Vaccines Are Helping Older People More Than We Knew

Many shots seem to have “off target” benefits, such as lowering the risk of dementia, studies have found. Let’s be clear. The primary reason to be vaccinated against shingles is that two shots provide 90 percent 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 R.S.V. is that their risk of being hospitalized with it declines by almost 70 percent in the year they get the shot, and by nearly 60 percent over two years.      

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

But other reasons for older people to be vaccinated are also 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 Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center.

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 R.S.V. vaccine, for example, became available only in 2023.

Still, the findings “are really very consistent,” said Dr. 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.”

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

The Centers for Disease Control and Prevention reported in mid-December that about 37 percent of older adults had not yet received a flu shot. Only 42 percent have ever been vaccinated against R.S.V., and fewer than a third received the most recent Covid vaccine.

The C.D.C. 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 percent of those 67 to 74 received it, and about 8 percent of those over 75.

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….

-Paula Span, NY Times

Vaccines Are Helping Older People More Than We Knew - The New York Times