Vaccines: Young or old, home or away

While more than half of Australians in the travel-loving 65-plus age bracket are at risk of pneumococcal pneumonia, only 1-in-5 is vaccinated against the potentially fatal disease, a national survey has found.

Conducted by Lung Foundation Australia as part of Pneumonia Awareness Week (May 9–15), the survey found 52% of people aged over 65 are at increased risk of contracting the bacterial infection through an existing medical condition or lifestyle factors – particularly current or past smoking.
Despite this higher risk, 40% of over 65s surveyed weren’t aware that a pneumococcal vaccine exists.
Often fatal, pneumonia affects the small sacs in the lungs which, in a healthy person, fill with air with each breath. Pneumonia infections (bacterial, viral or fungal) cause the lungs to fill with pus and fluid, which makes breathing painful, causing coughing and limiting oxygen intake.
Pneumococcal pneumonia, caused by the bacterium Streptococcus pneumoniae, is the only bacterial pneumonia for which vaccine protection is available.
A single dose of pneumococcal vaccine is recommended for adults when they reach 65 and is free for them under the Federal Government’s National Immunisation Program. Those who have a medical condition, such as cardiac, liver and congenital diseases, are at risk of infection and may require additional doses to ensure that they are adequately protected.

 Travel-loving Baby Boomers at risk

The ‘Breathe Well, Age Well’ research revealed that 2-in-3 Australian older adults consider themselves to be younger and fitter than their parents were at their age and 65% of those aged 65-74 did not consider their age to be a health risk factor.
“We are seeing the rise of a generation of healthy, fit and fabulous Australians in their mid-60s who love to travel,” Sydney-based respiratory physician, Associate Professor Lucy Morgan told Travelvax Australia.
“They take good care of themselves, and are dedicated to adding years to their life by exercising and eating well.
“Unfortunately, they don’t realise that developing pneumococcal pneumonia could change all of that.
“The stark reality is, due to their age alone, all adults 65 and older are at increased risk of contracting pneumococcal pneumonia.”

Vaccines not ‘just for kids’

The misconception that vaccines are for kids persists: only 1% of those aged 18–74 surveyed thought vaccination was important in maintaining good health throughout their adult years.
“Vaccination against the influenza virus and pneumococcal disease has been recommended for adults for many years now,” said Dr Eddy Bajrovic, Medical Director of Travelvax Australia.
“Originally targeted at older people, seasonal influenza vaccination is now recommended much more widely across the community and is free for people aged over 65, anyone with a chronic illness, and for pregnant women.
“It is now also routinely recommended for travellers because it is the most common vaccine-preventable health risk for people heading overseas.
“A relatively new vaccine against shingles (Herpes zoster) has recently been recommended for older people. From this November it will be free for people aged 70, with a 5-year catch up for the 71-79 years age group.”

Immunisation for older travellers

Vaccination is particularly important for travellers visiting developing overseas countries where the infectious ‘childhood diseases’ may still circulate widely, as well as the additional risk of the diseases linked to poor sanitation and hygiene.
It’s tempting to assume older travellers may have had the more common childhood diseases, such as measles, mumps and rubella (MMR) and been vaccinated against polio, diphtheria, and tetanus.
While it is true that these sometimes-fatal illnesses were more common in first half of the 20th century, it’s advisable for older travellers to check their immunisation status and get either a primary course or a booster, if required.
Tetanus is more common among older patients – even in developed countries like Australia – because many people aged over 55 have not had their original tetanus vaccinations boosted. Most deaths from tetanus occur in people over 70, especially women, so it’s better to have a 10-year booster here than have to have one overseas in the event of even a minor injury.

Some possible exceptions to vaccination

One exception is measles: People born before 1966 can be considered to be immune to measles and do not need to get tested or boosted. (People born after 1966 require two doses of MMR vaccine, at least one month apart.)
Similarly, hepatitis A is one of the most frequently recommended travel vaccines for travel to developing countries. Studies have found that more than 60% of Australians aged over 60 have protective antibodies to this common food- and water-borne disease (compared to around 5% of 20-year-olds) and so may not need to be vaccinated.
Australian health authorities suggest a blood test for people born before 1950 to check if they’ve had previous exposure to hepatitis A. If not, vaccination is generally advisable as the risk of severe – even fatal – illness from Hep A increases with age.

Travelling? Start preparing early

While they are protective and worthwhile at any age, vaccines may not work as quickly, as effectively, or for as long in older people as they do for younger people.
There can also be an increased risk of side-effects, most notably with the yellow fever vaccine, which may be required for travel to countries in Africa or South America.
Clearly, there is a host of good reasons for older adults planning overseas travel to visit a travel clinic or talk to their GP.
It’s also a good idea to make the appointment 6 weeks or more before departure.

For more advice on possible vaccinations for your next overseas journey, call Travelvax Australia’s obligation free travel health advisory service on 1300 360 164 (toll-free from landlines). You can also make an appointment for a pre-travel medical consultation at a Travelvax clinic to receive vaccines, any medication required, accessories, and personalised advice tailored to your itinerary and your medical history.

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