Immunizations

All older adults (age 65 or older) should have completed a primary series of diphtheria and tetanus toxoids. If needed, a primary series for adults is three doses of preparations containing diphtheria and tetanus toxoids; the first two doses should be given at least 4 weeks apart and the third dose 6-12 months after the second. Those who have completed a primary series should receive a booster dose every 10 years. Td should be used to provide protection against both diseases.

Persons with unknown or uncertain histories of receiving diphtheria or tetanus toxoids should be considered unvaccinated and should receive a full three-dose primary series of Td.

All older adults should receive influenza vaccine annually. They should also receive a single dose of pneumococcal polysaccharide vaccine. Revaccination should be strongly considered greater than or equal to 6 years after the first dose for those at highest risk of a) fatal pneumococcal disease (such as asplenic patients) or b) rapid decline in antibody levels (e.g., transplant recipients or those with chronic renal failure or nephrotic syndrome).