Seniors over 90 are generally advised to receive the same vaccine doses as other older adults, but with careful consideration of their overall health, immune system status, and specific risk factors. Vaccine recommendations for very elderly individuals focus on protecting them from diseases that can cause severe complications, such as influenza, COVID-19, pneumonia, shingles, and respiratory syncytial virus (RSV). However, the exact dosing and frequency may be adjusted based on their unique health profile and the type of vaccine.
As people age, their immune systems weaken—a process called immunosenescence—which means their bodies may not respond as robustly to vaccines as younger adults. To compensate, some vaccines recommended for seniors, including those over 90, are formulated at higher doses or include adjuvants (ingredients that boost immune response). For example, the flu vaccine for adults 65 and older often comes in a high-dose or adjuvanted version to provide stronger protection. This approach is also relevant for those over 90, who are at even greater risk of severe illness from the flu.
For COVID-19, updated booster vaccines are recommended for all adults, especially those 65 and older, including seniors over 90. These boosters are designed to protect against the most current virus variants. While the dosing schedule for COVID-19 vaccines may evolve with new variants and updated formulations, seniors over 90 typically follow the same guidance as other older adults, receiving boosters as recommended by health authorities. Their healthcare providers will consider their vaccination history, previous COVID-19 infections, and overall health to determine the best timing and number of doses.
Other vaccines important for seniors over 90 include pneumococcal vaccines to prevent pneumonia, shingles vaccines to reduce the risk of shingles and its complications, and the relatively new RSV vaccine, which is recommended for adults over 75 or those with certain health conditions. These vaccines generally follow the same dosing schedules as for younger seniors, but doctors may tailor recommendations based on individual health status.
In practice, healthcare providers assess seniors over 90 on a case-by-case basis. Factors such as frailty, chronic illnesses, immune system function, and potential vaccine side effects are considered to ensure that vaccination benefits outweigh any risks. For example, while the standard adult dose of a vaccine might be appropriate, some very frail seniors might receive modified schedules or additional monitoring after vaccination.
In summary, seniors over 90 are advised to receive the same vaccines a
