The Underappreciated Necessity of Adult Immunisation

May 20, 2024

Resource person: Dr Edward Chong Kah Chun, Consultant Geriatrician, Sunway Medical Centre, Sunway City

In Malaysia, while significant strides have been made in child vaccination campaigns, adult immunisation, especially among older people and those with chronic conditions, remain notably low. This gap highlights a crucial need for expanded healthcare coverage to include adults, a matter of urgency underscored by recent research findings indicating a rise in adult vaccine-preventable diseases.

According to some findings, vaccinations against ten vaccine-preventable diseases in 73 low- and middle-income countries between 2001 and 2020 are estimated to avert over 20 million deaths, save US$350 billion, and potentially increase economic productivity by US$820 billion . Despite evidence of adult immunisation being compelling, the coverage is still low in Malaysia, compared to childhood vaccination, where childhood immunisation is covered by over 95% under the National Immunisation Programme (NIP) in Malaysia.

This coverage gap exposes these groups to potentially life-threatening illnesses, especially those that can be prevented with a vaccine. “Immunisation efforts traditionally concentrate on children, overlooking the vital need for continued protection throughout adulthood. This is especially concerning as vaccine-preventable diseases typically can impact vulnerable populations such as the elderly, people with multiple chronic illnesses, and immunocompromised individuals,” explains Dr. Edward.

According to Dr Edward, the recommended age for the general population to consider essential vaccinations is 60 and above for the pneumococcal and influenza vaccines, but it is important to consider other vaccines such as Tdap especially if you share the household with newborn babies, infants or pregnant women to protect your loved ones from transmission of diseases. Influenza vaccines are also recommended every year. However, the risks of non-vaccination are profound and multifaceted. Any vaccine-preventable disease, if severe enough, is likely to result in irreversible complications to your health.

One such importance is the pneumococcal pneumonia and influenza vaccines for the vulnerable population. With pneumonia, a formidable adversary in the array of vaccine-preventable diseases, has been responsible for 11.1 % of deaths among Malaysians, the top three causes of death among Malaysians . Dr Edward also details the most crucial vaccines that adults in Malaysia should seriously consider getting, especially if they’re approaching their 60s or have been immunocompromised and have undergone cancer treatment or chemotherapy:

• Influenza (Flu) vaccine is recommended annually and is important to protect the elderly and immunocompromised against the flu virus, which can lead to severe respiratory complications among those who are older or have a history of chronic lung disease, diabetes, cancer treatment or heart disease. Pregnant mothers can also benefit from being vaccinated to prevent respiratory problems with their babies if they get it during pregnancy.

• Pneumococcal vaccines are essential in preventing pneumococcal pneumonia, which is considered one of the major causes of death among the elderly. This bacterial infection can lead to pneumonia, septicemia (infection of the blood) and meningitis (inflammation of the coverings of the brain and spinal cord). This vaccine is also essential for the elderly, those going for their Hajj or Umrah pilgrimages, those with chronic medical illnesses such as lungs, heart or liver disease, cancer treatment, or diabetes.

• Covid-19 vaccine, an essential vaccine for everyone, especially the elderly and those with weakened immune systems, to protect against COVID-19 and its complications.

• Varicella (chickenpox) vaccine for women planning for pregnancy and individuals who haven’t had chickenpox in households with newborn babies, as this can help protect the newborns from complications such as encephalitis (inflammation of the brain), pneumonia or hemorrhagic complications.

• Tetanus, Diphtheria, and Pertussis (Tdap) vaccine for all adults who have completed their base vaccines more than ten years ago. Once they have received their Tdap shot, a tetanus and diphtheria
Facing the health risks head-on

In light of these insights, the need for adult immunisation in Malaysia is clear. It extends beyond an individual concern; it is a matter of public health. “Prevention is better than cure,” Dr Edward reminds us, advocating for adults to be proactive about their health and wellbeing especially when a vaccine can prevent it.

Myths and Misconceptions in Adult Immunisation

There are numerous misconceptions about vaccination, which may cause the public some concerns. Dr Edward shares some of the myths and misconceptions about adult immunisation.

Myth 1: Vaccines are only necessary for children.

Adult vaccination protects against diseases that are harmful or even fatal to the elderly and immunocompromised individuals for all stages of life.

Myth 2: Adult vaccines are not safe.

Vaccines are thoroughly tested and monitored, offering a safer option than facing the diseases themselves.

Myth 3: Healthy adults do not need vaccinations.

Even healthy adults can benefit from vaccinations to prevent the spread of illness to more vulnerable populations, including the elderly and those with chronic medical conditions.

Myth 4: Vaccines can cause the diseases they’re meant to prevent.

Vaccines cannot cause these diseases; they use inactivated viruses or parts of the virus to build immunity.