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Vaccination of the elderly is very important to provide the immunity necessary to fight and prevent infections, so it is essential that people over 60 years old pay attention to the vaccination schedule and vaccination campaigns, especially that of influenza, which it is recommended for people over 55 and it happens annually.
The vaccines recommended in the vaccination calendar of the elderly, determined by the Brazilian Society of Immunizations in conjunction with the Brazilian Society of Geriatrics and Gerontology, are 8: against influenza, pneumococcal pneumonia, tetanus, diphtheria, hepatitis, yellow fever, viral triple, herpes zoster and meningococcal meningitis. Some of these vaccines are available from the Ministry of Health free of charge through SUS, while some can only be purchased at private clinics, such as against herpes zoster, meningococcus and hepatitis A, for example.
The vaccination schedule for the elderly follows the recommendations of the Brazilian Society of Immunizations in conjunction with the Brazilian Society of Geriatrics and Gerontology, and includes:
1. Flu vaccine
Influenza is a respiratory infection caused by different serotypes of the Influenza virus, thus preventing the flu. In addition, as in some cases due to the weakening of the immune system and changes in respiratory capacity, which is common as a person ages, the viruses responsible for the flu can favor the development of complications, such as pneumonia and thus flu vaccine is also able to prevent this complication.
The flu vaccine is composed of fragments of inactive viruses and, thus, there is no risk of causing infection in the person after vaccination, only stimulating the immune system's response, and is recommended for people over 55 years.
- When to take: 1 time a year, preferably before the beginning of autumn, when viruses begin to circulate more frequently and there is a greater chance of catching flu, as people usually stay longer indoors and with little circulation of air, which favors the circulation of the virus.
- Who should not take it: people with a history of anaphylactic reaction or severe allergy to chicken eggs and their derivatives, or any other component of the vaccine. The vaccine should be postponed in people with moderate to severe febrile infection or changes in blood clotting, if done intramuscularly.
The flu vaccine is offered free of charge by SUS, at health centers, and it is important that the vaccine be taken annually so that its protective effect is guaranteed, as the Influenza virus is capable of mutating and, thus, can become resistant to the previous vaccine. That is why it is important that the elderly get the vaccine every year during the government's campaign season to ensure that their immune system fights the flu virus effectively. See more about the flu vaccine.
2.Pneumococcal vaccine
The pneumococcal vaccine prevents infections caused by the bacteria Streptococcus pneumoniae, mainly pneumonia and bacterial meningitis, in addition to preventing this bacterium from spreading in the body and causing a generalized infection of the body.
There are 2 different types of this vaccine for the elderly, which are the 23-valent Polysaccharide (VPP23), which contains 23 types of pneumococci, and the 13-valent Conjugate (VPC13), which contains 13 types.
- When to take: usually, a 3-dose regimen is started, starting with VPC13, followed, after six to twelve months, by VPP23, and another boost dose by VPP23 after 5 years. If the elderly person has already received a first dose of VPP23, apply VPC13 after 1 year and schedule the booster dose of VPP23 after 5 years of the first dose.
- Who should not take it: people who have shown an anaphylactic reaction to the previous dose of the vaccine or any of its components. In addition, the vaccine should be postponed in case of fever or changes in blood clotting, if given intramuscularly.
This vaccine is made free of charge by SUS for elderly people with a higher risk of infection, such as those who are living in community nursing homes, for example, and the others can be vaccinated in private clinics.
3. Yellow fever vaccine
This vaccine provides protection against yellow fever infection, a dangerous viral infection transmitted by mosquitoes and can be administered at SUS health centers free of charge. This vaccine is recommended for inhabitants of endemic areas, people traveling to areas with the disease or whenever there is an international requirement, in an area considered to be at risk.
- When to take: Currently, the Ministry of Health recommends only 1 dose for life from 9 months of age, however, people who have never had the vaccine should take the dose if they live or travel to a high-risk region, which include rural areas in the North and Midwest of the country or countries that have cases of yellow fever, such as African countries and Australia, for example.
- Who should not take it: elderly people with a history of allergic reaction after ingesting chicken eggs or vaccine components, diseases that reduce immunity, such as cancer, diabetes, AIDS or use of immunosuppressive drugs, chemotherapy or radiotherapy, for example, and in cases of acute febrile illness.
