Health
Many Older People Embrace Vaccines. Research Is Proving Them Right.
Kim Beckham, an insurance agent in Victoria, Texas, had seen friends suffer so badly from shingles that she wanted to receive the first approved shingles vaccine as soon as it became available, even if she had to pay for it out of pocket.
Her doctor and several pharmacies turned her down because she was below the recommended age at the time, which was 60. So in 2016, she celebrated her 60th birthday at her local CVS.
“I was there when they opened,” Ms. Beckham recalled. After her Zostavax shot, she said, “I felt really relieved.” She has since received the newer, more effective shingles vaccine, as well as the pneumonia shot, the R.S.V. vaccine, annual flu shots and all recommended Covid vaccinations.
Some older people are really eager to be vaccinated.
Robin Wolaner, 71, a retired publisher in Sausalito, Calif., has been known to badger friends who delay getting recommended shots, sending them relevant medical studies. “I’m sort of hectoring,” she acknowledged.
Deana Hendrickson, 66, who provides daily care for three young grandsons in Los Angeles, sought an additional M.M.R. shot, though she was vaccinated as a child, in case her immunity to measles was waning.
For older adults who express more confidence in vaccine safety than younger groups, the past few months have brought some welcome research. Studies have found important benefits from a newer vaccine and enhanced versions of older ones, and one vaccine may confer a major bonus that nobody had foreseen.
The new studies are coming at a fraught political moment. The nation’s health secretary, Robert F. Kennedy Jr., has long disparaged certain vaccines, calling them unsafe and saying that the government officials who regulate them are compromised and corrupt.
This week, the secretary fired a panel of scientific advisers to the Centers for Disease Control and Prevention, replacing them with some who have been skeptical of vaccines. But so far, Mr. Kennedy has not tried to curb access to the shots for older Americans.
The evidence that vaccines are beneficial remains overwhelming.
The phrase “Vaccines are not just for kids anymore” has become a favorite for Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center.
“The population over 65, which often suffers the worst impact of respiratory viruses and others, now has the benefit of vaccines that can prevent much of that serious illness,” he said.
Take influenza, which annually sends from 140,000 to 710,000 older people to hospitals and is fatal in 10 percent of them.
For about 15 years, the C.D.C. has approved several enhanced flu vaccines for people over 65. More effective than the standard formulation, they either contain higher levels of the antigen that builds protection against the virus or incorporate an adjuvant that creates a stronger immune response. Or they’re recombinant vaccines, developed through a different method, with higher antigen levels.
In a meta-analysis in the Journal of the American Geriatrics Society, “all the enhanced vaccine products were superior to the standard dose for preventing hospitalizations,” said Rebecca Morgan, a health research methodologist at Case Western Reserve University and an author of the study.
Compared with the standard flu shot, the enhanced vaccines reduced the risk of hospitalization from the flu by 11 to 18 percent in older adults. The C.D.C. advises adults over 65 to receive the enhanced vaccines, as many already do.
More good news: Vaccines to prevent respiratory syncytial virus (R.S.V.) in people over 60 are performing admirably.
R.S.V. is the most common cause of hospitalization for infants, and it also poses significant risks to older people. “Season in and season out,” Dr. Schaffner said, “it produces outbreaks of serious respiratory illness that rivals influenza.”
Because the Food and Drug Administration first approved an R.S.V. vaccine in 2023, the 2023-24 season provided “the first opportunity to see it in a real-world context,” said Dr. Pauline Terebuh, an epidemiologist at Case Western Reserve School of Medicine and an author of a recent study in the journal JAMA Network Open.
In analyzing electronic health records for almost 800,000 patients, the researchers found the vaccines to be 75 percent effective against acute infection, meaning illness that was serious enough to send a patient to a health care provider.
The vaccines were 75 percent effective in preventing emergency room or urgent care visits, and 75 percent effective against hospitalization, both among those aged 60 to 74 and those older.
Immunocompromised patients, despite having a somewhat lower level of protection from the vaccine, will also benefit from it, Dr. Terebuh said. As for adverse effects, the study found a very low risk for Guillain-Barré syndrome, a rare condition that causes muscle weakness and that typically follows an infection, in about 11 cases per one million doses of vaccine. That, she said, “shouldn’t dissuade people.”
The C.D.C. now recommends R.S.V. vaccination for people 75 and older, and for those 60 to 74 if they’re at higher risk of severe illness (from heart disease, say).
As data from the 2024-25 season becomes available, researchers hope to determine if the vaccine will remain a one-and-done, or whether immunity will require repeated vaccination.
People over 65 express the greatest confidence in vaccine safety of any adult group, a KFF survey found in April. More than 80 percent said they were “very “or “somewhat confident” about M.M.R., shingles, pneumonia and flu shots.
