Elderly at general

As a person gets older, the immune systems become less effective at fighting against infections. This means that the elderly are more likely to catch infections, and they take longer time to recover from one. Even if vaccination was given during childhood, the immunity to combat disease may become less effective as we grow older. In addition, disease like flu which takes few days to recover when younger, can cause more serious illness in the elderly, and may even result in life-threatening complications.

Therefore, whether a person has other medical illness or not, the risk of infection increases with age. Generally, anyone who’s aged 65 and above may consider having the following vaccinations to prevent certain infectious diseases (“what vaccine I need”):

• Shingles vaccine

• Pneumococcal vaccine

• Influenza (flu) vaccine

• Tetanus, vaccine

As these vaccines are not currently provided by the Ministry of Health Malaysia vaccination programme, you may want to discuss with your doctor on which vaccines you need most.

Elderly with special risk

Some elderly, on the other hand, may have other medical conditions which put them at higher risk of getting certain infections. You should consult your doctor if you have these risk-factors.

Chronic lung diseases

Chronic lung diseases increase the risk and severity of lung infections. Examples of chronic lung diseases include chronic obstructive airway disease (COAD) and lung fibrosis. Preventable lung infections include flu and pneumococcus pneumonia. Vaccines advisable are:

• Pneumococcal vaccine

• Influenza (flu) vaccine

Advance heart disease

Advance heart disease from various causes (coronary heart disease, valvular heart disease) decreases a person ability to withstand moderate to severe lung infections. Therefore, preventing lung infections are recommended. Vaccines advisable are:

• Pneumococcal vaccine

• Influenza (flu) vaccine

Increase risk of meningococcal infection

Meningococcal infection may lead to meningitis, sepsis, permanent disabilities and even resulting in death. The following are people at risk:

• Those who had their spleen removed

• Those traveling to countries in where meningococcal infections are common (for example, when a person is performing pilgrimage in Makkah).

Vaccination against meningococcal infection is advised. There are 2 forms of meningococcal vaccines available in Malaysia:

• Meningococcal polysaccharide vaccine

• Meningococcal conjugate vaccine

Only the meningococcal conjugate vaccine is recommended for adults. If you are getting a booster, it should also be in the meningococcal conjugate form.

Increase risk of Hepatitis A infection

Hepatitis A infection is a disease cause by Hepatitis A virus (HVA) that leads to symptoms like jaundice, abdominal pain and vomiting. The infection can sometimes be severe. People are at risk when they

• Travel to or work in countries that have high or intermediate rates of Hepatitis A.

For more information on countries at risk, please visit the CDC’s travel page at: http://wwwn.cdc.gov/travel/yellowBookCh4-HepA.aspx

Vaccination advised is the Hepatitis A vaccine.

Increase risk of Hepatitis B infection

Hepatitis B infection is a contagious liver disease cause by Hepatitis B virus (HBV). It can manifest as an acute infection which only lasts for a few weeks. In addition, it can also stay on in the body leading to chronic infection that results in liver damage, liver cancer and even death. However, Hepatitis B infection is preventable.

Specifically for elderly, you may be at risk when you:

• Live with someone who has chronic Hepatitis B

• Are a hemodialysis patients

• Travel to countries with moderate to high rates of Hepatitis B

It is not too late even if you are older than 65 years old. This is important, if you have the risk-factors and was never vaccinated before.

Vaccination advised is Hepatitis B vaccine.

References

• Immyounity. 2011.http://www.vaccines.com/vaccines-seniors.cfm (accessed 25 April 2013)

• Centers for Disease Control and Prevention at www.cdc.gov (accessed 25 April 2013)

• Fact sheet for immunisation providers. Influenza vaccination 2010. http://www.immunise.health.gov.au (accessed 25 April 2013).