While there’s still much more to learn about SARS-CoV-2, the virus that causes COVID-19, one thing public health officials know for certain is that it will be circulating for quite some time.

“It has real staying power,” says Georges Benjamin, MD, executive director of the American Public Health Association (APHA) since 2002. “And it's going to be around. We're not going to eradicate it any time soon.”

But just as the virus adapts and changes, so should we, Benjamin says. By staying up to date on vaccines and COVID-19 recommendations for older adults, we can find ways to lead healthy and fulfilling lives amid a shifting “new normal.”

“We have been very successful in putting ourselves in a great position to be able to reopen our society, to be able to make a decision about when we should wear a mask or not. And as this virus evolves, I think our behavior and the things we do to protect ourselves should evolve with it,” he says.

NCOA talked to Benjamin and consulted other trusted public health sources to find answers to questions you may have about COVID and older adults at this stage of the pandemic. We hope you’ll find it a useful tool for learning to co-exist with the coronavirus and for building your own resiliency.

Do I need another updated COVID vaccine?

You should always consult your doctor before making health care decisions, but public health officials say that for those who are eligible, the answer is yes. The updated COVID vaccine you’ve been hearing about offers protection against the original coronavirus strain and the latest variants.

For anyone age 65 and older who already got one dose of the 2023/2024 updated COVID vaccine this past fall or winter, the CDC now recommends an additional dose as of February 2024. CDC Director Mandy Cohen, MD, MPH says that "most COVID-19 deaths and hospitalizations last year were among people 65 years and older. An additional vaccine dose can provide added protection that may have decreased over time for those at highest risk."

For some older adults, this new recommended dose will be the seventh COVID shot they’ve gotten since the pandemic began. If you’re feeling a little vaccine-weary, consider this CDC finding about COVID in vaccinated older adults: People 65 and older who had both doses of the Pfizer or Moderna vaccines had a 94% reduced risk of COVID-19 related hospitalization.1 

The vaccine that we have is very safe and effective for doing the thing that we want to protect people from the most, which is getting really sick and dying,” Benjamin says.

Will I always need a booster every few months?

Former White House COVID-19 Response Coordinatorshish Ashish Jha, MD, MPH, said that while the COVID vaccine may become an annual shot for healthy people in some age groups, older adults may continue to need more frequent vaccinations.2

It's always a good idea to check with your doctor about how often to get vaccinated, especially for people living with ongoing medical conditions.

If I’m vaccinated, do I still need to wear a mask indoors?

You can search to see how COVID is impacting your community and find mask-wearing guidance from the CDC. In areas where the COVID-19 community level is high, the CDC recommends wearing a high-quality mask. In areas where the community level is gauged as medium, masks are recommended when indoors in public if you are in a high-risk group.

Check with your health care provider for a personal assessment if you aren’t sure, and remember—wearing a mask is always an option if it makes you feel more comfortable and protected.

“I wear a mask when I'm around a lot of people whose vaccination status I'm unsure of, in an environment in which the virus can easily be transmitted,” Benjamin explains. “Which basically says, if I'm in a crowded space with a bunch of people that I don't know, I put on a mask.”

How long does COVID last in older adults?

New research shows that older adults may be at a higher risk of Long COVID, a post-COVID condition in which virus symptoms persist, return or develop. According to the National Institutes of Health (NIH), possible risk factors include older age and preexisting health conditions.3  Long COVID symptoms include tiredness, difficulty thinking or concentrating, headache, sleep problems, dizziness when standing, depression and anxiety.

“Another thing we've learned over the years is that this chronic syndrome called Long COVID is significant,” Benjamin says. “Depending on who's done the study, it impacts 20-25% of the people, on average … and it's much more prevalent in people who are unvaccinated or partially vaccinated. So, anything you can do to reduce your risk of getting substantial Long COVID is a good thing, and the vaccine clearly does that.”

How effective are COVID treatments?

Medications can help reduce the severity of COVID-19 symptoms in older adults, keep you out of the hospital and prevent death.4

NCOA offers a comprehensive look at antiviral COVID treatments, like Paxlovid and monoclonal antibody medications. You’ll also find other helpful articles about COVID-19 and older adults at NCOA’s coronavirus resource hub.

If you haven’t had the coronavirus, you may be wondering what to do if you get COVID. Talking to your health care provider about a treatment plan, even before getting sick, can be helpful. The CDC’s What to Do If You’re Sick guide may answer many of your questions, too. One important point is that you must act quickly. If you doctor determines that a treatment is right for you, you must start it within 5-7 days of the start of symptoms.

Here’s another protective COVID-19 recommendation for older adults: Keep a stock of COVID-19 home tests on hand. Older adults with Medicare Part B can receive up to eight tests per calendar month from participating pharmacies and health care providers.

What is the COVID risk by age?

