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.

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Using double duty drugs-COVID-19, migraine, and shingles

In 2020 SARS-CoV-2 caused a worldwide pandemic of infection. To treat this novel, or new, virus, infectious disease experts turned to old drugs while developing new unique drugs to treat it.

In this post I’m reviewing some drugs that treat multiple conditions. This post was updated August 5, 2020.

Many drugs originally developed to prevent or treat one condition can be “repurposed” to treat another.

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.

Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center (EOC) to coordinate with the World Health Organization (WHO), federal, state and local public health partners, and clinicians in response to the coronavirus disease 2019 (COVID-19) outbreak. CDC is closely monitoring the situation and working 24/7 to provide updates.
Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center (EOC) to coordinate with the World Health Organization (WHO), federal, state and local public health partners, and clinicians in response to the coronavirus disease 2019 (COVID-19) outbreak. CDC is closely monitoring the situation and working 24/7 to provide updates credit James Gathany, public domain

Treatment options for COVID-19

In 2020 SARS-CoV-2 caused a worldwide pandemic of infection. To treat this novel, or new, virus, infectious disease experts turned to old drugs while developing new unique drugs to treat it.

Chloroquine, an old malaria drug and its cousin hydroxychloroquine, used for rheumatoid arthritis and lupus received EUA, Emergency Use Authorization, from the FDA for use against COVID-19. At first it looked promising; President Trump even took it for prevention. But analysis of treatment results did not show fewer deaths but did find adverse heart effects so the EUA was withdrawn. However clinical trials using the drug can be continued.

In early July a hospital in Michigan released statistics showing more patients treated with hydroxychloroquine lived that those who weren’t, surprising other medical centers who did not find the same results in their patients.

As of August 2, 2020, the White House coronavirus task force member charged with coordinating the U.S. testing effort said that the nation needs to “move on” from the debate over hydroxychloroquine.  

Adm. Brett Giroir, assistant secretary of health and human services, said on NBC News’ “Meet the Press” that “from a public health standpoint, at first, hydroxychloroquine looked very promising” but at “this point in time, there’s been five randomized control, placebo-controlled trials that do not show any benefit to hydroxychloroquine.” 

“So, at this point in time, we don’t recommend that (hydroxychloroquine) as a treatment. There’s no evidence to show that it is,”

Adm. Brett Giroir

Another old drug however did reduce deaths in severely ill COVID-19 patients. Dexamethasone, a steroid, reduced mortality in patients who needed oxygen, either alone or by a ventilator and is now recommended for use in all such patients. Steroids treat a variety of conditions including severe asthma, rheumatoid arthritis, gout, lupus, autoimmune diseases, and multiple other inflammatory conditions.

illustration showing the coronavirus which causes COVID-19

 

Avoiding surgery for ectopic pregnancy

Ectopic pregnancy occurs when a fertilized egg implants outside of the uterus. As the fertilized egg begins developing into an embryo, it will eventually outgrow size of the Fallopian tube, and rupture, causing hemorrhage (bleeding) in the pregnant woman.

Ruptured ectopic pregnancies cause about 2.7% of pregnancy-related deaths. Ectopic pregnancy is a true medical emergency and usually requires surgery to prevent death. But another old medicine can in some cases spare a woman from losing her tube to either rupture or surgery.

Methotrexate is an old drug used to treat several forms of cancer as well as several inflammatory and autoimmune diseases, including psoriasis, multiple sclerosis, and Crohn’s Disease. Now, some patients can avoid surgery for an ectopic pregnancy by receiving one or two doses of methotrexate by the IM (intra-muscle) injection route.

The treatment is not 100% effective; patients must follow their doctor’s instructions for follow up carefully, as surgery may still be necessary.

https://medlineplus.gov/images/femalereproductivesystem.png

Prevention of migraine pain and disability

Migraine, although not exclusive to women,occurs much more frequently in them than men. For infrequent headaches,non opiate pain relievers are effective and recommended. But for severe, frequent, or persistent symptoms prevention is recommended to improve quality of life.

