Vaccination update

by DR GEORGIA PAGE MBBS, FRACGP, BSc (Biomedical)

The focus on vaccination is often on children but what about our over 65 population? Older people suffer higher rates of serious illness and death from infectious diseases such an influenza, pneumococcal disease and herpes zoster. This is because as we get older, our immune systems become less effective at protecting us. Despite these vaccinations being government funded, through the National Immunisation Program, elderly vaccination rates are low. Only 74% of adults aged over 65 years receive their free vaccines compared to over 90% of children. Immunisation plays a vital role in keeping older people healthy as they age. 

During the COVID 19 pandemic, vaccination is more important then ever. Unfortunately it will still be some time until we have a vaccination to protect against the novel Coronavirus, however we can still prevent outbreaks of vaccine preventable diseases. Vaccinating against diseases such as influenza will reduce the hospitalisation rate of those with the flu and reduce further pressure on our health system. 

Influenza Vaccination
Influenza is a viral infection that causes the sudden onset of fever, muscles aches and pain, headache, cough and fatigue. It is worse than the common cold, very contagious and can lead to more serious health problems especially in the elderly. 

Last year was a particularly severe flu season with over 700 flu related deaths in Australia, with the majority of these deaths occurring in the elderly. As the over 65 population have significantly higher rates of hospitalisation and death compared to younger people they need extra protection against influenza. For this reason the 2019 flu vaccine for the over 65’s has been ‘’enhanced’’ to offer better protection again the flu subtypes that specifically affect the older population. The high dose “Fluad’’ vaccines, that cover the 4 post common circulating flu strains, are available at medical practices from mid April and are government funded. 

Although the flu vaccine doesn’t offer 100% protection, if you still get infected it can make your illness milder and it also helps protects the vulnerable groups around you such as babies, the frail and those with chronic health conditions. Vaccine effectiveness can decline after 3–4 months so with peak flu season usually from July to September, the end of April and May are good times to get your vaccines. 

Are the new influenza vaccines safe?
The new influenza vaccine are safe but can cause mild side effects. This can range from a sore arm or some mild flu-like symptoms such as fevers and muscle aches. More severe reactions are rare. It is NOT possible to get the flu from the vaccine because it doesn’t contain any live influenza virus. However the flu vaccination doesn’t protect against other respiratory viruses circulating around the time of vaccination which is often mistaken for the flu. 

Pneumococcal Vaccination 
Pneumococcal disease is a bacterial infection that causes many illnesses such as pneumonia, meningitis and blood poisoning. It has a higher rate of complications, hospitalisation and premature death in the elderly. Vaccination against pneumococcus is recommended for the over 65’s and is government funded. This Pneumococcal Polysaccharide Vaccine (23vPPV) is affective against the 23 most common strains of pneumococcal bacteria that causes disease in Australia. People with chronic illnesses that have a higher risk of pneumococcal infection may also require a booster dose after 5 years. 

Side effects include a sore arm at the injection site for a few days, low grade fevers and tiredness. 

Shingles (herpes zoster) vaccine 
Shingles or Herpes Zoster is a disease caused by reactivation of the chicken pox virus. It causes a painful, blistering rash and even when the rash has gone it can cause severe burning pain (post-herpetic neuralgia) that can last for months or longer. 1 in 3 people will get shingles at some point in their lives but as we get older the risk of complications and post-herpetic neuralgia is higher. 

A single dose of the shingles vaccine (Zostavax) is recommended for all adults aged over 60 years who have not previously received a dose. The vaccine is free for adults aged 70 years with catch up for those aged 71–79 funded until October 2021. As it is a live virus it should not be given to someone with a low immune system or those on medications that lowers your immunity so your doctor or immunisation provider should check this with you.

Side effects after a shingles vaccination includes soreness, redness, itch and swelling at the injection site. Rarely you can develop a chicken pox like rash at the injection site. 

Booster vaccinations 
As we get older we loose immunity to some of our childhood vaccinations and a booster dose is recommended. 

A booster dose of tetanus/diptheria containing vaccine is recommended for adults > 50 years of age who have not received a tetanus containing vaccine in the previous 10 years. A booster dose is also required in the event of a tetanus prone injury if it has been more than 5 years since the last booster.

A booster dose of the pertussis (whooping cough vaccine) is also recommended for adults > 65 years who have not had a previous dose in the last 10 years and also for adults in close contact with children < 6months if it has been than 10 years since the last dose. The pertussis booster dose comes in combination with tetanus and diptheria (dTpa) do if you are due for a tetanus shot ask your doctor if you should be covered for pertussis as well. This vaccine however is not funded under the National Immunisation Program. 

If you are travelling overseas or are medically at risk you may require other vaccinations so please discuss with your doctor or immunisation provider. 

Georgia enjoys all aspects of general practice and has been working at Your Family Doctors at Erina for the last 12 years. The practice has a fabulous team and they pride themselves on delivering good quality health care, with that special personal touch. For more information call 4365 4999, check the website www.yourfamilydoctors.com.au or like them on facebook. 

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