Vaccination for Senior Citizens is an important part of preventive care
“Immunization is prevention — you cannot wait until an outbreak to vaccinate. Reducing spread of disease in communities by a simple vaccine is a wise step. Outbreaks are expensive.”
 
It is well recognized that vaccination is among the most cost-effective clinical preventive methods currently available in the world. Vaccination is recommended throughout life to prevent vaccine-preventable diseases and their sequel.
 
The government of India considers childhood vaccination as the first priority, and there is no focus yet on adult immunization. Thus, adult vaccination in India is the most ignored part of health care services. As
vaccines are crucial to prevent mortality of over 25% deaths caused by infections in older persons, there is an urgent need to address this problem.
 
Older adults need immunization for several reasons:
 
1. They may not have received the vaccines in their childhood 
2. New vaccines for adults have become available
3. Immunity acquired in childhood can fade with age
4. Older adults or those who are chronically ill are more susceptible to vaccine-preventable diseases and complications
5. With age, the immune system becomes weaker - a phenomenon called immuno-senescence 
6. Both herd immunity and cocoon immunity are enhanced by vaccinations leading to lessening or even eradication of infectious diseases
 
The World Health Organisation (WHO) had mandated that all senior citizens above 65 years of age must receive adult vaccination of flu, pneumonia, diphtheria, tetanus and acellular pertussis, and against herpes zoster.
 
However, pneumonia polysaccharide vaccine and herpes zoster vaccine need not be a priority on every country's schedule for those over 65 years. Some of these vaccines are expensive. Ideally, they should be part of a government health programme but individuals must consider taking them as per their needs. 
 
In the debilitated elderly and in those with lowered immunity, infections can prove fatal. In others, prolonged hospitalisation and admission to the intensive care unit (ICU) with ventilator support is the order of the day. In my experience, nearly 40% of the elderly admitted to ICU for community acquired pneumonia ended up requiring ventilator assisted breathing. The mortality rate in these patients was quite high. Since community acquired pneumonia is a vaccine preventable disease, the pneumococcal and influenza vaccines are routinely advisable.
 
We, as doctors typically recommend inoculation against pneumonia, flu, shingles (herpes zoster), diphtheria, pertussis and tetanus. Here is a list of the vaccines that I recommend along with the approximate costs. These vaccines are easily available with any chemist or stockist and can be administered by your general practitioner. 
 
1. Vaccine: Influenza
 
Disease prevented: Flu
Dosage: Single dose annually
Cost: Rs500 to Rs800
The influenza virus mutates, hence vaccines against the prevalent species is freshly manufactured. These vaccines are especially necessary in patients with chronic respiratory disorders or during a flu pandemic. 
 
2. Vaccine: Pneumococcal
 
Disease prevented: Pneumonia
Dosage: Single dose
Cost: Rs1,200 to Rs4,000
A person needs one dose of 13-valent pneumococcal conjugate vaccine administered to immune-competent adults aged 65 years or older (PCV13), followed by one dose of 23-valent pneumococcal polysaccharide vaccine (PPSV23) at least a year after PCV13 and that is enough. 
 
3. Herpes zoster (Zoster vaccine recombinant, adjuvant)
 
Disease prevented: shingles (or what is called Nagin in Maharashtra)
Dosage: two doses three to six months apart
Cost:  Rs7,000-Rs8,000 per dose in India
For adults aged 60 years or above, two doses of recombinant zoster vaccine (RZV) only are administered two–six months apart regardless of past episode of herpes zoster or chicken pox. In India, we leave it to
the individual to take the herpes zoster vaccine since it is too expensive for universal immunisation. Two doses have to be taken for lifelong immunity.
 
4. Vaccine: Tetanus, diphtheria, pertussis  (TT/Td/Tdap)
 
Disease prevented: Tetanus, diphtheria, pertussis
Single dose
Cost: Rs150 to Rs200
 
5. H1N1 vaccine
Disease prevented: swine flu
Free immunization of high-risk individuals and those suffering from diabetes and hypertension is done by the state and only a single dose is required. 
 
(Dr Rekha Bhatkhande is the former dean of Shushrusha Citizens’ Cooperative Hospital Ltd. She is also a social activist and President of the Family Welfare Agency as well as Dilasa Group of Senior Citizens.)
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    COMMENTS

    arshiya shaikh

    3 months ago

    Very informative.. I wish to get these vaccinations for my mother .. where can I get it done in Mumbai. Awaiting your reply. Thanks

    robin varghese

    1 year ago

    Thanks Dr,

    Nasreen Rustomfram

    1 year ago

    There is every reason for making adult vaccination as well known as child vaccination. Less than five percent of adults are aware of it.
    The govt must take up a public campaign and work with manufacturers to offer it at the cheapest possible price. Government Hospitals must provide this regimen.