Although the Covid vaccine drew lower support among all adults, more than two-thirds of older adults expressed confidence in its safety.
Even skeptics might become excited about one possible benefit of the shingles vaccine: This spring, Stanford researchers reported that over seven years, vaccination against shingles reduced the risk of dementia by 20 percent, a finding that made headlines.
Biases often undermine observational studies that compare vaccinated with unvaccinated groups. “People who are healthier and more health-motivated are the ones who get vaccinated,” said Dr. Pascal Geldsetzer, an epidemiologist at the Knight Initiative for Brain Resilience at Stanford and lead author of the study.
“It’s hard to know whether this is cause and effect,” he said, “or whether they’re less likely to develop dementia anyway.”
So the Stanford team took advantage of a “natural experiment” when the first shingles vaccine, Zostavax, was introduced in Wales. Health officials set a strict age cutoff: People who turned 80 on or before Sept. 1, 2013, weren’t eligible for vaccination, but those even slightly younger were eligible.
In the sample of nearly 300,000 adults whose birthdays fell close to either side of that date, almost half of the eligible group received the vaccine, but virtually nobody in the older group did.
“Just as in a randomized trial, these comparison groups should be similar in every way,” Dr. Geldsetzer explained. A substantial reduction in dementia diagnoses in the vaccine-eligible group, with a much stronger protective effect in women, therefore constitutes “more powerful and convincing evidence,” he said.
The team also found reduced rates of dementia after shingles vaccine was introduced in Australia and other countries. “We keep seeing this in one data set after another,” Dr. Geldsetzer said.
In the United States, where a more potent vaccine, Shingrix, became available in 2017 and supplanted Zostavax, Oxford investigators found an even stronger effect.
By matching almost 104,000 older Americans who received a first dose of the new vaccine (full immunization requires two) with a group that had received the earlier formulation, they found delayed onset of dementia in the Shingrix group.
How a shingles vaccine might reduce dementia remains unexplained. Scientists have suggested that viruses themselves may contribute to dementia, so suppressing them could protect the brain. Perhaps the vaccine revs up the immune system in general or affects inflammation.
“I don’t think anybody knows,” said Dr. Paul Harrison, a psychiatrist at Oxford and a senior author of the study. But, he added, “I’m now convinced there’s something real here.”
Shingrix, now recommended for adults over 50, is 90 percent effective in preventing shingles and the lingering nerve pain that can result. In 2021, however, only 41 percent of older Americans had received one dose of either shingles vaccine.
A connection to dementia will require further research, and Dr. Geldsetzer is trying to raise philanthropic funding for a clinical trial.
And “if you needed another reason to get this vaccine,” Dr. Schaffner said, “here it is.”
Health
Your resting heart rate could reveal more about your health than you think, doctors say
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The simple act of noting how fast your heart is beating while you’re at rest may be the key to measuring your overall health.
Resting heart rate is defined by Mayo Clinic as the number of times your heart beats each minute while you’re awake, calm and not moving.
A normal resting heart rate ranges from 60 to 100 beats per minute for adults. A slower resting heart rate means the heart does not have the work as heard to pump blood through the body — something typical of someone who is more fit.
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Athletes who are very fit may have a resting heart rate closer to 40 beats per minute, according to Mayo Clinic.
Your resting heart rate can vary due to a variety of factors, including age, physical activity levels, sleep health, smoking, cardiovascular disease, high cholesterol, diabetes, stress, anxiety, hormones, body type and certain medications.
A normal resting heart rate ranges from 60 to 100 beats per minute for adults, according to medical experts. (iStock)
But a resting heart rate that’s often too high or too low may signal a health issue.
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A high resting heart rate, even if it’s slight, is usually a sign that something else may be going on in the body, such as anemia, an infection or a thyroid problem, according to Cleveland Clinic.
A high resting heart rate, even if it’s slight, is usually a sign that something else may be going on in the body. (iStock)
If your heart rate is regularly above 100 beats per minute, this is a sign to talk with your heart care provider.
The same advice applies if you are not a trained athlete and your resting heart rate is frequently below 60 beats per minute.
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Talk to your doctor if other symptoms such as fainting, dizziness or shortness of breath occur.
How to measure your heart rate
You can check your own heart rate by tracking your pulse on your wrist or neck. The best time of day to measure resting heart rate is first thing in the morning, says Mayo Clinic.
Place your index and middle fingers inside the wrist below the thumb, to feel the radial artery; or, do so on the side of the neck, to feel the carotid artery.