The yellow fever vaccine should only be administered in cases of greatest need, avoiding its use for frail elderly people and people with compromised immunity. This is because the vaccine is made from samples of live attenuated viruses and there is a rare risk of developing a serious reaction, with a similar picture to yellow fever, called "virus visceralization".
4. Meningococcal vaccine
This vaccine provides protection against the bacteria Neisseria meningitidis, also known as Meningococcus, which is able to spread through the bloodstream and cause serious infections, such as meningitis and meningococcemia, which is when the bacteria responsible for meningitis reaches the bloodstream and causes a generalized infection.
As there are still not many scientific studies done with this vaccine in the elderly, it is usually recommended in some cases of greater risk, such as in situations of epidemic of the disease or trips to areas of risk.
- When to take: a single dose should be administered in cases of epidemics.
- Who should not take it: people with allergies to any component of the vaccine. Defer in case of illness with fever or diseases that cause clotting disorders.
The meningococcal vaccine is only available in private immunization clinics.
5. Herpes zoster vaccine
Herpes zoster is a disease caused by the reactivation of the chicken pox virus that can remain lodged on the nerves of the body for several years, and causes the appearance of small, red and very painful blisters on the skin. This infection is more common in the elderly and in people with weakened immunity, and as it can be very uncomfortable and leave painful sequelae on the skin that can last for years, many elderly people have opted for prevention.
- When to take: A single dose is recommended for all people over the age of 60. For people who have already had herpes zoster, wait at least six months to 1 year for the vaccine to be applied.
- Who should not take it: people with allergies to the components of the vaccine, or those with impaired immunity due to illnesses or use of medications, such as people with AIDS, cancer, using systemic corticosteroids or chemotherapy, for example.
The shingles vaccine can be applied in private vaccination clinics. Find out more about what it is and how to treat herpes zoster.
6. Tetanus and diphtheria vaccine
The double viral vaccine, or dT, provides protection against infections by tetanus, which is a serious infectious disease that can lead to death, and diphtheria, which is a very contagious infectious disease.
- When to take: every 10 years as a backup for people who have been correctly vaccinated in childhood. For elderly people who have not been vaccinated or who have no record of the vaccine, it is necessary to do the 3-dose schedule with an interval of 2 months between each one and then to have the booster every 10 years.
- When not to take: in the case of an anaphylactic reaction prior to the vaccine or any of its components. It must be postponed in case of blood clotting diseases, if done intramuscularly.
This vaccine is available free of charge at health centers, however, there is also the adult triple bacterial vaccine, or dTpa, which in addition to tetanus and diphtheria protects against pertussis, in addition to the tetanus vaccine separately, which are available in private clinics in immunization.
7. Triple viral vaccine
This is the vaccine against measles, mumps and rubella viruses, which is necessary in cases of increased risk for infection, such as outbreaks, trips to risky places, people who have never been infected or who have not received 2 doses of vaccine throughout life.
- When to take: only 2 doses are required throughout life, with a minimum interval of 1 month.
- Who should not take it: people with severely compromised immunity or who have had an anaphylactic reaction after eating an egg.
It is not available for free to the elderly, except during campaign periods, and it is necessary to go to a private immunization clinic.
8. Hepatitis vaccine
Protection against hepatitis A and hepatitis B can be acquired through separate or combined vaccines, for people who do not have immunity against these diseases, who have never been vaccinated or who do not have vaccine records.
- When to take: the hepatitis B vaccine, or the combined vaccine A and B, is given in 3 doses, in the schedule 0 - 1 - 6 months. The isolated hepatitis A vaccine, on the other hand, can be taken after a serological evaluation that indicates a lack of immunity against this infection or in situations of exposure or outbreaks, in a two-dose schedule, with an interval of 6 months.
- Who should not take it: people with anaphylactic reaction to the components of the vaccine. It should be postponed in cases of acute febrile illness or coagulation changes if used intramuscularly.
The hepatitis B vaccine can be made free of charge by SUS, however vaccination against hepatitis A is only available in private immunization clinics.