Vaccinations for Adults Over 65

As we get older, our immune systems change – and not necessarily for the better! This can leave us vulnerable to infections and their complications that may not have previously been a concern. Fortunately we are able to prevent some of these infections which include Shingles, Influenza and Pneumococcus.

What is Shingles?

Shingles is a painful rash that is caused by the same virus as chicken-pox – once you have this virus it remains in your body and when it reactivates it is called shingles. This virus is called varicella zoster virus.

How do I know if I have it?

A shingles rash presents on one half of the body and only over a relatively small area. The pain may be described as a burning, stabbing, tingling, itching or numbness. It can be very sensitive to touch and the rash may only appear several days after the pain begins.

It is usually incredibly painful and depending on the location may lead to blindness, hearing loss, scarring and pneumonia. The most common complication, particularly in older adults is when the pain persists even after the rash is gone. This is called ‘post-herpetic neuralgia’ and can last for months or even years which can be debilitating. Some may initially mistake the pain for a heart attack or kidney problems so it’s important to see a doctor as soon as you suspect infection.

How is it treated?

If recognised early enough (within 72 hours), anti-viral medication can be given to stop the disease from worsening. Other treatments involve pain management such as lotions or pain killers.

“If one has shingles one will never forget the pain – all day, all night, no rest.” Brian Quinn – aged 73.

What is Influenza?

Influenza or “The Flu” is a virus that causes a respiratory illness. It is not to be confused with the common cold, and is generally much more severe. Peak infection periods occur over the late winter months and early spring.

Symptoms

Symptoms include fever and chills, tiredness and fatigue, muscle aches and pains, sneezing, cough, loss of appetite and sore throat. In the elderly, fever may be absent and the only signs and symptoms of flu may be confusion, shortness of breath and worsening of a chronic condition.

The symptoms can last for over two weeks and you may become so ill you need to be hospitalised. This may be due to complications including pneumonia, bronchitis and even heart disease which can lead to death. 

How is it treated?

It is hard to stop the disease from progressing and anti-virals have a very limited role in treatment. Treatment mostly involves supportive care such as pain management and rehydration.

 

What is Pneumococcus?

Pneumococcus is a bacteria called Streptococcus pneumoniae that is the most common cause of pneumonia (lung infection), but may also cause infection of the blood and infection of the linings of the brain (meningitis).

Symptoms

Common symptoms include fever, general unwellness, cough, shortness of breath, coloured sputum and chest pain. In adults over 65 symptoms may vary, with no fever and only drowsiness and confusion.

Why is it dangerous?

Despite the effectiveness of antibiotics in most cases there are those who may have a form that is resistant to antibiotics or may be too late in the disease to receive effective treatment. These cases often involve children or adults over 65.

 

What is the Role of Vaccines?

What is a Vaccine?

A vaccine is something that helps the body to identify dangerous infections in a safe way before coming into contact with them. By having a vaccine, the body is able to recognise these infections in the future and can destroy them quickly before they can begin cause any major problems.

How Vaccines Work?

Vaccines work in two different ways. The most commonly understood way is direct immunity. This involves the body receiving the vaccine and therefore being able to respond to the infection faster to the point where people don’t even realise they were infected, or if they do develop some symptoms, they will be a lot less severe.

The second is herd immunity. This concept is where the majority of the population is immune and therefore prevents the spread of disease amongst those who may be too unwell or too young to receive the vaccine. For this to work best, a certain proportion of the population needs to be vaccinated.

Why these vaccines are important for those over 65

  • To stop the spread of disease! Even if you believe you are well and can fight the disease you may come into contact with those that didn’t get the vaccine, such as a friend going through chemotherapy or someone with a chronic disease. People who are already unwell are not able to deal with an infection as well and have more severe outcomes.
  • Immune systems don’t function as well when you get older even if you are otherwise fit and healthy, therefore your bodies aren’t able to fight the disease off as well as someone in their 20’s. This is known as ‘immunosenesence’.
  • As you get older the symptoms may become less obvious for the disease. This means recognition of the disease may happen later and you may be too sick for treatment to be effective.

How can I get the vaccine?

Vaccination can be provided by your local GP, some pharmacies and specialised clinics that may visit workplaces or nursing homes.

The flu vaccination is updated yearly as the virus mutates very fast. This means it is important to get the vaccine every year. After the age of 65, everyone is eligible for a free flu vaccination each year.

The pneumococcal vaccine is free for those aged 65 and over (age 50 and over if you are an Aboriginal or Torres Strait Islander). This can be given again after 5 years to boost immunity if your GP considers you at high risk of getting pneumonia.

Shingles vaccine is a one off dose. It is free at the age of 70, or if you missed out at this age it will be free until age 79. Despite this it is recommended to all adults over the age of 65 or if you have a weakened immune system.

Concerns about vaccination

But I’m allergic to eggs, can I be vaccinated? Yes! Previously, the flu vaccine was created using the help of egg proteins but with the advancement of technology, egg is no longer used in the current flu vaccines in Australia. However, if you DO have any allergies, please discuss with your doctor before having any medications or vaccinations.

Can the vaccine give me the infection? There are different types of vaccines which work in various ways. The flu vaccine and pneumococcal vaccine are inactivated vaccines which work by having a piece of protein which the body recognises as the infection, but as it does not contain the entire particle of the virus or bacteria and therefore is not alive, there is no possibility of it causing infection.

The shingles vaccine is a live vaccine, so it contains a weakened and altered version of the live virus. In otherwise healthy individuals this will not cause an infection due to its weakened state. However, it should not be given to individuals who are acutely unwell or those who have a weakened immune system caused by treatments that they are taking such as radiation, chemotherapy or corticosteroids, or due to conditions such as HIV/AIDS, or cancer of the lymph, bone, or blood.

You can learn more about the different vaccine types at https://immunisationalliance.org.au/news/live-attenuated-vaccines-vs-inactivated-vaccines/ .

How else can I protect myself from getting infections?

Staying up to date with your vaccinations are an important part of preventing infection but we also recommend taking care of your overall health as this can help you recover much faster if you do become sick. If you are sick, stay at home and rest and drink plenty of fluids. Cover your cough or sneeze with a tissue or you elbow to prevent the spread of the disease. Avoiding or minimising contact with sick people is an obvious but important way to prevent getting infections.

Disclaimer: If you suspect that you may have any of these infections please consult your local health care professional.

 

References

https://beta.health.gov.au/health-topics/immunisation/immunisation-throughout-life/immunisation-for-seniors

http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home