season is complicated by a new player- COVID-19, caused by the SARS-CoV-2. If you get sick, please do not assume your illness is “just the flu” ; this could have serious, perhaps fatal consequences for you and your loved ones.

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Where I live, North America, we’ve just observed the first day of fall, also known as the autumnal equinox. And especially in healthcare, we unofficially view it as the start of the “cold and flu” season. To those of you in the southern hemisphere, happy spring. You also have a respiratory illness season during fall/winter.

Respiratory infections

By “cold and flu” we means acute respiratory infections caused by a variety of viruses including

  • influenza
  • respiratory syncytial virus (RSV)
  • adenovirus
  • rhinovirus
  • coronavirus

and less often several bacteria, most commonly

  • Streptococcus
  • Mycoplasma
  • Haemophilus
  • Legionella
  • Pertussis (whooping cough)

These cause diseases called by various names including

  • colds/flu
  • influenza
  • pharyngitis (throat infection)
  • otitis media (ear infection)
  • bronchitis
  • sinusitis
  • pneumonia
  • laryngitis
  • COVID-19
  • whooping cough
  • bronchiolitis-infants and children
  • croup-mostly children

This year’s cold/flu season is complicated by a new player- COVID-19, caused by the SARS-CoV-2.

Acute vs chronic

We call these illnesses acute because they (usually) come on fairly suddenly, run their course within a few days to sometimes a few weeks, and then resolve. Sometimes they don’t resolve and become chronic.

Some underlying factor may prevent healing. There may be a chronic condition that is out of control, or has not been previously diagnosed. You may need a doctor’s evaluation to determine whether it’s “just a cold” or perhaps asthma, COPD ,or allergic rhinitis.

Many of these illnesses tend to occur seasonally, such as influenza and RSV. Others can occur year round. So far we don’t know if COVID-19, due to the SARS-CoV-2 , will be year round or seasonal. Unlike influenza, it did not abate during the summer this year.

What are respiratory symptoms?

Symptoms of respiratory illness involve some combination of the nose, sinuses, ears, throat, larynx (voice box), trachea, bronchus, and lung

  • Sneezing, stuffy  or runny nose,
  • Sinus pain, pressure
  • coughing, wheezing, shortness of breath
  • sore throat, hoarseness
  • ear pain, fullness

often along with systemic symptoms such as

  • fever and/or chills
  • body aches, fatigue, 
  • nausea, vomiting, diarrhea 
  • headache
  • loss of appetite

 

Coping with respiratory illness

Although these infections make us miserable and can temporarily disable us from work and school, most otherwise healthy people recover uneventfully, even from COVID-19. Nevertheless, we should take them seriously.

 

 

Don’t panic.

Fever ,especially in children, alarms parents. Don’t ignore it but don’t panic either. Reading this post should help you keep calm about fever .

a woman taking her temperature
This photograph depicted a woman who was using a modern, battery-powered oral thermometer, in order to measure her body temperature. In order to return an accurate reading, this particular type of thermometer needed to be placed beneath the user’s tongue, for a set amount of time, beeping when the ambient, sublingual temperature was reached. Photo credit-James Gathany, CDC, public domain

Some  people are at risk of developing  severe symptoms and serious complications from respiratory illnesses, so seek medical help sooner, rather than later. These include

  • Infants, especially under one month old
  • Older adults,starting at about age 50, with risk increasing with age, especially combined with chronic disease
  • Those with chronic lung disease, like asthma, COPD, emphysema, cystic fibrosis
  • People who smoke cigarettes or vape
  • People on medications or with diseases that suppress the immune system
  • Serious chronic diseases – diabetes, liver disease, kidney disease, heart disease, cancer 
  • Obesity (a risk factor for COVID-19 complications)
  • Pregnancy

If you are not sure if you fit into one of these categories, ask your doctor.

Stay home.

These illnesses spread person to person, so minimize contact.

Keep your kids home from school and stay home from work, at least the first few days, when you are  the most contagious. When  there is widespread illness in your community, avoid crowds and public gatherings.

Resting, getting extra sleep, drinking fluids and staying warm and dry  make staying at home therapeutic.

Wash hands.

Speaking of person to person contact, the best way to avoid getting or giving germs is to wash your hands often, but especially after being with others ,using a restroom,  and before cooking or eating. Cleaning household surfaces helps too, as well as clothing and linens. Don’t forget to clean your cell phone, tablets, and keyboards too. Use hand sanitizer if hand washing can’t be done.

Wear a mask

You probably remember that early on in the pandemic, the CDC did not recommend wide spread wearing of masks. I suspect this was to prevent hoarding of masks (remember toilet paper? ) and because they did not know how widely the virus was circulating in the United States.

But that has changed; when experts learn new information they reassess and update recommendations. Whenever you expect to have close contact with people outside your household wear a mask that covers your nose and mouth. In some situations, eye coverings are also warranted but that is not universally recommended now.

Use medication wisely.

Some of these illnesses have a specific medication that clear it faster- strep throat, influenza, pneumonia. The others will “run their course” and meds are used to help relieve symptoms.

Many people assume that any illness with fever, sore throat and cough will improve with an antibiotic. The fact is, most will not. Antibiotics only treat infections caused by bacteria, and most of these are caused by viruses. To learn more read about

These illnesses cause the greatest overuse of antibiotics, contribute to the cost of health care, and the development of antibiotic resistance. Please do not insist on an antibiotic if the doctor says you don’t need it; if offered an antibiotic, ask why.

 

 

6 smart facts about antibiotic use

 

 Be patient

The “24 hour virus” is for the most part a myth. Expect to be ill anywhere from 3 to 10 days; some symptoms, especially cough, can linger for weeks. If you are a smoker, this is a great time to quit. 

But if after 7-14 days you are not getting better or are getting progressively worse, something more may be going on, so it’s wise to seek professional medical help.

Is it flu or is it COVID?

The arrival of COVID-19 this year creates a dilemma since symptoms overlap other respiratory infections and the possible outcomes run the gamut of no symptoms to death.

So this year, if you develop respiratory symptoms, healthcare clinicians will likely test you for COVID-19 , both to guide your care and to protect your family, co-workers, and healthcare workers.

Please do not assume your illness is “just the flu” ; this could have serious, perhaps fatal consequences for you and your loved ones.

Prevention of respiratory infections

Respiratory infections don’t have to happen. We know that they are mostly spread person to person, so what we each do matters. So what can you do?

  • Stay home when you are ill.
  • Observe physical distancing when disease is spreading in your community.
  • Wear a mask when recommended by public health professionals.
  • Practice careful hygiene on hands and surfaces.
  • Get available vaccinations.

 

 

 

exploring the HEART of respiratory illness

I would love for you to share this  information (but not your germs) on your social media pages.

FLU VACCINE: We all have a role in protecting each other.
used with permission CDC


Dr. Aletha