The talk of the town at the moment is all about the COVID-19 vaccination rollout. This is especially important for our senior population who are more vulnerable to the complications of COVID-19 disease. As we get older, our immune systems become less effective at protecting us so it is important that recommended vaccinations are up to date to help reduce the risk of serious illness and death from infectious diseases. This does not only include protecting against Covid 19, but also Influenza, Pneumococcal disease and Herpes Zoster (shingles). Immunisation plays a vital role in keeping older people healthy as they age.

COVID 19 VACCINATION

The last 12 months have certainly been testing times for those around the world due to the COVID-19 pandemic. The long awaited Covid vaccine has been delivered to millions of people around the world and now it’s Australia turn to be part of the rollout to reduce the risk of serious disease and death.  The risk of serious illness from COVID-19 increases with age. The rate is higher for those with other serious health conditions or a weakened immune system.

Australia’s Therapeutic Goods administration (TGA) has approved two COVID-19  vaccines for use in Australia.  

• Pfizer vaccine – which requires 2 doses at least 21 days apart
• AstraZeneca Vaccine – requires 2 doses given 4 – 12 weeks apart (the recommended interval is 12 weeks )

The vaccine is free and voluntary for everyone in Australia, however will be rolled out first to high priorities groups. Presently in Australia phase 1a and Phase 1b of the roll out have commenced. You can check what phase you are eligible for in the rollout through the COVID-19 vaccine eligibility checker; https://covid-vaccine.healthdirect.gov.au/eligibility. This site will also tell you what vaccination centres and General Practices are COVID-19 Vaccination providers near you. It is important to check this site regularly as more vaccination centres becomes available and as we progress through the rollout into Phase 2.

ARE COVID-19 VACCINES SAFE

Before vaccines are approved by the TGA they go through a rigorous process to ensure their safety. Once approved they are still monitored closely for safety and side effects. The benefits of the vaccine need to clearly outweigh the risks.

Common reactions to the COVID-19 vaccination include a sore arm, headache, low level fever and chills,  muscle pain, tiredness or joint pain. Most side effects are mild and don’t last for long , usually settling within 1 -2 days.   If you experience a more severe reaction after vaccination it is important to talk to your healthcare provider.

There have been very rare reports of a condition called Thrombosis with Thrombocytopenia Syndrome (TTS) associated with the AstraZeneca vaccination.  This involves the formation of blood clots  (thrombosis) and low levels of platelets (thrombocytopenia) about 4 – 20 days after vaccination and can occur in the brain (called a cerebral venous sinus thrombosis) and abdomen. This condition is very  rare (4 – 6 cases per million doses) but can be serious and lead to death. At this stage there has not been any specific risk factors confirmed for TTS but it has been reported to be more common in the younger population (eg age under 50).  

The Australian Technical Advisory Group on Immunisation (ATAGI) have recommended that currently the use of the Pfizer vaccine is preferred over the AstraZeneca vaccine in adults under 50 years of age who have not already received their first dose of AstraZeneca vaccine. However, the benefits of vaccination with the AstraZeneca vaccine outweigh the risks for older adults (50 years and older) and those with increased risk of exposure to COVID-19 (e.g. through employment or overseas travel). Please check with the regularly updated government website and your doctor if you have more questions about COVID-19 vaccinations to help you make informed decisions.

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. The over 65 population have significantly higher rates of hospitalisation and death compared to younger people so they need extra protection against influenza.  For this reason the influenza vaccine for the over 65’s has been ‘’enhanced’’ to offer better protection again the flu subtypes that specifically affect the older population. The government funded high dose ‘’Fluad Quad’’ vaccines, covers the 4 post common circulating flu strains, and are only available at General Practices.  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 INFLUENZA VACCINES SAFE?

The 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 70’s and is government funded.   Prevenar 13 is affective against the 13 of the most common strains of pneumococcal bacteria that causes disease in Australia. People with certain chronic illnesses that are under the age of 70, but have a higher risk of pneumococcal infection may also require a pneumococcal vaccination booster.

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 , 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) so 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.

Please note that vaccination recommendations are always changing as more research and evidence emerges.  Next time you have a check up with your doctor, have a chat to see if your vaccinations are up to date.

RESOURCES

The Australian Government Covid 19 Eligibility checker – https://covid-vaccine.healthdirect.gov.au/eligibility

The latest news and information about Covid-19 vaccines in Australia – https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines

Immunisation for Seniors – https://www.health.gov.au/health-topics/immunisation/immunisation-throughout-life/immunisation-for-seniors