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The Importance of Elderly Vaccination

The Importance of Elderly Vaccination

The population across the planet goes through an accelerated aging process. According to the World Health Organization (WHO), the number of people over 60 will jump from the current (1) 841 million to 2 billion by 2050. By 2020, the number of older people will have surpassed (1) that of children with up to five years.

If we consider only Brazil, the scenario is no different. Estimates by the Brazilian Institute of Geography and Statistics (IBGE) indicate that the number of people in this age group will more than triple in the coming decades: from 19.6 million in 2010 to 66.5 million in 2050 (2).

Increasing longevity is great news, but it's also a challenge. What to do to ensure the best possible quality of life for the group? The answer to part of the question is in vaccines, which are able to prevent millions of deaths each year.

It is not childish thing

Unfortunately, the thought that only children need to be vaccinated persists. Adolescents and adults are usually immunized only during periods of outbreaks, which could be minimized or avoided if vaccination coverage were higher and / or more homogeneous. The elderly, in turn, are in the habit of looking only for the annual influenza vaccine.

As the immune system naturally becomes weaker with aging, not getting vaccinated means exposing yourself to an unnecessary risk of preventable diseases that can aggravate chronic conditions and lead to hospitalization or death.

The person who gets the vaccine, in addition to protecting himself, helps reduce the circulation of viruses and bacteria in the environment and contributes to the health of those who can not be immunized for any reason.

Vaccination is a matter of personal care and collective responsibility. Consult your doctor.

It is safe

Vaccine development is an arduous task that can take decades to materialize. This is because, in addition to researching the best components for the formula, it is necessary to follow a series of steps to ensure that the vaccine is effective and does not cause damage to the body:

  • Preclinical phase: evaluates if the results obtained in the laboratory are repeated in animals
  • Clinical phase 1: evaluates whether the vaccine is safe and elicits an immune response in a small group of humans
  • Clinical Phase 2: defines the dosage and the most appropriate intervals. The group of participants reaches hundreds of people
  • Clinical Phase 3: confirms the results of the previous phase and studies more accurately adverse events. Thousands of volunteers receive the vaccine.

When the vaccine finally reaches the population, there is a constant monitoring to investigate reports of unexpected adverse reactions.

What vaccines to take?

The vaccine is the primary available resource to prevent some extremely serious infectious diseases that can kill and / or cause significant sequelae in affected individuals.

The World Health Organization (WHO), which has described the invention of the vaccine as the second largest public health achievement in the world - after drinking water - estimates that 2 to 3 million lives are spared (measles, mumps and rubella) and the threefold bacterial vaccine (tetanus, diphtheria and pertussis) (3).

For the elderly, there are ten recommended vaccines. Six of them are routine indications: influenza, pneumococcal 13 and 23, triple acellular bacterial type of adult (diphtheria, tetanus and whooping cough), hepatitis B and herpes zoster. In addition, the threefold viral vaccine (measles, mumps and rubella) and those that prevent yellow fever, hepatitis A, and meningococcal diseases caused by ACWY are recommended in special situations after medical evaluation.Get to know a little more about each:

Routine

Influenza

Indications: protection from influenza, which is usually more severe and cause more complications in the elderly

  • Scheme: one dose, annual
  • Adverse reactions : pain, redness and hardening in the region of application (15 to 20% of vaccinated). Fever, malaise and muscle pain occur in 1% to 2% of those vaccinated six hours after the application and persist for 1 to 2 days.
  • Contraindications: people with severe allergy (anaphylaxis) to any component of the vaccine or previous dose
  • Pneumococcal (VPC13 and polysaccharide conjugate - VPP23)

Indications: protection of diseases caused by pneumococcal bacteria, especially pneumonia, meningitis and generalized infections. This bacterium is more common at the extremes of life: children and elderly

  • Scheme: apply the VPC13 and, from six to 12 months later, apply the VPP23. VPP23 should be repeated 5 years later.
  • For those who started the scheme with VPP23, the one-year interval for the application of VPC13 and five years for the application of the second dose of VPP23 is indicated. The recommended interval between the VPC13 dose and the second dose of VPP23 is six to 12 months.)

