Vaccination in Older Adults in Singapore: A Summary of Recent Literature

Abstract

Singaporeans are living longer and not having enough babies to replace themselves, with projected 20% of the population aged 65 years and above by 2030. These worrying trends can exert significant pressure on Singapore's economy and society. Health-resource utilisations are increasing as our population ages, with increase in hospitalisations, emergency room visits and consumption of pharmaceutical drugs. Interventions such as vaccinations in older people are well-studied approaches to prevent infections and the related complications. The Advisory Committee on Immunization Practice (ACIP) by the US Centers for Disease Control and Prevention (CDC) recommends routine immunisation against influenza, tetanus, pneumococcal pneumonia as well as herpes zoster infections in all people aged 65 years and above. The administrations of other vaccines (meningococcal, hepatitis A and B, varicella and Haemophilus influenzae type b) are recommended only in older people with certain risk factors. Despite the benefits of vaccination in older people, the data in the West shows that the rate of vaccination in this age group remains lower than targets recommended by the World Health Organisation (WHO). The main barriers to vaccinations exist in the healthcare system, health care providers, patients and caregivers. Interventions are warranted to increase awareness among physicians, to engage the involvement of the pharmacist/nurse to provide standing orders and reduction in cost of vaccination; this potentially improves vaccination uptake to protect our increasing elderly population.