“The older you are, the more you're at risk, and that's just because of normal biology,” Benjamin says. “As we get older, our immune systems become less resilient. We certainly are protected from a lot of infections that we've seen through our lifetime. But as we get older, when that system gets faced with a new infectious threat, it is certainly not as robust as when we were 20, like many of our systems.”

Research continues to show that underlying medical conditions also increase the COVID-19 risk, and severity, for older adults, too. These are chronic kidney disease, chronic obstructive pulmonary disease (COPD), heart disease, diagnosed diabetes, and obesity.5

Protect yourself by getting vaccinated, making sure any diseases you have are well-controlled and taking other “common-sense precautions,” Benjamin says.

What are the risks to members of racial and ethnic minority groups?

The COVID-19 pandemic exposed the widespread and lethal consequences of health inequities affecting underserved communities. CDC data updated in September 2022 found that compared to the white, non-Hispanic population, members of other racial and ethnic groups were at a higher risk of getting COVID-19, being hospitalized and dying.6

In a statement released on March 11, 2022, the second anniversary of the pandemic, Benjamin emphasized the need “for health interventions that address the inequities that COVID-19 exposed, disparities of care in communities of color and lower-income Americans that led to higher rates of infection and deaths.”7

In November 2022, the public health authority said there had been “big improvements in the vaccine disparity—big improvements in who's getting their vaccination.”

“The numbers we still have are still unacceptable in terms of the number of people getting sick and that disparity,” Benjamin says.

While APHA, the CDC, NCOA, and others commit to improving health equity, public health officials are shining the light on another dangerous trend.

“We knew the urban centers got hit early on, and they tended to have a fair number of communities of color. But now as you begin to move out into rural America, middle America, and particularly in communities where their elected leaders and the media convinced people that the virus was a hoax … they're now beginning to see that those folks are getting infected, and they’re getting sick from getting infected,” Benjamin says.

He calls the fallout, from those who politicized COVID-19 and vaccinations, “a real concern.”

We’ve really got to convince these folks that have politicized this pandemic that it's a bad thing to do and that they're working against their own best interests and the best interests of their constituents, or their family members, or their viewers or listeners, if they're in the media.”

How can I encourage friends and family members to get vaccinated?

With travel back in full swing, there are more opportunities for families to gather and catch up on hours of lost in-person conversations around dinner tables. COVID-19 is a likely topic. When there are differences, Benjamin suggests starting conversations by “meeting people where they are.”

“I ask them very clearly, ‘What are your concerns?’ I try first of all to listen to their perspective and then try to directly address their concerns. … I just tell them what I need to tell them and give them my best advice. … And if they're very focused on getting their information from a single source that I think is giving them misinformation, I try to give them other places to become better informed and hope that they will go there. And I encourage them to do that.”

Everyone can follow his example, and share easy-to-follow information from scientifically sound sources like the CDC and the World Health Organization. Because when all adults adhere to sensible public health guidelines, communities are safer for everyone, Benjamin says.

Today, we can live our lives. We can go out to baseball games and restaurants and go see our grandkids. But like everything else, it comes with some protections that we need to have.

"Protection No. 1 is to get fully vaccinated and encourage your loved ones to get fully vaccinated," Benjamin says. "That's the most important protective thing we can do. With that, it gives us the freedom to decide to wear a mask or not. … What I try to do, and I encourage others to do, is practice reasonable risk reduction.”

Sources

1. Centers for Disease Control and Prevention. Fully Vaccinated Adults 65 and Older Are 94% Less Likely to Be Hospitalized with COVID-19. Page last reviewed August 4, 2021. Found on the internet at https://www.cdc.gov/media/releases/2021/p0428-vaccinated-adults-less-hospitalized.htm

2. AMA. Vaccines and Boosters Offer Best Protection from COVID Winter Wave with Ashish Jha, MD, MPH. October 6, 2022. Found on the internet at https://www.ama-assn.org/delivering-care/public-health/vaccines-and-boosters-offer-best-protection-covid-winter-wave-ashish

3. National Institutes of Health. Long COVID. Oct. 5, 2022. Found on the internet at https://covid19.nih.gov/covid-19-topics/long-covid

4. Centers for Disease Control and Prevention. COVID-19 Treatments and Medications. Oct. 19, 2022. Found on the internet at https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html

5. Centers for Disease Control and Prevention. Data Tracker: Underlying Medical Conditions. Nov. 6, 2022. Found on the internet at  https://covid.cdc.gov/covid-data-tracker/#underlying-med-conditions

6. Centers for Disease Control and Prevention. Risk for COVID-19 Infection, Hospitalization, and Death by Race/Ethnicity. Sept. 15, 2022. Found on the internet at https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html

7. American Public Health Association. Reflecting on the lessons of the pandemic. March 11, 2022. Found on the internet at https://apha.org/News-and-Media/News-Releases/APHA-News-Releases/2022/pandemic-anniversary