Botox, onabotulinumtoxin A, has been FDA approved for treating chronic migraine, meaning patients with frequent headaches and other migraine symptoms for at least 3 months.

Yes the same drug used to treat wrinkles,Botox, can prevent migraine.

Manufactured by Allergan, a vial containing 200 units costs $1452, per goodrx.com. For migraine, the drug is injected in the upper facial muscles by a physician specifically trained in its use.

 

Preventing cancers with the HPV vaccine

Infection with the HPV, human papillomavirus, causes genital warts, an uncomfortable condition but not life threatening. However it can also cause changes in the cervix called CIN which can lead to cervical cancer.

According to a review of clinical trials by Cochran, vaccination against this virus effectively prevents infection and thus fewer cases of CIN. Since a significant percentage of CIN progresses to cancer, we can expect fewer women will develop invasive cervical cancer, the 4th most common cancer in women worldwide.

The vaccine, Gardasail 9, originally approved for use in females ages 9 to 26 years,received FDA approval for use up to ages 17 to 45 years in both males and females.

The vaccine is intended to prevent cancers of the anus, vulva, vagina, and cervix.

The American Cancer Society, ACS, recommends routine vaccination from ages 9-12 years, to prevent the greatest number of cancers, since the vaccine is less effective at older ages. The ACS encourages physicians to offer “catch-up” vaccination to people through age 26 years. For persons older than 26 years, the vaccine offers much less cancer prevention so the society does not recommend it.

HPV-16 E5 Oncoprotein
Description:
A koilocyte is a squamous epithelial cell that has undergone structural changes as a result of infection by human papillomavirus (HPV). This image of a koilocyte shows human ectocervical cells (HEC) expressing HPV-16 E5 oncoprotein, and immortalized with HPV-16 E6 and E7 oncoproteins. Formation of koilocytes requires cooperation between HPV E5 and E6 oncoproteins. The cell culture is stained with hematoxylin and eosin (H&E).

This image was originally submitted as part of the 2016 NCI Cancer Close Up project.

This image is part of the NCI Cancer Close Up 2016 collection.


Source:
National Cancer Institute \ Georgetown Lombardi Comprehensive Cancer Center
Creator:
Ewa Krawczyk
Date Created:
2006
Date Added:
April 11, 2016
Reuse Restrictions:
None – This image is in the public domain and can be freely reused. Please credit the source and, where possible, the creator listed above.

Stopping shingles-and strokes- with the zoster vaccine

Zoster is a reactivation of the varicella/zoster virus that causes chickenpox. It causes a painful rash known as shingles;the pain may continue after the rash is gone. It can happen at any age, but symptoms tend to be worst in older persons.

The new zoster (shingles) vaccine, Shingrix, prevents the painful rash much more effectively than the original vaccine Zostavax. It ranges in effectiveness from 91% to 97% at preventing shingles, depending on age. The first vaccine was 51% effective.

However, the original shingles vaccine may not prevent shingles as well, but it may prevent strokes due to inhibiting inflammation causes by the shingles virus.

Researchers at the CDC reviewed the Medicare health records of more than 1 million people age 66 or older who received Zostavax between 2008 and 2014, and 1 million people of the same age who had not received the vaccination. Researchers took into account age, gender, race, medications and existing health conditions.

Based on these records, the Zostavax reduced stroke risk by 18% for the most common type of stroke. During the years they reviewed, the Shingrix was not in use, so they couldn’t say if it would also show a protective effect.

Signs of Stroke
Signs of Stroke

Stroke is the fifth leading cause of death in the U.S. and causes more serious long-term disabilities than any other disease. Every minute counts, especially during the COVID-19 crisis. The best way to help someone having a stroke is to recognize the symptoms and call 9-1-1. www.stroke.nih.gov/index.htm
before you leave, here’s another post you might enjoy

exploring the HEART of health

Thanks for joining me to review some old drugs with new tricks.

Dr. Aletha

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