Recommendations, usage and efficacy of immunizations for the elderly

Nurse Pract. 1992 Mar;17(3):51-2; 58-9. doi: 10.1097/00006205-199203000-00009.


Significant levels of older-adult mortality and morbidity are associated with vaccine-preventable diseases, specifically influenza and pneumococcal disease. Even though current guidelines for this age group recommend a single vaccination against pneumococcal pneumonia, an annual influenza vaccination and a combined tetanus-diphtheria toxoid booster every 10 years after completion of a primary series, immunization levels remain extremely low. This article presents information regarding usage, efficacy and cost-effectiveness of these vaccines. Physician non-compliance and misinformation, negative patient attitudes and a shortage of effective programs for vaccine delivery account for vaccine underutilization. Recommendations from health care providers significantly affect whether a person will be immunized. Increased vaccine usage was noted in clinic-based programs that initiated organizational or administrative interventions, such as patient and physician reminders, physician-performance feedback, medical-record checklists and the use of non-physician health care staff to monitor patient vaccination status and to dispense vaccines. Providing organized education and vaccination programs in institutional and public settings may also help target the older-adult population. The future success of adult immunization will depend not only on increased professional and public awareness but also on the development of new approaches to vaccine delivery.

MeSH terms

  • Aged*
  • Attitude to Health
  • Clinical Protocols / standards
  • Health Education
  • Health Promotion
  • Humans
  • Immunization / economics
  • Immunization / standards*
  • Immunization / statistics & numerical data
  • Immunization Schedule*