Vaccination Update

Last week, I attended an “old boys” luncheon with some of my fellow retired friends and among other topics, we began discussing medical issues including what were the current vaccination recommendations for seniors, especially those of us who travel. There seemed to be universal doubt among all of us as to whether or not we need another Covid booster, should we get a shot for RSV and what about measles immunity for persons of our age, now that outbreaks are exploding around the world? What immunization should we update if travelling to Europe or Central America? Are all of the recommended vaccines publicly funded? There were far more questions than answers and, although I’ve written about vaccinations in the past, the landscape is changing constantly, and new recommendations are being announced.

In the past, we often relied on our personal physician to remind us of the recommended vaccines and boosters but with the shortage of family physicians as well as the pressures on those in practice, this very often does not happen. This may be true in many cases for other preventive health measures such as cancer screening, physical examinations and disease monitoring. Accordingly, it is important for all of us to look after ourselves and our families, becoming aware of immunization updates, health screening and monitoring recommendations and current medical treatments.

COVID: Most of us have had five or six shots for Covid and many have had the infection one or more times. The last modified vaccine was introduced to cover the recent strain of the virus and many of us received that booster in the autumn of 2023. Since that time, the prevalence of Covid has decreased but it’s by no means eradicated, and up-to-date boosters are still recommended. Health Canada recommends that you get an updated Covid vaccine if it’s been at least six months since your last Covid dose or since you last had Covid (whichever happened later). Vaccinations are available free of charge through public health units, some physicians’ offices and, in some provinces, by pharmacists. Regular boosters may reduce your risk of becoming infected or reinfected, as well as reducing the risk of long Covid. Vaccination is particularly important for those with certain medical conditions, as well as those of us over the age of 65.

RSV: Respiratory syncytial virus is a common and highly contagious virus that appears most commonly during the fall and winter months and can cause serious complications, especially in children, immunocompromised adults and persons older than 60. The disease affects the respiratory system and hospitalizations for the infection among seniors have been increasing in recent years. A vaccination called Arexvy was approved by Health Canada last August for recommended use in persons over the age of 60. Boosters are not needed for another two years or possibly longer. Unfortunately, the cost of the vaccine – up to $300 – is not yet covered by the provinces and territories but may be covered by some private insurance plans. Ontario does provide it free for adults aged 60 years and older who are living in long-term care homes, elder care lodges or certain retirement homes. The vaccine is available through participating pharmacies.

INFLUENZA: The “flu virus” is still the most common winter infection and all Canadians over the age of six months have been urged to get their “flu shot” each autumn. This is especially true for seniors, those with chronic health conditions and those who travel where risk of exposure to the virus is higher. Since flu viruses may change over time, modifications are made each year to combat expected strains of influenza A and influenza B. Therefore, yearly shots are needed. Health Canada reports that there are more than 12,000 hospitalizations and 3,500 deaths each year from influenza.

MEASLES: The recent outbreak of measles across the world has made all of us question whether we, as well as our extended families, are protected against this very contagious virus. Those of us born before 1970 most likely have already had measles or come in contact with the virus, providing immunity. According to Health Canada, only those in the military, a health-care provider or those travelling outside of Canada – especially to Europe – should have one or two doses of measles vaccine to ensure protection.

The first measles vaccine was introduced in the early seventies and was given to the majority of children but, initially, only one dose was recommended. It was subsequently found that two doses gave better protection. Current products publicly funded are an MMR – a measles vaccine along with protection against mumps and rubella (German measles), and an MMRV – one for measles, mumps, rubella and varicella (chicken pox). All children should receive these two shots and adults who are in doubt about their having had measles or a vaccination as a child, especially those travelling to countries with increased measles activity, should have one or two doses of MMR vaccine as recommended by their physician or public health provider. The federal government provides a Travel Advice and Advisories by destination website at, which you should review.

SHINGLES: The chicken pox virus that may have infected you as a child can lie dormant for many years in your body and erupt at any age as an adult in the form of shingles. This can be serious and is especially debilitating among seniors and those with certain chronic health conditions. Although not publicly funded, it is strongly recommended that you get immunized by your physician or pharmacist with the highly effective Shingrex vaccine, given in two shots 60 days apart. In Ontario, for those between the ages of 65 and 70, the vaccine is free. For younger adults who have been immunized against chicken pox, the vaccine is not necessary.

PNEUMONIA: Pneumococcal disease is a serious bacterial infection that can affect the inner ear, sinuses, lung and blood and can be fatal, especially in those over 65. The polysaccharides vaccine (PPSV) is funded and recommended by Health Canada for those over the age of 65 and is highly effective in preventing certain types of pneumonia. Some adults who had previous types of vaccine for pneumonia are advised to get this particular vaccine.

DIPHTHERIA, PERTUSSIS, TETANUS AND POLIO: These vaccines have been administered to children for decades such that it is rare to see cases any more in Canada. Tetanus and diphtheria boosters should be administered every 10 years.

TRAVEL IMMUNIZATIONS: If you’re travelling outside of North America, you should review the potential risks for certain diseases in the countries that you will be visiting. There are specific vaccines, for example yellow fever, cholera and hepatitis A & B.

The federal government provides up-to-date recommendations regarding specific vaccines and other protections which you should take when travelling to your destination abroad. The information about travel vaccinations is found at

Public health units and specialized travel health clinics are the main source for information and access to recommended vaccines. These visits should be arranged at least six weeks before travel.

Keeping up to date with your immunizations is often a difficult task, especially if medical records are difficult or impossible to acquire. Immunization schedules and available vaccinations are hard to keep track of in an ever-changing climate. Recommended vaccines have come a long way in reducing morbidity and mortality, especially for seniors and those with chronic medical conditions. Don’t ignore these important advisories for you and your family. Your health and your life may depend on it. Review your immunizations with your physician, health-care provider or public health unit as to their recommendations and get the shots that you need.

By Robert MacMillan MD