Three illnesses that hit harder as we age

Older adults face greater risks from shingles, pneumococcal disease, and RSV. Here’s how families can prepare.

10:48 a.m. Sept. 12, 2026

DUANE CROSS
MCO Publisher•Editor

Most families know some of the things they are supposed to watch as parents and grandparents get older. Blood pressure gets checked. Somebody finally moves that loose rug in the hallway before it causes a fall.

Infectious disease is easier to overlook.

Shingles sounds like a miserable rash. Pneumonia is something most of us have heard about all our lives. RSV still gets talked about mostly when babies are getting sick.

Get older, though, and all three become a different animal.

That is worth knowing in Moore County, where roughly one out of every four residents is 65 or older. The county is older than Tennessee as a whole, and plenty of local families have a parent, grandparent, neighbor, or church friend living at home and doing just fine on their own.

The point is not to spend your later years waiting on the next thing to go wrong. It is to take care of a few things while everybody feels good.

Shingles can hurt long after the rash is gone

If you ever had chickenpox, the virus that caused it never really left.

It stays quiet in the body and can show back up years later as shingles. The risk rises with age, and what begins as burning, itching, or an odd patch of sensitive skin can turn into the blistering rash most people associate with the disease.

For an older adult, the rash may not be the worst of it.

Shingles can leave behind postherpetic neuralgia, or PHN, a nerve pain that remains where the rash had been. For some people, that pain lasts for months. For others, it hangs on for years. Shingles around the face can also threaten the eye and cause other serious complications.

There is a good deal families can do before it ever gets that far.

The Centers for Disease Control and Prevention recommends two doses of Shingrix for adults 50 and older, generally given two to six months apart. That recommendation still applies if somebody has already had shingles. In healthy adults 50 and older, the vaccine is more than 90% effective at preventing shingles and PHN.

It is worth checking whether both doses were actually received. Plenty of people remember getting “the shingles shot” but cannot say whether they went back for the second one.

Families should also know what shingles can look like before the blisters appear. Pain, itching, or tingling can start several days ahead of the rash. Once shingles is suspected, this is not something to doctor at home for a week while waiting to see what it does. Antiviral treatment works best when it is started early; CDC clinical guidance says treatment is most effective within 72 hours of symptoms beginning.

So ask about the vaccine now. If that strange, painful rash ever shows up later, make the call.

Pneumonia may not look like pneumonia

Most people have heard somebody refer to “the pneumonia shot,” which makes the whole subject sound fairly simple.

It isn't quite. Pneumococcal bacteria can cause pneumonia, but they can also get into the bloodstream or cause meningitis. Those infections can turn serious, especially in older adults.

What families need to know is that an older person with pneumonia may not look the way we have been taught to expect.

There may be coughing, fever, chest pain, or trouble breathing. But CDC also warns that older adults with pneumococcal pneumonia can become confused or less alert rather than showing the more familiar symptoms.

If an older parent who is normally sharp is suddenly confused, sleeping far more than usual, or just plainly not acting like himself or herself, do not dismiss it as age. Something may be going on even if there is no dramatic fever or hacking cough.

Vaccination is another thing worth settling before anybody gets sick. Current CDC guidance recommends a pneumococcal conjugate vaccine for adults 50 and older who have never received one. The confusing part is that the recommendations have changed over the years, and what somebody needs now depends on which pneumococcal vaccines he or she may have received before.

Nobody needs to memorize PCV15, PCV20, PCV21, and every other abbreviation on the chart. Take the vaccine record to the doctor or pharmacy and ask whether it is current. If nobody in the family can remember what was given 10 or 15 years ago, say so. That is still better than assuming the question was settled somewhere along the way.

RSV isn't only a childhood illness

Mention RSV and a lot of folks still think about babies. That makes sense. RSV can be dangerous for infants, and that is where much of the public discussion has been.

It can also put an older adult in the hospital.

Most people who catch RSV have something that feels like a cold. Age, frailty, and certain health problems can change that picture. RSV can lead to pneumonia, and it can make existing heart or lung disease worse. CDC estimates that RSV sends between 110,000 and 180,000 Americans age 50 and older to the hospital each year.

Someone with chronic heart or lung disease deserves closer attention. So does an older adult with a weakened immune system or certain other medical problems. Trouble breathing, chest pain or pressure, sudden dizziness or confusion, or symptoms that are getting worse are reasons to seek medical help rather than trying to ride it out.

There is now a vaccine for older adults, too. CDC recommends one RSV vaccination for everyone 75 and older. Adults ages 50 through 74 should receive one if they are at increased risk of severe illness. Unlike the flu shot, this is not currently an every-year vaccine. Someone who has already received an RSV vaccine does not need another dose at this time.

For those who need it, late summer and early fall are considered the best time to get the shot in most of the country. September is a pretty sensible time to ask.

Figure it out before Sunday morning

This does not require turning Sunday dinner into a medical conference. It may be as simple as asking Mom whether she ever went back for that second shingles shot, then helping her find out if nobody remembers.

Maybe Dad got a pneumonia vaccine years ago. Fine. Which one? Does he need anything else now? The pharmacist or his doctor can sort that out much more easily while he is standing there feeling well than the family can from a hospital waiting room after he gets sick.

Keep a current medication list somewhere the family can find it, and know who gets called when the doctor's office is closed. If an older relative lives alone, someone ought to know enough about their normal routine to recognize when something isn't right.

Moore County families already do a fair amount of that without giving it a name. Somebody calls to check in. A neighbor notices when the car hasn't moved. Around here, somebody usually notices when a familiar face doesn't show up.

That matters with these illnesses because getting older can change the warning signs along with the risk.

Moore County residents who need to check their vaccination history or ask what they may be due for can start with their doctor or pharmacist. The Moore County Health Department, at 251 Majors Blvd., also provides health services and can be reached at (931) 759-4251. It is best to call ahead and ask about the availability of a particular vaccine.

Nobody needs to spend much time worrying about shingles, pneumococcal disease, or RSV.

But it is worth spending a few minutes figuring out where things stand before somebody gets sick. Better to sort that out at the kitchen table than try to remember it on the way to the emergency room.