護理師向一群長者講解疫苗的重要性。護理師應建議一位健康的 65 歲病人接種哪些疫苗？（選所有適合的）
A nurse is teaching a group of older adults about the importance of vaccines. Which vaccines should the nurse recommend for a healthy 65-year-old client? (Select all that apply.)
- AAnnual Influenza vaccine✓ 正解年度流感疫苗
- BPneumococcal vaccine✓ 正解肺炎鏈球菌疫苗
- CHerpes zoster (Shingles) vaccine✓ 正解帶狀疱疹（皮蛇）疫苗
- DRotavirus vaccine輪狀病毒疫苗
- ETetanus-diphtheria-pertussis (Tdap) booster every 10 years✓ 正解每 10 年補打破傷風-白喉-百日咳 (Tdap) 疫苗
健康促進的一個關鍵領域是免疫預防。對於 65 歲以上的長者，免疫系統逐漸衰退，預防感染是維持生活品質的重點。選項 A（流感）需每年接種，因為病毒株每年變異且長者併發症多。選項 B（肺炎鏈球菌）是 65 歲以上的基本建議，可預防敗血症與肺炎。選項 C（帶狀疱疹）目前建議 50 歲以上即應施打（如 Shingrix 兩劑），能有效預防疱疹後神經痛。選項 E（Tdap）則是用於維持破傷風、白喉及百日咳的抗體效價，建議每 10 年補打一次。選項 D 錯誤，輪狀病毒疫苗是給嬰兒施打的，不適用於成人。臨床思路應聚焦於該年齡層常見且致命的感染症。
A key area of health promotion is immunization. For adults aged 65 and older, the immune system gradually declines, and preventing infection is essential to maintaining quality of life. Option A (influenza) requires annual administration because viral strains mutate each year and older adults are at high risk for complications. Option B (pneumococcal) is a basic recommendation for those 65 and older, helping to prevent sepsis and pneumonia. Option C (herpes zoster) is currently recommended for adults aged 50 and older (e.g., the two-dose Shingrix series) and effectively prevents postherpetic neuralgia. Option E (Tdap) maintains antibody levels against tetanus, diphtheria, and pertussis, and a booster is recommended every 10 years. Option D is incorrect because the rotavirus vaccine is administered to infants and is not indicated for adults. The clinical focus should be on infections that are common and life-threatening in this age group.
美國的疫苗接種多由藥局（CVS/Walgreens）或基層診所主導，護理師角色重在評估與施打。台灣 65 歲以上長者可享有公費流感及肺炎鏈球菌疫苗（13 價與 23 價有特定時程），帶狀疱疹疫苗目前在台灣多需自費，護理師需向病人解釋其必要性與費用差異。