Vaccinations for the Elderly

Ageing is a fact of life. With the advancement of modern medicine, humans are living longer than ever. The average Singaporean female can be expected to live to the age of 86 years while the average Singaporean male, up to 80 years.

Old age causes a slow and steady deterioration of the body’s defence system – a concept called immunosenescence. This age-induced immunodeficiency causes the elderly adult to be susceptible to invading pathogens. Two common infections that can be prevented via vaccinations are the flu virus and pneumonia bacteria.


Influenza Vaccination

The flu virus can have devastating effects on one’s health – especially in the elderly as they have reduced defences towards the virus. The infection can lead to hospitalisation and even admission to intensive care. It also comes with the risk of death. Due to the heightened stress that the influenza virus puts on the immune system, the elderly are predisposed to various complications of the flu, which include heart attack, stroke and viral lung infection. With the flu virus, the body reacts by assuming a hyper-inflammatory state, which causes blood to clot easily.

It is therefore prudent that we try our best to prevent influenza infections. Vaccines have been proven to be safe and effective in preventing influenza infection. Although the efficacy of the vaccine is decreased in the elderly, it is still better for them to be vaccinated because vaccination can lessen the severity of the effects of the influenza infection.

Due to the highly variable and “face-changing” character of the influenza virus, the vaccine needs to be updated every year. Vaccine companies will choose between the prevalent influenza strains from either the Northern or Southern Hemisphere winter as the vaccine for the year. An annual dose of the vaccine will provide protection against the influenza virus.


Pneumonia Vaccination

Pneumonia is commonly caused by bacteria that infects the lungs, bringing on severe coughing, fever and chest pain. In Singapore, pneumonia is the second leading cause of death, with the elderly and children at high risk. Pneumonia is preventable through vaccinations. It is recommended that all adults above 65 years of age be vaccinated with two kinds of pneumonia vaccines, namely PCV 13 (Prevenar), and PPSV 23 (Pneumovax).

The current national pneumonia vaccination recommendation is one dose of Prevenar 13 at age 65 and above, followed one year later by Pneumovax 23, for adults who have no immunity or who have never been vaccinated. This ensures the most effective protection against pneumonia.


The Importance of Vaccination

Prevention is always better than cure, and disease prevention is always the goal of the family physician. The vaccines are well studied and safe for elderly adults, and the potential side effects – injection site pain, fever or allergic reactions – are minimal.

It is also convenient for the elderly to obtain the vaccine. Adults aged 65 and above can now use Medisave to cover the cost of vaccinations, and both vaccines can be administered at the same time as long as it is on different parts of the body.

Talk to your doctor today to find out more about these vaccinations, and give yourself the best protection against these diseases.

by Dr Chua Chong Bing

Family Physician, Healthway Medical Group



by Dr Philip Koh

Chairman, Medical Board, Healthway Medical Group

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