Vaccine in Older Patients
💉 Vaccination is a cornerstone of preventive medicine. In the UK, the NHS recommends specific vaccines for older adults (≥65 years) and high-risk groups (those with chronic conditions, immunosuppression, or special exposures). Proper immunisation reduces the risk of serious illness, hospitalisation, and death.
Flu Vaccine (Seasonal Influenza)
- 🧓 Eligibility (Free on NHS):
- All adults aged 65 and over.
- Individuals aged 6 months–65 years with chronic conditions (respiratory, cardiac, renal, hepatic, diabetes, neurological).
- Immunocompromised patients (chemotherapy, steroids, biologicals, immunotherapy).
- Pregnant women, healthcare workers, and residents of long-term care facilities.
- Close contacts of vulnerable or “shielded” patients.
- 💊 Quadrivalent Flu Vaccine: Patients undergoing immunotherapy should receive the quadrivalent (QIV) formulation, even if aged ≥65, because it provides broader strain coverage and better protection.
Pneumococcal Vaccine
- 🫁 Indications:
- All adults ≥65 years (routine, single dose).
- Chronic illness: respiratory disease, chronic heart/kidney/liver disease, diabetes.
- Functional or anatomical asplenia, CSF leaks, cochlear implants, immunosuppression.
- 🔬 Types:
- PCV13 (conjugate): Mainly for younger, high-risk groups.
- PPV23 (polysaccharide): Standard single dose for adults ≥65.
Shingles (Herpes Zoster, VZV) Vaccine
- 🌟 Routine Offer: Adults aged 70–79 years.
- ⚠️ Contraindication: Live vaccine NOT safe in immunocompromised (steroids, chemo, biologics, HIV).
- 🆕 Non-live Shingrix: Available and suitable for immunosuppressed patients; requires specific eligibility assessment and may involve a two-dose schedule.
Additional Recommendations
- 🦠 Tetanus/Diphtheria Boosters: Every 10 years, especially in older adults or high-risk occupational exposure.
- 🧪 COVID-19 Booster: Annual dose for ≥65s, high-risk groups, and health/social care workers.
- 🧷 Hepatitis B: For chronic renal/liver disease, healthcare staff, and at-risk groups (e.g., IV drug use, high-risk sexual exposure).
✨ Key Teaching Point: Around 10% of hospitalised older adults are admitted due to vaccine-preventable infections. Preventive vaccination is simple, cost-effective, and saves lives. Always check the latest NICE and NHS immunisation schedules.
