Importance of influenza vaccination for the elderly – theSun

AS chairman of the Malaysian Influenza Working Group (MIWG), I noted with interest the recent announcement by Health Minister Datuk Seri Dr Dzulkefly Ahmad regarding the plan to provide free annual influenza vaccinations for older persons under the National Immunisation Programme, beginning in 2025.

This announcement comes almost a year after MIWG, along with partner organisations such as the Malaysian Society of Geriatric Medicine, the Academy of Family Physicians of Malaysia and 30 other organisations, initiated a petition requesting 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, often do not show regular symptoms when infected by influenza. Instead, they can experience other symptoms such as a decline in overall health, increased risk of injuries due to falls and others.

For those who are unaware, influenza is more serious than a cold it is not just the flu but can be deadly.

While everyone, including young and healthy people, is at risk of contracting influenza, it often takes a heavier toll on older adults. It takes only 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 illnesses often require hospitalisation and may lead to death.

Up to 70% of influenza-related hospitalisations and 85% of influenza-related deaths occur among those 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 for those with heart and pulmonary disease, five times for those with heart diseases, and three times for those with diabetes.

In addition, influenza infection can worsen or complicate NCD symptoms such as exacerbation of diabetic symptoms, causing fluctuations in glucose levels.

These manifold risks are well acknowledged, resulting in many countries, including Thailand, Laos, the Philippines and Singapore, already offering free influenza vaccines to older persons.

Tackling ongoing risks

While we look forward to this on our shores, I urge Malaysians to take action sooner rather than later to protect themselves and their loved ones against influenza as the 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 can help reduce severe illnesses and complications, the cost of treatment and management as well as the corresponding burden on our healthcare practitioners and resources. Most importantly, influenza vaccinations can help save lives.

Heightened awareness 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 highlighted that more education is needed to dispel common fears and misconceptions.

For example, 52% of respondents still feel that influenza is only a concern in cold climates, and though 70% were aware that it can be prevented through vaccination, 64% were concerned about serious side effects, with 28% believing the misconception that the influenza vaccine is not suitable for people their age. In addition, 69% believe they were already protected through the Covid-19 vaccine.

With such thoughts 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 one of the aged countries by 2030, with 15.3% of our population being 60 years old and above, and hence, the burden of influenza on our 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.

We must acknowledge that awareness is important at all levels, involving government and non-government stakeholders, healthcare professionals and communities, to change perceptions and encourage action.

As frontliners who witness first-hand the effects of heightened risk and complications from influenza among older adults, I call upon the entire community of healthcare professionals to continue acting as advocates and playing an active role in educating and encouraging yearly influenza vaccination, especially among this vulnerable population.

Prof Dr Zamberi Sekawi

Chairman

Malaysian Influenza Working Group

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