How to Prevent Colds and Flu in Older Adults
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A s we age, our immune systems often aren’t able to fight off infections as effectively as they once did. That makes winter, when viruses such as colds and influenza can circulate widely, a potentially dangerous time for older adults.
Neither a cold nor the flu is pleasant. Colds can cause a sore throat and sneezing, and flu brings a high fever, stuffiness, aches, and chills. Both can progress to pneumonia, a serious disease that kills tens of thousands of people in the U.S. every year.
Recent research suggests that the flu may also raise the risk of a heart attack or stroke. For example, a March 2018 study in the European Respiratory Journal evaluated medical records of Scottish adults and found that those who’d had pneumonia or influenza were several times more likely to have a heart attack or stroke within 28 days.
Last year’s flu season was one of the most severe in years. What that means for this season isn’t clear, however, because the flu is notoriously difficult to predict. Right now, flu activity is still relatively low—just 2.3 percent of doctor’s visits were for flu-like illnesses during the week of Thanksgiving, the most recent data available from the Centers for Disease Control and Prevention—but it has begun increasing.
Here, how to reduce your risk and to take proper care of yourself if you do get sick.
Get the Flu Shot
You may be wondering whether the annual flu vaccine is worth it, because the shot isn’t a guarantee; its effectiveness last year was only 40 percent.
But that still meant the chances of catching the flu were reduced, says Ann Falsey, M.D., a professor of medicine at the University of Rochester Medical Center. And if you have the vaccine and get the flu anyway, “you are much less likely to end up in the hospital, get pneumonia, and die of the flu,” she says.
For instance, a study of Danish heart failure patients published this week in the journal Circulation found that people with heart failure who received a flu shot were 18 percent less likely to die from any cause than those who weren’t vaccinated. In the study, getting a flu shot annually was also linked with better survival than less frequent flu vaccination. (The study was observational, so researchers were unable to prove definitively that the flu shot led to lower risk of death—only that the two were related.)
If you haven’t had a flu shot yet, now is the time. The vaccine takes about two weeks to become fully effective, so it’s ideal to get it before flu season ramps up, according to the CDC. But if you put it off, it’s not too late to be vaccinated later in the fall or winter.
What kind of shot should you get? The standard one contains three or four strains of the flu that scientists predict are most likely to circulate.
But if you’re 65 or older, you have additional options designed specifically for older adults to produce a stronger immune response.
One of them, called Fluzone High Dose, is four times as strong as the standard vaccine. The other, Fluad, contains an additional substance that prompts a boosted immune response.
Early evidence suggests that these vaccines provide better protection for older adults than traditional flu shots. But if they’re unavailable at your doctor’s office or pharmacy, a standard vaccine will reduce your risk of flu.
Flu shots are covered under Medicare and most private insurance plans, but the fee you pay may vary depending on the type of vaccine.
Get a Pneumonia Vaccine, Too
In addition to an annual flu shot, you should be vaccinated against pneumococcal bacteria. Pneumonia, or lung inflammation, causes 30 to 40 percent of all hospitalizations among older adults.
Viruses and fungi can cause the illness, but a key concern with colds and the flu is secondary bacterial infections, especially from pneumococcal bacteria. This can occur during recovery from a cold or the flu. It usually happens like this: You start to feel better but then take a turn for the worse and have a new fever and cough.
Two vaccines protect against some strains of pneumococcal bacteria: the PCV13 (Prevnar) is about 75 percent effective at preventing severe pneumococcal infections, and the PPSV23 (Pneumovax) is 50 to 85 percent effective against severe disease.
You should get both starting at age 65. Have the PCV13 first and the PPSV23 a year later.
If you’ve already had the PPSV23 because of another health condition, it’s fine to get PCV13 second as long as you wait at least a year between vaccines.
A good time to ask about pneumococcal vaccines is when you go in for a flu shot. It’s safe to get either of the two at the same time as the flu shot, according to the CDC.
Practice Healthy Habits
These tips can also help keep you from getting sick:
Wash your hands right. Use soap and water, and scrub for at least 20 seconds. Wash before and after eating or cooking, and after using the bathroom, being around someone who’s sick, or blowing your nose, coughing, or sneezing.
Be germ-savvy. Try to avoid touching your eyes, nose, and mouth—easy places for germs to enter your system. And be diligent about cleaning surfaces that are frequently touched in your home, such as doorknobs, especially if someone is sick.
Keep away from sick people. Because older adults may have less robust immune systems and catch colds and the flu more easily, it’s key to avoid contact with sick people. That includes grandchildren and other family members. And if you get sick, limit your contact with others, and cough or sneeze into your elbow or a tissue to protect those around you.
Keep fit overall. Maintaining a healthy lifestyle, which should include regular exercise (aim for 150 minutes of moderately intense activity, such as brisk walking, per week) and a nutritious diet, can help protect you from infection.
Skip supplements. Plenty of products are claimed to boost immunity. But there’s little or no evidence to support this for most of them, says Namita Ahuja, M.D., senior medical director for the UPMC Health Plan in Pennsylvania.
If You Do Get Sick
Even if you’re diligent, it’s possible you’ll come down with a cold or the flu. If you do, here’s what to do next:
Pay attention to your symptoms. Colds and the flu aren’t synonymous; they usually present differently. With a cold, symptoms come on gradually, and you probably won’t have a fever but will have a sore throat followed by sneezing, a stuffed or runny nose, and a cough. With the flu, you may also develop a cough, but initial symptoms such as a fever, chills, and fatigue usually come on suddenly. Colds usually resolve after a few days, but the flu often lasts longer than a week.
Treat yourself right. Older adults who think they might have the flu should go to a doctor right away. That’s because older adults are among those who are at higher risk for flu complications such as pneumonia and might benefit from taking antiviral medications such as oseltamivir (Tamiflu and generic).
These prescription medications can reduce the severity of the illness but are most effective when taken within 48 hours of the start of symptoms. A doctor may use a lab test to help diagnose the flu, but if you have symptoms, a positive test result isn’t necessary before taking an antiviral.
Whether you have the flu or a cold, over-the-counter medications can ease discomfort. Acetaminophen (Tylenol and generic), ibuprofen (Advil and generic), and naproxen (Aleve and generic) can lower a fever and alleviate pain. If you take other medications regularly, ask your doctor about them and any other OTC drugs for cold and flu symptoms, because they can interact.
And don’t underestimate the power of a bowl of chicken soup. Research suggests that it may actually help you feel better.
Know when to get emergency help. Most people recover just fine from colds and the flu. But both can turn into an emergency. Get medical attention immediately from a doctor or at an emergency room if you have shortness of breath, chest pain, confusion or dizziness, or persistent vomiting, or if you start to improve but suddenly begin to feel worse. Even if you don’t notice any of the above, it’s a good idea to call a doctor if your symptoms don’t improve after a week or so.
Editor’s Note: A version of this article also appeared in the November 2018 issue of Consumer Reports On Health. It has been updated to reflect new research.
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