Every fall and winter, the United States sees an uptick in the number of people who fall ill to influenza and other seasonal diseases. This flu season typically stretches from October to May, with December through February as peak months.
Some years are worse than others, and the 2024 to 2025 season has been especially bad as a “quad-demic” of COVID-19, influenza, respiratory syncytial virus (RSV) and norovirus converge to make more people sick than in a typical flu season.
However, safe, effective vaccines can dramatically lower your risk of contracting one of these illnesses or blunt their impact if you are infected. These vaccines are also critical for older adults who live in nursing homes. Here’s everything you need to know about vaccination in these long-term care facilities.
Why Nursing Home Residents Are At Risk
For nursing home residents, who tend to live in close quarters and require higher levels of care, the threat of flu, COVID-19, RSV and pneumonia is especially pronounced.
“When we talk about the population of older adults who live in a nursing home, they are by definition frail. They are not healthy,” explains Dr. Preeti Malani, professor of medicine in the division of infectious diseases at the University of Michigan and a special advisor to the university president.
The immune system tends to weaken with age, and older adults are less able to fight off infections naturally. The chances that they’ll become very sick and need to be hospitalized from illnesses like the flu thus increases significantly.
“Flu can be life-threatening,” Malani emphasizes.
According to 2024 data from the CDC, an estimated 70% to 85% of seasonal flu-related deaths have occurred in people age 65 and older, and 50% to 70% of seasonal flu-related hospitalizations have occurred among people in that same age group.
[READ: Tips for Choosing a Good Nursing Home]
What to Know About the Flu Vaccine
The flu shot is a critical piece of preventive care.
“Vaccines are the best way to prevent, or at least lessen, the symptoms these viruses can cause,” says Kim Elliott, Nashville-based senior vice president and chief nursing officer of Brookdale Senior Living. “An annual flu shot is a must-have for older adults, especially those in skilled nursing communities.”
The flu vaccine is reformulated each year to target the strain or strains of flu that are anticipated to be most prevalent in the coming flu season. This reformulation isn’t always spot-on — public health experts make their best estimation of which strain will be dominant and work from there. This results in variability in the vaccine’s rate of efficacy from year to year and is one reason why certain flu seasons are worse than others.
Nevertheless, it’s imperative to get a flu shot every year to maintain a baseline of immunity that can help prevent infection and reduce the severity of illness if you do contract the flu.
The CDC reports in the 2023–2024 flu season, the vaccine prevented an estimated 9.8 million flu-related illnesses, 4.8 million medical visits, 120,000 hospitalizations and 7,900 deaths.
[READ: How to Get Rid of a Cold and the Flu]
What to Know About the Pneumonia Vaccine
In addition to an annual flu vaccine, older adults are strongly encouraged to get the pneumococcal vaccine that helps prevent pneumonia, an infection in the lungs that can develop as a complication of the flu. Unlike the flu shot, the pneumonia shot doesn’t have to be delivered annually. Protection from the vaccination lasts for several years.
The CDC currently recommends that people age 50 to 64 get pneumococcal vaccines on a schedule recommended by their health care provider based on their individual history of vaccination and current health status.
There are two types of pneumococcal vaccines available, and they each target specific strains of bacteria that can cause pneumonia. Both are widely available and effective at preventing pneumonia.
[READ: A Patient’s Guide to Walking Pneumonia.]
What to Know About COVID-19 and the COVID Vaccine
The COVID-19 pandemic that started in spring 2020 lingers on, most notably in congregate care settings where older adults may easily pass the infection on to others. COVID-19 causes a wide range of respiratory symptoms, but it can also trigger gastrointestinal and neurological problems, organ damage and leave a lasting mark with long COVID.
A massive global public health effort led to the rapid development of vaccines for COVID-19, and these vaccines helped curtail the worst of the pandemic. They are now widely available and are recommended for virtually everyone, particularly for those who live in nursing homes because of their vulnerability to complications from infection.
Similar to the flu vaccine, the COVID-19 vaccine changes regularly to keep in step with how the virus that causes the illness mutates over time. This means you’ll need to get boosters of the vaccine routinely to help prevent infection.