Place your index and middle fingers on the side of the neck, to feel the carotid artery — and count how many beats per minute. (iStock)
Count the number of times your pulse beats in 15 seconds, then multiply this number by four to calculate beats per minute.
Wearable devices can also detect and track resting heart rate, although this may not always be accurate.
How to lower your heart rate
If your resting heart rate is higher than normal, there are a few ways to work toward lowering it.
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Vigorous exercise is “the best way” to lower your resting heart rate and increase the heart’s aerobic capacity and max heart rate, according to Harvard.
For those who don’t exercise regularly, it’s important to work your way up in difficulty when following a new workout routine.
Vigorous exercise is “the best way” to lower your resting heart rate, Harvard Health says. But it’s vital to work your way up carefully. (iStock)
Some medications, such as beta blockers, can also lower heart rate. In the same way, managing stress through holistic methods such as meditation or yoga can also help.
Cleveland Clinic also recommends cutting back on harmful substances such as drugs and alcohol, which can dehydrate you and raise your heart rate.
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Adequate sleep can also help bring your heart rate down, in addition to maintaining a healthy weight.
Cardiologist Tamanna Singh, M.D., shared with Cleveland Clinic that lowering your heart rate takes time as various lifestyle changes kick in.
Managing stress through holistic methods such as meditation or yoga can help lower your resting heart rate,
“Just like building your biceps and triceps, it takes time for your heart to become stronger,” the doctor said.
Singh recommended focusing on heart rate patterns rather than dialing in on just the number.
Take note of how your heart rate changes after eating certain foods, when you’re dehydrated or after you’ve begun a new exercise or stress management routine.
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“If you notice that your heart rate is consistently over 100, mention it to your doctor, especially if you’ve tried making lifestyle changes and they don’t seem to be working,” she said.
“Your resting heart rate isn’t the be-all, end-all of your health, but it’s definitely a marker that you should pay attention to.”
Health
GLP-1 Users’ Guide to Protein Snacks: Here’s What a Dietitian Actually Recommends
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Health
Coffee may have powerful effect on liver health, major study suggests
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The health benefits of morning coffee may go beyond a wake-up call, according to a massive new study linking the beverage to a significantly lower risk of severe liver disease, liver cancer and liver-related death.
Published in the journal Clinical Gastroenterology and Hepatology, the research used data from 354,957 participants enrolled in the UK Biobank.
Researchers tracked individuals who had no history of cirrhosis or liver cancer at the start of the study for an average of 13 years, according to a press release.
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Participants who drank one to two cups of coffee daily showed a 20% lower risk of developing cirrhosis and a 31% lower risk of liver-related mortality compared to non-coffee drinkers.
The protective effects became even more noticeable at higher levels of consumption.
Data revealed that heavy coffee drinkers had significantly lower levels of liver fat and liver iron. (iStock)
Individuals who drank five or more cups of coffee per day experienced a 32% reduction in cirrhosis risk, a 42% lower risk of liver-related death and a 47% lower risk of developing hepatocellular carcinoma, the most common form of primary liver cancer.
While previous studies have hinted at coffee’s positive relationship with liver health, this study provides biological evidence to support the statistical trends, the researchers said.
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To better understand why coffee may protect the liver, the researchers conducted additional analyses using imaging data from a subgroup of nearly 29,000 participants and blood samples from approximately 50,000 individuals.
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The data showed that heavy coffee drinkers had significantly lower levels of liver fat and liver iron, as well as lower odds of developing fibroinflammation, which is the scarring and inflammation that often precedes permanent liver damage.
Participants who drank one to two cups of coffee daily showed a 20% lower risk of developing cirrhosis. (iStock)
The blood analysis linked coffee consumption with lower levels of some proteins known to trigger inflammation and tissue scarring, along with higher levels of proteins essential for healthy liver function.
Notably, the study found that the liver-protective benefits were similar for both caffeinated and decaffeinated coffee, suggesting that these benefits are driven by naturally occurring compounds not related to caffeine.
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While the benefits persisted regardless of whether the coffee was consumed black or with sweeteners, the researchers observed that adding sugar or artificial sweeteners slightly weakened the beneficial effects, particularly concerning markers of liver inflammation.
Researchers observed that adding sugar or artificial sweeteners slightly weakened the positive effects. (iStock)
While these findings suggest that coffee consumption is an accessible dietary habit for supporting liver health, the authors noted that it should serve as a complement rather than a replacement for standard preventative health practices.
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Because the research relied on self-reported dietary questionnaires from the UK Biobank, the findings could be susceptible to changes in participants’ coffee-drinking habits over the 13-year follow-up period.
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Additionally, as an observational study, it can only establish a strong correlation and cannot prove cause and effect, as other factors may influence the outcomes.
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