    GLN Prasad

    1 year ago

    If Govt can not provide such vaccines to Senior Citizens, at least they must spread awareness among public, mainly villagers. They should be made available at every Govt dispensary and individual letters can be generated and sent through e mail to all senior citizens as through AADHAR they have data base of senior citizens. Unfortunately, many citizens are not even aware of such vaccines.

    Full-fat Dairy Is Good After All!
    Slowly, but surely, nutritional orthodoxy of the past few decades is being discredited in favour of age-old choices. According to new research by the University of Texas Health Science Center (Houston) (UTHealth), enjoying full-fat milk, yogurt, cheese and butter is good, after all! The study, published on 11 July 2018 in the American Journal of Clinical Nutrition, found no significant link between dairy fats and heart disease and stroke, often associated with high intake of saturated fat. It may be remembered that coconut oil is another item high in saturated fat, which used to be demonised once, but is now lauded as a super-food.
     
    According to the study, certain types of dairy fat may help guard against a severe stroke. According to Marcia Otto the study's first and corresponding author and assistant professor in the department of epidemiology, human genetics and environmental sciences at UTHealth School of Public Health, “Our findings not only support, but also significantly strengthen, the growing body of evidence which suggests that dairy fat, contrary to popular belief, does not increase risk of heart disease or overall mortality in older adults. In addition to not contributing to death, the results suggest that one fatty acid present in dairy may lower risk of death from cardiovascular disease, particularly from stroke.” 
     
    The study evaluated the link between fatty acid present in dairy and heart disease and related it over a 22-year period. For the study, about 3,000 adults of 65 years and older, who had three types of fatty acids, were tested at the beginning in 1992 and again after six years and 13 years. This methodology, as opposed to the self-reported consumption, which is more common, gave a better insight into the long-term exposure to these fatty acids, according to the report. None of the fatty acid types was associated with total mortality in a statistically significant way. One type of fatty acid was linked to lower cardiovascular disease deaths! People, who consumed more whole-fat dairy products, had a 42% lower risk of dying from stroke.
     
    All this undermines the Dietary Guidelines for Americans (copied in many parts of the worlds) which recommends serving fat-free or low-fat dairy, including milk, cheese, yogurt, and/or fortified soy beverages. What nutritionists and doctors are unaware of, or don’t care about, is that low-fat dairy foods, often, include added sugars which may affect cardiovascular and metabolic health.
     
    Whole-fat dairy foods are rich sources of calcium and potassium which are essential for health. Dr Otto said: “Consumers have been exposed to so much different and conflicting information about diet, particularly in relation to fats, that it is important to have robust studies, so people can make more balanced and informed choices based on scientific fact rather than hearsay.” 
     
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    COMMENTS

    Anindya Bhattacharya

    1 year ago

    It is interesting to note that no doctor reader has participated in the discussion. I request Mr. Debashis Basu to publish follow ups on this topic from experts. Let us have more perspectives from experts. The quest is important and ongoing questioning of the facts ( so called) known to us need to be challenged continuously without bias.
    I congratulate Moneylife to bring in the topic into discussion. Can we get more authentic / research based facts directly from published papers avoiding data from You tube / other internet sources who never take responsibility of published data?

    Saravanan R

    1 year ago

    It is silly for Mr. Anand Vaidya to instigate the fight here. If at all, it should be challenged with University of Texas Health Science Center (Houston) (UTHealth). ML Digital team has not done the said research

    Anand Vaidya

    1 year ago

    ML Digital team, hear this "People like to hear good news about their bad habits"
    Also remember that many "studies" are biased, lack data or objectivity, have statistical and method errors - even those conducted by US/EU universities.
    Many jump to wrong conclusions, especially those funded by Dairy/Meat/Egg industry in the west.
    Milk of cows is designed for calves. Milk of another species is unnecessary for human health. Milk is full of sat-fats, anti-biotics, white blood cells (yeah, pus cells) and IGF-1 which is the precursor to various cancers. Cow's milk's role in Type-1 Diabetes is well documented.
    Cheese is good? What next? Cigarettes are healthy?

    PLEASE DON'T SPREAD SUCH WRONG MESSAGES.

