COVID-19 vaccines: CDC says people ages 65 and up should get a shot this spring – a geriatrician explains why it’s vitally important

In my mind, the spring season will always be associated with COVID-19.

In spring 2020, the federal government declared a nationwide emergency^[1], and life drastically changed. Schools and businesses closed, and masks and social distancing were mandated across much of the nation.

In spring 2021, after the vaccine rollout, the Centers for Disease Control and Prevention said those who were fully vaccinated against COVID-19 could safely gather with others who were vaccinated^[2] without masks or social distancing.

In spring 2022, with the increased rates of vaccination across the U.S., the universal indoor mask mandate^[3] came to an end.

In spring 2023, the federal declaration of COVID-19 as a public health emergency ended^[4].

Now, as spring 2024 fast approaches, the CDC reminds Americans that even though the public health emergency is over, the risks associated with COVID-19 are not. But those risks are higher in some groups than others. Therefore, the agency recommends that adults age 65 and older receive an additional COVID-19 vaccine^[5], which is updated to protect against a recently dominant variant^[6] and is effective against the current dominant strain.

Increased age means increased risk

The shot is covered by Medicare^[7]. But do you really need yet another COVID-19 shot?

As a geriatrician^[8] who exclusively cares for people over 65 years of age, this is a question I’ve been asked many times over the past few years.

In early 2024, the short answer is yes.

Compared with other age groups, older adults have the worst outcomes^[9] with a COVID-19 infection. Increased age is, simply put, a major risk factor^[10].

In January 2024, the average death rate from COVID-19 for all ages was just under 3 in 100,000 people^[11]. But for those ages 65 to 74, it was higher^[12] – about 5 for every 100,000. And for people 75 and older, the rate jumped to nearly 30 in 100,000.

Even now, four years after the start of the pandemic, people 65 years old and up are about twice as likely to die from COVID-19 than the rest of the population. People 75 years old and up are 10 times more likely to die^[13] from COVID-19.

Vaccination is still essential

These numbers are scary. But the No. 1 action people can take to decrease their risk is to get vaccinated^[14] and keep up to date on vaccinations to ensure top immune response. Being appropriately vaccinated is as critical in 2024 as it was in 2021 to help prevent infection, hospitalization and death from COVID-19.

The updated COVID-19 vaccine^[15] has been shown to be safe and effective^[16], with the benefits of vaccination continuing to outweigh the potential risks of infection^[17].

The CDC has been observing side effects on the more than 230 million Americans who are considered fully vaccinated^[18] with what it calls the “most intense safety monitoring in U.S. history^[19].” Common side effects soon after receiving the vaccine^[20] include discomfort at the injection site, transient muscle or joint aches, and fever.

These symptoms can be alleviated with over-the-counter pain medicines or a cold compress to the site after receiving the vaccine. Side effects are less likely if you are well hydrated when you get your vaccine.

Long COVID and your immune system

Repeat infections carry increased risk, not just from the infection itself, but also for developing long COVID as well as other illnesses^[21]. Recent evidence shows that even mild to moderate COVID-19 infection can negatively affect cognition, with changes similar to seven years of brain aging. But being up to date with COVID-19 immunization has a fourfold decrease in risk of developing long COVID symptoms^[22] if you do get infected.

Read more: Mounting research shows that COVID-19 leaves its mark on the brain, including with significant drops in IQ scores^[23]

Known as immunosenescence^[24], this puts people at higher risk of infection, including severe infection, and decreased ability to maintain immune response to vaccination ^[25] as they get older. The older one gets – over 75, or over 65 with other medical conditions – the more immunosenescence takes effect.

All this is why, if you’re in this age group, even if you received your last COVID-19 vaccine in fall 2023, the spring 2024 shot is still essential to boost your immune system so it can act quickly if you are exposed to the virus.

The bottom line: If you’re 65 or older, it’s time for another COVID-19 shot.

References

1. ^{^} declared a nationwide emergency (www.federalregister.gov)
2. ^{^} safely gather with others who were vaccinated (www.cnn.com)
3. ^{^} universal indoor mask mandate (www.nytimes.com)
4. ^{^} public health emergency ended (www.hhs.gov)
5. ^{^} additional COVID-19 vaccine (www.cdc.gov)
6. ^{^} updated to protect against a recently dominant variant (www.yalemedicine.org)
7. ^{^} covered by Medicare (www.medicare.gov)
8. ^{^} As a geriatrician (uvahealth.com)
9. ^{^} older adults have the worst outcomes (www.mayoclinic.org)
10. ^{^} major risk factor (www.cdc.gov)
11. ^{^} just under 3 in 100,000 people (covid.cdc.gov)
12. ^{^} it was higher (www.cidrap.umn.edu)
13. ^{^} 10 times more likely to die (covid.cdc.gov)
14. ^{^} is to get vaccinated (www.cdc.gov)
15. ^{^} updated COVID-19 vaccine (www.yalemedicine.org)
16. ^{^} has been shown to be safe and effective (www.cdc.gov)
17. ^{^} outweigh the potential risks of infection (www.cdc.gov)
18. ^{^} who are considered fully vaccinated (usafacts.org)
19. ^{^} most intense safety monitoring in U.S. history (www.cdc.gov)
20. ^{^} soon after receiving the vaccine (www.cdc.gov)
21. ^{^} as well as other illnesses (time.com)
22. ^{^} fourfold decrease in risk of developing long COVID symptoms (www.scientificamerican.com)
23. ^{^} Mounting research shows that COVID-19 leaves its mark on the brain, including with significant drops in IQ scores (theconversation.com)
24. ^{^} immunosenescence (doi.org)
25. ^{^} maintain immune response to vaccination (doi.org)