Strengthening your immunity as you grow older

“As we get older, our physical self is not as strong and robust as we were when we were 22, and the same holds true for our immune system,” says William Schaffner, an infectious-disease specialist at Vanderbilt University School of Medicine in Nashville.

Your body is likely to produce fewer infection-fighting T-cells than it once did, and you may also have higher levels of chronic inflammation. Both factors can make you more vulnerable to illness. But you can take several steps to help bolster your immunity. Experts recommend these five.

If you’ve had — or been vaccinated against — diseases such as measles or mumps, that protection remains throughout adulthood, Schaffner says.

But some illnesses are trickier. After you’ve had chickenpox, for example, the virus lies inactive near your brain and spinal cord. It can reactivate years later to cause shingles, a painful blistering body rash. Other diseases such as influenza require annual shots each year.

Here’s what you need to maximize your immune response:

An annual flu vaccine. People 65 and older are at higher risk for complications from this virus than younger adults, so the vaccine is crucial. Two versions of the flu shot are designed for older adults. One, Fluzone High-Dose, contains four times the antigen (which helps your body build up protection against flu viruses) as a regular flu shot. The second, Fluad Quadrivalent, contains an ingredient that helps your body create a stronger immune response after you’ve been vaccinated. There’s no data comparing these head-to-head, and both seem to work well, says Schaffner, so he recommends that you get whichever your local pharmacy or doctor’s office has. If neither is available, get the regular flu shot.

Pneumococcal vaccine. This helps prevent pneumonia, a potential complication of flu and the coronavirus. The Centers for Disease Control and Prevention recommends that all adults 65 and older get the vaccine known as PPSV23 (Pneumovax 23). Depending on your health, your doctor may also recommend another vaccine, PCV13 (Prevnar 13).

A coronavirus booster. The CDC advises a booster of any of the three coronavirus vaccines (five months after the second Moderna or Pfizer-BioNTech, or two months after the Johnson & Johnson). If you got the Johnson & Johnson shot, the CDC says your booster preferably should be Moderna or Pfizer-BioNTech. For those who received the Moderna or Pfizer-BioNTech vaccines the first time, it doesn’t matter which one you get for your booster, a strategy known as “mix and match.” Keep in mind, Moderna’s booster shot is half the dose from the first two shots. So if you’re getting a Moderna booster, you’ll want to make it clear to the provider that you don’t want one of the initial shots. Pfizer and Johnson & Johnson’s dose amounts are unchanged for booster shots.

Shingles vaccine. Shingrix, a newer vaccine, is about 97 percent effective in people in their 50s and 60s, and 91 percent effective for those who are 70 and older, according to the CDC. It’s given in two doses, two to six months apart.

Tdap vaccine. If you are unsure whether you got this shot as a teenager, you’ll probably need it, for protection against tetanus, diphtheria and pertussis. (The CDC advises that Boostrix be used for people 65 and older when feasible.) After that, you’ll need a Td or Tdap booster every 10 years.

An eating style that includes a wide range of nutrients, such as the Mediterranean diet, may help make a difference in your immune system’s response. A study published in March in the journal Frontiers in Nutrition found that regions where people were more likely to follow this dietary pattern had fewer infections and deaths from covid-19.

“It may also help ramp down chronic inflammation, which can contribute to worse outcomes from the disease,” says Katherine L. Tucker, director of the Center for Population Health at the University of Massachusetts Lowell. To eat for immunity, choose a largely plant-based diet, rich in fruits and vegetables, whole grains, legumes, nuts, and seeds, along with small amounts of healthy fats such as olive oil, she says.

Consider putting the following on your plate regularly:

Fatty fish. It’s rich in omega-3 fatty acids, which research shows improve the functioning of immune system cells. Tucker recommends two servings per week of fish such as salmon or sardines.

Sunflower seeds and almonds. Nuts and seeds are generally healthy. But sunflower seeds and almonds have immunity benefits, Tucker says.

Low-fat yogurt. Yogurt contains probiotics, “good” bacteria that help build your gut microbiome. And a healthy microbiome is key for immunity, says Lauri Wright, chair of the department of nutrition and dietetics at the University of North Florida in Jacksonville.

Also, don’t smoke. Keep alcohol consumption way down (one drink a day for women, and two for men, maximum) and work to maintain a healthy weight.

A brisk daily 30- to 45-minute walk may go a long way in boosting immunity. “Exercise improves the function of T-cells and natural killer cells, the immune cells that are on your body’s front line when it comes to fighting viruses,” says David Nieman, director of the Human Performance Laboratory at the North Carolina Research Campus in Kannapolis. Nieman’s research found that the more fit women are in their 60s, 70s and 80s, the less likely they are to develop upper respiratory infections. “We found their T-cells were operating at a level similar to a 40- or a 50-year-old woman,” he says. Consider adding tai chi: A 2020 study published in the journal Medicines found that this gentle mind-body exercise had a small but significant effect on immune function.

Even one night of lousy sleep has been shown to destroy some natural killer cells, which you need for good immunity. One 2021 study published in the journal Sleep Health found that people who got less than five hours of sleep a night were 44 percent more likely to report a head or chest cold than those who slept for seven to eight hours. For better sleep, try to maintain the same sleep schedule every day so that you wake up and go to bed at the same time, says Guibin Li, a geriatrician at Ohio State University Wexner Medical Center. This keeps your circadian rhythms running smoothly, which may improve immunity, she says. Most older adults need seven to eight hours of sleep a night.

Though mask-wearing and other precautions we’ve been taking throughout the pandemic don’t actually improve immunity, they can help protect you from exposure to viruses. “The flu essentially disappeared last year, which shows how effective these types of interventions are,” says Fred Ko, a geriatrician at Mount Sinai Hospital in New York.

And together, they can make a real difference. “While the flu vaccines are great, they still have some holes,” says John Swartzberg, an infectious-disease specialist at the University of California at Berkeley. “If you add masks, social distancing and avoiding crowds, it really helps fill in those holes.”

Aside from needed vaccines, wearing masks in crowded indoor areas may be the most important step in preventing covid-19 and flu, Swartzberg says. For example, older research found that wearing surgical masks led to roughly three times less aerosol shedding of the flu virus. In addition, avoid obviously sick people and wash your hands well and often.

Copyright 2022, Consumer Reports Inc.

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