Vaccination schedule for the elderly

The vaccines recommended in the vaccination calendar of the elderly are 8: against influenza, pneumococcal pneumonia, tetanus, diphtheria, hepatitis, yellow fever, viral triple, herpes zoster and meningococcal meningitis.

Many of them are made available by 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.

Vaccination of the elderly is very important to provide the immunity necessary to fight and prevent infections, so it is essential for people aged 60 or over.

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

The flu is the respiratory infection caused by the influenza-like virus and, therefore, prevents not only the flu, but also pneumonia, the need for hospitalization and the risk of death caused by these microorganisms.

These vaccines are made up of inactivated and fragmented viruses, therefore, without risk of causing infection in the person after vaccination.

When to take: 1 time a year, preferably before the beginning of autumn, when viruses begin to circulate more frequently and the chances of catching flu Who should not take: people with a history of anaphylactic reaction or severe allergy to the chicken egg and its 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, every year and must be repeated annually to guarantee its effect, since each year the viruses undergo changes, which can impair the vaccine's effectiveness.

2. Pneumococcal vaccine

This vaccine prevents infections caused by the bacterium Streptococcus pneumoniae , mainly pneumonia, as well as other serious diseases such as meningitis or bacteremia, which is 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, VPC13 should be applied 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 done 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.

The yellow fever vaccine is especially indicated in the following cases: 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 risky region, which include rural areas in the North and Center-West of the country and some municipalities in the States of Maranhão, Piauí, Bahia, Minas Gerais, São Paulo, Paraná, Santa Catarina and Rio Grande do Sul. Who should not take: elderly people with a history of allergic reaction after ingestion of 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 febrile illness acute.

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 picture similar to yellow fever, called "virus visceralization".

4. Meningococcal vaccine

This vaccine provides protection against the bacterium Neisseria meningitidis , also known as Meningococcus, which is able to spread through the bloodstream and cause serious infections, such as meningitis and meningococcemia.

As there are still not many scientific studies done with this vaccine in the elderly, it is usually recommended in some cases of higher risk, such as in situations of epidemic of the disease or trips to areas at 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. Postpone 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 for several years on the nerves of the body, 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 shingles, you must wait at least six months to 1 year before applying the vaccine. Who should not take it: people with allergies to the components of the vaccine, or those with immunity compromised by illnesses or use of medications, such as people with AIDS, cancer, using systemic corticosteroids or chemotherapy, for example.

The herpes zoster 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 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 triple adult bacterial vaccine, or dTpa, which in addition to tetanus and diphtheria protects against pertussis, in addition to the tetanus vaccine separately, which are available at 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, travel 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 free of charge 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 A and B vaccine, is given in 3 doses, in the schedule 0 - 1 - 6 months. The hepatitis A vaccine alone can be taken after serological evaluation that indicates a lack of immunity against this infection or in situations of exposure or outbreaks, in a two-dose regimen, 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 by SUS, however hepatitis A vaccination is only available in private immunization clinics.