Let's Talk Vaccines: An Interview with a Pharmacist

Vaccines save lives. This is not up for argument.

As a healthcare provider, I took an oath to provide evidence-based health education and services that benefit persons, communities, and populations as a whole.

August is Immunizations Awareness Month. This week, I sat down with Dr. Amisha Patel, PharmD, RPh to review the basics of vaccines, how they work, dispel decades-old myths, and list the most common annual shots for older adults. Here's a recap:

What are immunizations??

In simple terms, immunizations are vaccines. Vaccination is a simple, safe, and effective way of protecting you against harmful diseases, before you come into contact with them. Vaccines use your body’s natural defenses to help build resistance to specific infections and make your immune system stronger.?

How do vaccines work?

When you get a vaccine, your immune system recognizes the invading germ, produces antibodies, [and then] remembers the disease and how to fight it. If you are exposed to the germ in the future, your immune system can quickly destroy it before you become unwell. Our immune systems are designed to remember. Once exposed to one or more doses of a vaccine, we typically remain protected against a disease for years or decades. This is what makes vaccines so effective. Rather than treating a disease after it occurs, vaccines prevent us in the first instance from getting sick.

Why are vaccines important?

Two key reasons to get vaccinated are to protect ourselves and to protect those around us. Because not everyone can be vaccinated, they depend on others being vaccinated to ensure they are also safe from vaccine-preventable diseases.?

What are some key myths and facts related to immunizations?

• Over the years, the safety of vaccinations has heavily been debated. One of the biggest issues of debate is regarding the possible link between autism and thimerosal - a mercury preservative that was found in vaccines, particularly the measles-mumps-rubella (MMR) vaccine. The Institute of Medicine?conducted a thorough review on this possible link, and the final report released in May 2004 stated that no link was found between the MMR vaccine and autism. Although thimerosal is no longer found in childhood vaccines, some parents still have concerns about vaccinations, and patient education is key to easing these fears and concerns. In the February 2009 issue of Clinical Infectious Diseases, results from a new review reported that no link exists between vaccines and autism.?
• Can vaccines cause the disease? Some people say the majority of people who get the disease have been vaccinated. This is another argument frequently found in anti-vaccine literature. This implies vaccines are not effective. However, no vaccine is 100% effective. To make vaccines safer than the disease, the bacteria or virus is killed or weakened. Unfortunately, not all vaccinated persons develop immunity as each individual's body reacts differently. Most routine childhood vaccines are effective for 85-95% of recipients.??

What are the most common or highly recommended immunizations for older adults? At what age? How frequently???

Influenza (flu)

• Everyone aged 6 months and older should get an annual flu vaccine, but the protection from a flu vaccine can lessen with time, especially in older adults.?
• Ideally you should get your vaccine by the end of October each year so you are protected when flu season starts. It takes at least 2 weeks for the vaccine to be effective. However, if you don’t get the vaccine by the end of October, it’s not too late. Flu season typically peaks in December or January. As long as the flu virus is spreadings, getting vaccinated will help protect you.?
• There are flu vaccines designed specifically for older adults. The CDC (Centers for Disease Control and Prevention) recommends that people aged 65 and older receive a higher dose flu vaccine or an adjuvant flu vaccine that helps create a stronger immune response and are potentially more effective than the standard flu vaccine for people in this age group.

COVID-19

• Older adults are more likely than younger people to get very sick from COVID-19. The CDC recommends that older adults stay up to date with COVID-19 vaccines, including booster shots.?

Pneumonia

• It is recommended that all adults aged 65 and older get a pneumococcal vaccination. Since there are multiple forms of the pneumonia vaccine, it’s best to talk to a healthcare provider to find out which is best for you.?

Shingles (caused by the same virus as chickenpox; as you get older the virus can become active again and cause shingles)

• Healthy adults aged 50 and older should get vaccinated with the shingles vaccine, SHingrix, which is given in two doses.
• You should get a shingles vaccine even if you’ve already had chickenpox, the chickenpox vaccine or don't remember whether you had chickenpox. You should also get the shingles vaccine if you’ve already had shingles or received the older Zostavax vaccine.
• However, you should not get a vaccine if you currently have shingles, are sick or have a fever, have a weakened immune system or have had an allergic reaction to Shingrix.?

TDAP (tetanus, diphtheria, pertussis)

• Most people get vaccinated as children, but you also need booster shots as you get older to stay protected. CDC recommends that adults get a Tdap or Td booster shot every 10 years.?

Depending on comorbidities, providers may recommend other vaccines but these are the most common vaccines important for older adults.

If an older adult was interested in getting their immunizations, what are their options? Similarly, for those who are hesitant, with whom should they discuss their concerns and options??

It has become easier to get vaccines as many of the vaccines for older adults are available at the doctor’s office, the health department, a community health clinic, some workplaces and their local pharmacies. You don’t need to worry about making an appointment to go to your doctor’s office to receive your vaccinations. For example, most pharmacies let you walk in (or call ahead to make an appointment) and receive your vaccination the same day. However, before getting any vaccine, we always recommend speaking with a doctor or pharmacist about your health history, including past illnesses and treatments, as well as any allergies. A healthcare provider can address any concerns you have.?

Why is it so important that we educate and encourage adults and older adults about the importance of age-related immunizations?

Vaccines are very safe and can help keep older adults from getting serious or life-threatening diseases such as pneumonia, flu, COVID and whooping cough. Older adults are at a higher risk of developing serious complications from these diseases that can spread to other parts of the body and cause hospitalization or even death.?

For example, getting the flu if you have heart disease increases the stress on your heart, and therefore, your risk of a heart attack. If you have diabetes, a flu infection can raise your blood glucose to dangerous levels. If you have impaired lung function, the flu infection can lead to serious respiratory illnesses.?

What are some of the risks of not getting immunized against commonly treatable and/or preventable diseases???

When more people decide not to vaccinate, the diseases the vaccines prevent against have the potential to flare up and even get out of control. When more people get vaccinations, it makes everyone less likely to get the diseases they are vaccinated against. This control of diseases is called herd immunity, and benefits the entire community.?

As a pharmacist, what role do you play in immunizations??

Although the decision to receive vaccines is still a patient’s choice, as one the of the most accessible healthcare professionals, pharmacists can be instrumental in providing patients with pertinent information to make informed choices when it comes to immunizations in terms of the benefits as well as the risks. Pharmacists are also in a unique position to identify those patients who are in target groups for certain vaccinations. They also may be able to ease the fears of many patients by providing them with the facts as well as the significant risks associated with not being vaccinated.

Although not all pharmacists will elect to obtain the certification needed to administer vaccines, pharmacists who do not administer vaccines also have an important role in promoting the importance of vaccinations in other ways, which include: history and screening of a patient, patient counseling, documentation, and public education and awareness.?

What is one takeaway you’d like the audience to consider as it relates to aging and immunizations??

I’ve learned it’s important to keep the patient involved in their own health care. Having a conversation and explaining the importance of vaccines for older adults can prevent long term illnesses, hospitalizations and death from vaccine-preventable diseases. I like to remind people that getting your vaccines protects you, but it protects the people around you too, such as infants who are too young to be vaccinated or people with weakened immune systems who are at higher risk of severe illness. Take control of your health by making sure you are up-to-date on all the vaccines recommended for you!

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At Caregiver Consulting & Healthy Solutions, we are dedicated to helping you navigate aging together.

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