    REPLY

    Debashis Basu

    In Reply to Anand Vaidya 1 year ago

    It would do no good to cling on to orthodox beliefs which have now been scientifically discredited. You need to educate yourself with facts. Start with this book https://www.amazon.in/Eat-Fat-Thin-Mark-Hyman/dp/1473631149/ref=sr_1_1?s=prime-day&ie=UTF8&qid=1531739947&sr=8-1&keywords=eat+fat+get+thin and follow people like Dr Aseem Malhotra, UK's top cardiologist, on twitter

    Parthasarathy J

    In Reply to Debashis Basu 1 year ago

    It's today's conclusion by modern science. Tomorrow as per industry requirements they will come with another new discovery. Don't conclude only people living in era are intelligent.

    Anand Vaidya

    In Reply to Debashis Basu 1 year ago

    Unfair for you to accuse me of "clinging to orthodox beliefs" when I, a typical lacto-vegetarian, cow worshipping Hindu, has realized that Dairy is wrong ethically, healthwise and changed my habits and views, It is you, who is unwilling to learn and clinging to old ideas not supported by hard science by supporting eating of 70% saturated fats and antibiotics and Milk of ANOTHER SPECIES!!!

    Anand Vaidya

    In Reply to Debashis Basu 1 year ago

    Even Dr Mark Hyman seems to recommend avoiding Dairy: https://www.youtube.com/watch?v=0O-ehIkwGME

    Anand Vaidya

    In Reply to Debashis Basu 1 year ago

    I have done months of reading/listening to great doctors such as Dr John McDougall, Dr Garth Davis (Bariatric Surgeon), Prof Colin Campbell (China Study fame), Dr Neil Barnard (PCRM head) and ofcourse Dr. Dean Ornish and many other vegan gurus. I have altered my food habits as per their advice (Whole Food Plant Based-abbreviated WFPB). and seen significant improvement in weight loss, cholesterol & blood sugar readings without "dieting"... Same results have been obtained by millions others.
    Dairy is unethical during "production", unnecessary for human health and ecological disaster (Dairy & meat production). Please watch the video by Joseph Keon - Whitewashed on youtube.

    Debashis Basu

    In Reply to Anand Vaidya 1 year ago

    “The great enemy of truth is very often not the lie--deliberate, contrived and dishonest--but the myth--persistent, persuasive and unrealistic. Too often we hold fast to the cliches of our forebears. We subject all facts to a prefabricated set of interpretations. We enjoy the comfort of opinion without the discomfort of thought. - John Kennedy

    Anand Vaidya

    In Reply to Debashis Basu 1 year ago

    Don't throw quotes at me. Please watch NutritionFacts.org by Dr. Michael Greger. Then we can discuss

    SRIDHAR IYER

    In Reply to Debashis Basu 1 year ago

    U r absolutely right, Sir. We need to rethink and revisit all our modern beliefs and practices. Our grandfathers/mothers were more healthier than us. They were physically more capable and also ailment free till their late stages. Nowadays we hear of heart attacks even in twenties. I think our age old Indian practices have been corrupted by the Western influences and habits. Even regarding the benefits of coconut oil...Researches are showing that it is the best oil amongst all. Keralites majorly consume coconut oil on daily basis....look at their skin tone and hair colour.
    Thumps up to your views and articles.

    Danny Allen

    In Reply to SRIDHAR IYER 1 year ago

    Very true. Only in the 20th century the low fat and vegetable oil consumption started growing. One needs to go to dietdoctor.com and read and listen to eminent experts on why saturated fat is good and it is the carbs from genetically modified grains and sugar which is the culprit for inflamation that leads to various diseases.

    Abdul Salim Pottengal

    In Reply to Anand Vaidya 1 year ago

    Dear Sir
    Kindly go through some articles related to Low Carb and High Fat (LCHF) diet. Fats are that much villain as you said? You compared it to cigaretes, please do a thorough study about fats..

    Anand Vaidya

    In Reply to Abdul Salim Pottengal 1 year ago

    LCHF has been debunked and discredit already. It can lead to weight loss in the short term. But long term safety is a big iffy.

    Humans belong to the primate category. We don't handle meat very well, if at all. Unlike cats big & small and other true carnivores.

    Watch this video wrt Ketodiets (LCHF is more or less same thing): https://www.youtube.com/watch?v=gS2F4B4ZT3Q

    Danny Allen

    In Reply to Anand Vaidya 1 year ago

    I beg to differ. I followed LCHF 3 years back and lost 18 kgs and maintained it !
    Todays grains are devoid of nutrition because of pesticides and GM. Also vegetable oils are highly processed to make them fit for consumption. Watch " butter makes my pants fall off" on youtube to get a better insight on how the human body reacts to saturated fats.

