A 72-year-old female with a history of COPD and hypertension presents for her annual influenza vaccine. She asks about other recommended vaccines. She reports receiving her last tetanus booster approximately 8 years ago. Her immunization record shows she completed her primary series of childhood vaccines but has no record of adult vaccines besides the flu shot. She is allergic to sulfa drugs. What vaccine, beyond influenza, should you prioritize recommending and possibly administer today, based on current Canadian immunization guidelines?

Question: A 72-year-old female with a history of COPD and hypertension presents for her annual influenza vaccine. She asks about other recommended vaccines. She reports receiving her last tetanus booster approximately 8 years ago. Her immunization record shows she completed her primary series of childhood vaccines but has no record of adult vaccines besides the flu shot. She is allergic to sulfa drugs. What vaccine, beyond influenza, should you prioritize recommending and possibly administer today, based on current Canadian immunization guidelines?

Answer options:

• Meningococcal vaccine (Men-C-C)
• Varicella vaccine ✅ Pneumococcal polysaccharide vaccine (PPSV23) and recombinant zoster vaccine (RZV)
• Hepatitis B vaccine

Correct answer: Pneumococcal polysaccharide vaccine (PPSV23) and recombinant zoster vaccine (RZV)

Explanation: For individuals 65 years and older, both pneumococcal vaccination (PPSV23, often followed by PCV13 if not previously given, or utilizing a sequential approach) and recombinant zoster vaccine (RZV) are highly recommended. Her history of COPD also places her at increased risk for pneumococcal disease. Her sulfa allergy is not a contraindication to these vaccines. Prioritizing these two offers significant protection for her age and comorbidities.