As of October 2024, the CDC recommends that people age 65 and older receive two doses of any 2024-2025 COVID-19 vaccine (Moderna, Novavax or Pfizer-BioNTech) separated by six months, regardless of vaccination history. There is, however, one exception: If you’ve never been vaccinated against COVID-19, the CDC recommends you receive two doses of the Novavax COVID-19 vaccine followed by a third dose of any COVID-19 vaccine six months later.
What to Know About RSV and the RSV Vaccine
RSV is a common infectious disease caused by a virus. Cases often spike during flu season, and the disease can cause a range of respiratory symptoms and potentially dangerous complications. While RSV is more common in very young children, it can be devastating for older adults.
The FDA has licensed three RSV vaccines for use in the U.S. in adults age 60 and older. The CDC recommends that all adults age 75 and older and adults age 60 to 74 who are at increased risk of severe RSV receive a single dose of any of the FDA-licensed RSV vaccines.
The RSV vaccine is not delivered annually, so if you’ve had this vaccine, you should be set for a while. Talk with your health care provider about your risk of RSV and whether you need this vaccine.
Vaccine Safety and Efficacy
In recent years, concerns about potential side effects and unintended consequences related to vaccines have gained traction and left some people wary of getting vaccines. But many of these fears are unfounded; Food and Drug Administration–approved vaccines, such as the annual flu shot, the COVID-19 vaccine, the RSV vaccine and pneumonia shots, are safe and effective for the vast majority of people.
There are several persistent myths that surround vaccines, among them a fear that getting vaccinated can make you sick. But quite simply, “flu vaccine does not cause flu,” Malani says.
Although sometimes people may feel lousy for a few days after receiving the vaccine, it’s not the flu but rather a mild side effect of the injection. These symptoms typically mean your body is mounting the immune response the vaccine is intended to trigger, so it means it’s working. And in some cases, these symptoms aren’t related to the vaccine at all. Rather, they are a coincidence of other seasonal sniffles and colds circulating at the same time. All of the above is true for many other vaccines, including the COVID-19 vaccine, the pneumonia vaccine and the RSV vaccine.
Concerns about efficacy and side effects are widespread, and it’s true that no vaccine is 100% effective. There are potential side effects to any medical intervention, including vaccines, and there are some people who simply can’t take vaccines because of allergies, being immunocompromised or other contraindications.
Despite this nuance, vaccination remains the most effective tool available to help prevent flu, COVID-19, RSV and pneumonia among the general population and particularly among older adults in nursing homes.
In addition, data from the CDC indicates that in the 2022–2023 season, only 68.3% of workers in long-term care facilities got a flu shot. That’s the lowest among health care professionals. By comparison, 85.7% of workers in hospitals received the influenza vaccine.
You should consider vaccination rates and mandatory vaccination policies when you’re looking to place a loved one in a nursing home or other long-term care facility.
“It’s not an unreasonable thing to ask,” Malani points out. “Vaccination is a marker of safety in general and the overall culture” of the facility.
Protect Others by Protecting Yourself
Reluctance to vaccinate impacts not only the individual who’s making that choice, but also the health of others in the community.
Dr. Tanya Gure, a geriatrician with the Ohio State University Wexner Medical Center in Columbus, says she discusses the influenza vaccine with all of her patients beginning in late summer and into the fall. The flu, she notes, can exacerbate chronic health issues; heart disease, for instance, is associated with worse outcomes with the flu.
To overcome resistance to vaccination, Gure reviews “at length the overwhelming benefits of getting the influenza vaccine for the patient and their loved ones.”
When the facts are presented in this light, “patients are often very receptive to getting the flu vaccine to protect their loved ones, even if they are ambivalent about getting it for their own benefit,” she adds.
Elliott recommends other simple measures that can prevent illness and cut down on transmission:
— Cover your coughs and sneezes with a tissue.
— Wash your hands often.
— Avoid people who are sick as much as possible.
— Stay home if you’re unwell to prevent spreading germs to others.
— Clean and disinfect high-touch surfaces.
— Manage chronic health conditions.
— Take care of your overall health by exercising, eating right, drinking plenty of water and getting good quality sleep.
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Vaccination in Nursing Homes originally appeared on usnews.com
Update 02/18/25: This story was previously published at an earlier date and has been updated with new information.
