Vaccines: The Shots That Matter for Seniors

What you need to know about vaccines and your Medicare plan

Updated on: November 2, 2020

Originally posted on: December 19, 2018
Express Scripts Pharmacist Mr. Reyes specializes in medication management issues for seniors. Topics include best practices for managing multiple prescriptions.

Are you getting the recommended vaccines you need? Many people aren’t aware that they can benefit from getting vaccinated even as they get older; in fact, according to the Centers for Disease Control (CDC), flu and pneumonia combined are the eighth leading cause of death among seniors 65 and older. But you can do something to protect your health by staying up to date on your vaccines.

How to Get The Vaccines You Need

If you are enrolled in Medicare, your Part B coverage automatically covers the seasonal flu shot, including the swine flu vaccination (H1N1) and pneumococcal (pneumonia). If you are at high risk for Hepatitis B, this may also be covered. Speak with your coverage provider to determine whether the Hepatitis B vaccine is payable under Part B or Part D coverage.

You can get your vaccinations from your primary care physician or at some retail pharmacy chains. Walgreens and CVS, for example, offer immunizations from certified health professionals at convenient hours, with no appointment necessary.

“Flu and pneumonia combined are the eighth leading cause of death among seniors”

What Vaccines Are Right for You?

Many adults aren’t aware that the need for immunizations continues as you age. The vaccines you may have received as a child can wear off, putting you and your family at risk for new and different diseases. Medicare Part D generally covers vaccines not covered by Part B, as long as the vaccine is reasonable and necessary to prevent illness. You will find information on each condition and the vaccines available to seniors below.

  • Influenza:

    Your immune system weakens with age, which can make you more susceptible to the flu. Research shows that 90% of seasonal flu-related deaths, and from 50% and 60% of seasonal flu-related hospitalizations in the United States, occur in people 65 years and older.

    • Seniors are encouraged to get their flu shots by October.
    • This vaccine needs to be repeated each year.
    • Part B covers this vaccine.
  • Shingles:

    Shingles affects your nerves and causes a painful rash and blistering. If you had the chickenpox, then you may be at risk for shingles. Although people of any age can contract the virus, seniors (60+) account for over half of all shingles cases. Plus, complications are more common among seniors.

    • This is a one-time vaccine.
    • Part D covers this vaccine.
  • Whooping Cough (Pertussis):

    Whooping cough or pertussis is on the rise in older adults. Symptoms are similar to those of the common cold (runny nose, nasal congestion, cough), but can quickly escalate into uncontrollable coughing, which may cause vomiting and extreme fatigue.

    • A one-time vaccine may be available to seniors over 65. Consult your doctor to determine an appropriate vaccine schedule.
    • Part D covers this vaccine.
  • Pneumonia (Pneumococcal):

    C now recommends two vaccines for seniors, given in sequence, to help protect against bacterial infections such as sepsis, meningitis and pneumonia. The two vaccines work together to offer broader protection. Overall, pneumonia, meningitis and bloodstream infections kill tens of thousands of people each year in the United States. Of those deaths, 18,000 are adults ages 65 and older.

    • Vaccine dosing and sequence may vary depending on your medical history. Consult your doctor to determine an appropriate vaccine schedule.
    • Part B covers this vaccine.

The CDC has a quiz that might help you decide what vaccines you need. Your doctor or pharmacist can also provide you with information on available vaccines.