Making A Stand: Influenza Vaccination For Older Adults — Prof Dr Zamberi Sekawi

To set the foundation for a successful vaccination programme, more intensive educational campaigns are needed, strategically designed to address misconceptions and alleviate concerns.

As chairman of the Malaysian Influenza Working Group (MIWG), I noted with interest the recent announcement by Health Minister Dzulkefly Ahmad.

It is welcome news that the Ministry of Health is planning to provide free annual influenza vaccinations for older persons under the National Immunisation Programme, beginning 2025.

This comes almost a year after MIWG, together with partner organisations such as the Malaysian Society of Geriatric Medicine, Academy of Family Physicians of Malaysia, and more than 30 other organisations initiated a petition to request government-funded influenza vaccinations for our senior citizens who are particularly vulnerable to influenza-related complications.

This is important, as older persons experience a decline of immunity as they age, and, unlike healthy adults, they often do not show regular symptoms when infected by influenza – instead, they could experience other symptoms like a decline in overall health, increased risk of fall injuries, and so on.

For those who are unaware, influenza is much more serious than a cold — it’s not “just the flu”. In fact, it can be deadly.

And while everyone, including young and healthy people, are potentially at risk of influenza, it often takes a heavier toll on our older adults. All it takes is one infection to increase the risk of heart attack by 10 times and stroke (caused by a blood clot) by eight times. 

Older persons are also more likely to experience complications such as pneumonia, inflammation of the heart, and sepsis. These often require hospitalisation, and may even lead to death.

In fact, up to 70 per cent of influenza-related hospitalisations and 85 per cent of influenza-related deaths occur among those aged 65 years and above.

Furthermore, the risk of influenza-related deaths increases with the presence of more than one non-communicable disease (NCD), which is the case with many of our older adults.

This risk of influenza-related death increases by 20 times in those with heart and pulmonary disease, five times in those with heart disease, and three times in those with diabetes.

Furthermore, influenza infection could worsen or complicate NCD symptoms such as exacerbation of diabetic symptoms, causing fluctuations in glucose levels.

These manifold risks are well acknowledged, so much so that many other countries including neighbouring Thailand, Laos, the Philippines, and Singapore, have already begun offering free influenza vaccines to older persons.

Tackling the ongoing risk
While we look forward to this on our own shores, I urge Malaysians to take action sooner rather than later to protect themselves and their loved ones against influenza, as the influenza virus circulates year-round in tropical climates like ours.

The threat, therefore, is always present. Southeast Asia is ranked third highest in influenza-related deaths but only 2-3% of Malaysians are vaccinated against influenza. The influenza vaccine has been around for close to 80 years, since 1945, with extensive research supporting its safety records.

Protecting ourselves and our loved ones with a simple annual shot would help to reduce severe illness and its complications, the cost of treatment and management, as well as the corresponding burden on healthcare practitioners and resources.

Most importantly, influenza vaccinations can help to save lives.

Heightened Awareness Is Needed

Although the influenza vaccine is well-established in many parts of the world, a recent IPSOS survey in Malaysia involving around 600 respondents aged 65 years and older has highlighted that more education is needed to dispel common fears and misconceptions.  

For example, 52 per cent still feel that influenza is only a concern in cold climates, and though 70 per cent are aware that it can be prevented through vaccination, 64 per cent are concerned about serious side effects, with 28 per cent believing the misconception that the influenza vaccine was not suitable for people their age.

In addition, 69 per cent believe they are already protected through the Covid-19 vaccine.

With such thoughts so prevalent, it is hardly surprising that vaccination ranked a lowly eighth place in self-care practices.

Moving Towards Better Vaccine Coverage

Malaysia is moving towards becoming an ageing country by 2030, with 15.3 per cent of our population aged 60 years old and above. Hence, the burden of influenza on older persons is a public health concern that we can no longer afford to ignore.

To set the foundation for a successful vaccination programme, more intensive educational campaigns are needed, strategically designed to address these misconceptions and alleviate their concerns.

At the same time, we must acknowledge that awareness is important at all levels, involving government and non-government stakeholders, health care professionals, and communities, to change perceptions and encourage action.

As frontliners who have witnessed first-hand the effects of heightened risk and complications from influenza amongst older adults, we call upon health care professionals to continue acting as advocates and playing an active role to educate and encourage yearly influenza vaccinations especially among this vulnerable population.

Prof Dr Zamberi Sekawi is chairman of the Malaysian Influenza Working Group (MIWG).

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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