Хіміопрофілактика й імунізація в пацієнтів літнього віку

Atherosclerotic cardiovascular disease (coronary artery disease, stroke)

Aspirin chemoprevention

Daily

For adults ≥ 60 years: Initiating low-dose aspirin for the primary prevention of cardiovascular disease not recommended (D recommendation by the USPSTF).

For adults 40–59: Low-dose aspirin individualized for adults who have a ≥ 10% risk of cardiovascular disease (C recommendation by the USPSTF)

For all people with a history of heart attack, stroke, coronary artery stent placement, or coronary artery bypass graft surgery: Low-dose aspirin still recommended by the ACC/AHA for secondary prevention.

COVID-19

COVID-19 vaccine

Boosters as they are available

For everyone over 6 months old: Recommendation by the CDC‡

For people ages 6 years and older if unvaccinated or previously received only monovalent vaccine doses: Recommended to receive 1 bivalent mRNA vaccine dose (for those with a monovalent dose, at least 8 weeks after)

Adults ≥ 65: May receive 1 additional bivalent mRNA vaccine dose at least 4 months after the first dose of a bivalent mRNA vaccine. 

People who are immunocompromised: Case by case basis after discussion of risk and benefit

Influenza

Influenza vaccine

Yearly

For everyone: Recommendation by the CDC†

Pneumococcal infection

Pneumococcal vaccine

Once or twice depending on specific vaccine

For adults > 65 who have never received a pneumococcal vaccination: PCV15 followed by PPSV23 at least 1 year later or PCV20 alone, recommended by the CDC

For older adults who have received pneumococcal vaccination when they were < 65 years: Choice of pneumococcal vaccine based on previous pneumococcal vaccination history and underlying medical conditions (see Centers for Disease Control and Prevention: Pneumococcal Vaccination).

Tetanus

Tetanus vaccine

Every 10 years

For adults > 19 who never received Tdap§: 1 dose of Tdap unless they have specific contraindications to the pertussis vaccine (dose is given at any time, regardless of the timing of the last dose of the Td vaccine) recommended by the CDC

For all people who have received Tdap: A Td or Tdap booster every 10 years recommended by the CDC

Zoster

Herpes zoster vaccine

2-dose series once at age 50

For people ≥ 50: Two doses of the recombinant zoster vaccine (RZV) vaccine 2–6 months apart, regardless of the history of zoster or varicella, recommended by the CDC

For immunocompromised patients: Possibly a shorter interval between the 2 doses of RZV