    Super-Foods That Heal
    In this article, I am going to share with you, information about a few super-foods, and some homemade remedies, that can help in your quest for better health. A fit body will breed positivity and energy. So, along with regular exercise, yoga and meditation, it is also important to eat right. Remember the old adage—eat food like medicine to avoid eating medicine like food.
     
    Garlic: Garlic contains natural chemicals which are excellent antioxidants that protect your heart tissues from getting ruptured fast. Though consumption of three to five raw garlic cloves early in the morning is a good cure for reducing cholesterol levels in the blood, many individuals find that this leads to bad breath. To address this problem, one can add a few garlic cloves to boiled vegetables. Roasting garlic in oil and adding salt is not recommended. Garlic can reduce hypertension / high blood pressure. Consumption of garlic at regular intervals will address symptoms like bloated stomach, constipation and poor digestion. Regular consumption of garlic will also make your skin glow. Garlic rasam is popular in south Indian households. Pickle manufacturers sell garlic pickle but it is loaded with chemical preservatives, excess chilli powder, excess oil and salt. However appetising it may appear, avoid garlic pickle available off the shelves as it will do you more harm than good.
     
     
    Methi (Fenugreek): Methi is rich in iron, calcium, chlorophyll, minerals, and nutrients. Methi leaves available in the market have to be sorted and cleaned well. The leaves can be mixed with wheat flour to make methi parathas that can be had along with a teaspoon of desi ghee. Aloo-methi is a popular vegetable in India; but frequent consumption of potatoes can lead to obesity. If you love alo- methi, the trick is to make it palatable by using homemade seasonings on it and using fewer potatoes. Methi sambar is popular in south India. Finely chopped methi leaves can be added to other vegetables when sambar is being prepared.
     
    Fenugreek seeds are often used for seasoning along with other Indian condiments like mustard—especially when sambar is being prepared. Soak methi seeds in a cup of water overnight; these can be had early in the morning on an empty stomach. Alternatively, mix soaked methi seeds in fresh curd and consume it after sprinkling salt.
     
    Here is a homemade remedy for controlling sugar levels in the blood. Take 250 grams of methi seeds; add 100 grams of ajwain and 50 grams of black cumin seeds. Roast them dry and grind them to a fine powder. Consume one teaspoon in the mornings and evenings and you will find an improvement in your metabolic rate. Sugar levels in the blood will also be controlled better. As this powder contains cumin as well as ajwain, digestion will improve and those with problems of constipation or flatulence will find instant relief.
     
     
    Black pepper powder and cumin powder can replace masala powders available in the market. The masalas available off the shelves contain salt, an excess of chilli powder and also preservatives that can wreak havoc with your body’s immune system. Pepper and cumin have healing properties and homemade masalas are superior to the ones available in the market. 
     
    Some Quick Home Remedies 
    1. A pinch of cinnamon powder along with one teaspoon of honey can clear a sore throat.
     
    2. Brush your teeth with lemon juice and salt at least twice a week. This leads to whitening of teeth.
     
    3. If you are suffering from cold/ running nose, swallow a single garlic clove.
     
    4. Ajwain wrapped in a muslin cloth and heated on a pan can be placed to your chest in case you have chest congestion due to cold and cough.
     
    5. Cinnamon powder boiled with water improves digestion.
     
    6. Regular consumption of diluted ginger juice (1: 10—one portion of ginger juice with 10 portions of boiled and cooled water) can help burn belly fat.
     
    7. Dried ginger powder crushed and boiled in water can help in warding off cold and improving digestion.
     
    8. During winter, consume black pepper sambar at least twice a week. This is prepared using small amounts of tamarind (or replace tamarind with kokum), black pepper and lentils. Curry leaves are used to top up the sambar and make it yummy. When had with rice, this can be a great combination along with roasted papad.
     
    9. Honey and lemon in a glass of lukewarm water can help in weight loss.
     
    10. Regular consumption of bitter gourd can help control blood sugar.
     
    11. Consumption of jambool fruit is good for diabetics. Jambool powder available in ayurvedic shops can be mixed in lukewarm water (one teaspoon in a glass of water) and consumed before breakfast. This will enable better control of diabetes.
     
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    COMMENTS

    nikhil keny

    1 year ago

    thank you so much for such an vital information.will definitely start consuming garlic as soon as possible.

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