Anyone taking VPP23 in the first two doses should receive a dose of VPC13 at least one year after the last dose of VPP23 . If the second dose of VPP23 was administered before age 65, a third dose is recommended, with a minimum interval of five years after the last dose.

Adverse reactions: pain at the site of application (60.0% of vaccinates), swelling or tenderness (20.3%), redness (16.4%), headache (17.6%), fatigue (13.2%) and muscle pain (11.9%). More severe local reactions, with swelling of the whole arm, reaching to the elbow, hematoma and red spots can occur in less than 10% of the vaccinated

  • Contraindications: people with severe allergy (anaphylaxis) to any component of the vaccine or previous dose
  • Adult acellular bacterial triple (dTpa)

Indications: protection of diphtheria, tetanus and whooping cough

  • Scheme: with complete basic vaccination schedule, reinforcements every ten years. With incomplete timing, one dose of dTpa followed by two doses of the adult double bacterial vaccine (two-fold, and four to eight months after the dTpa dose). If adult double-acting bacterial doublets are not available, all three doses may be given with dTpa
  • Adverse Reactions: headache, injection site reactions (pain, redness and swelling), tiredness and malaise occur in more than 10% of children over 10 years of age, adolescents and adults vaccinated
  • Contraindications: people who presented with anaphylaxis or neurological symptoms caused by some component of the vaccine after previous dose administration
  • Hepatitis B

Indications : protection of hepatitis B, a disease transmitted mainly by blood and sexual contact. It is more and more frequent in the elderly

  • Scheme: three doses. the second dose should be given one month after the first dose and the third dose six months after the first dose (10% of the vaccinated). Loss of appetite, drowsiness, diarrhea, nausea, vomiting, bloating, malaise, low fever and hardening at the application site (1% to 10%). Rhinitis, vertigo, skin rashes, muscle pain and muscle stiffness (0.1% to 1%).
  • Herpes zoster
  • Contraindications: people who have had an anaphylactic reaction to some component of the vaccine or the previous dose.
  • Herpes zoster

Indications: protection of herpes zoster, better known as "shingles". The disease is a late manifestation of who had chickenpox at some point in life.

  • Adverse reactions: itching, redness, swelling and pain at the injection site (34% of the vaccinees). Fever (1%), respiratory symptoms (1.7%), fatigue (1%), diarrhea (1.5%) and skin changes (1.1%)
  • Contraindications: Immunosuppressed persons, pregnant women, people with untreated active tuberculosis and individuals with severe allergy (anaphylaxis) to any of the vaccine components.
  • Specific situations
  • Yellow fever

Indications: protection of yellow fever for people who live or intend to travel to areas where the disease is endemic. In patients over 60 years of age, it is only recommended if the risk of infection is greater than that of adverse events.

Scheme: one dose and one booster after 10 years if the risk of contracting the disease persists

  • Adverse reactions : pain at the site of application (4% of vaccinated adults). Fever, headache and muscle pain (4% in the first time vaccinated and 2% in those receiving the second dose). Although very rare, serious events such as encephalitis, meningitis, and infection causing yellow fever can occur.
  • Contraindications: people with severe immunosuppression due to illness or use of medication, patients who have undergone organ transplants, or who have cancer , people with a history of thymic disease or who have had demyelinating neurological disease within 6 weeks after the previous dose of the vaccine, children under six months of age, women who breastfed children up to six months old, and people with a history of allergy (anaphylaxis) to formula components and to chicken egg. In principle, there is a contraindication for pregnant women, but the administration should be analyzed according to the degree of risk, for example, when outbreaks occur.
  • Hepatitis A
  • Indications: protection of hepatitis A, which is transmitted by water or contaminated food and close contact with someone with the disease. Adverse reactions: loss of appetite, drowsiness, diarrhea, nausea, vomiting, swelling, diarrhea, nausea, vomiting, diarrhea, (1% to 10% of vaccinated), respiratory symptoms, rhinitis, vertigo, skin rashes, muscular pain and muscle stiffness (0.1% and 1%).

Meningitis ACWY

  • Contraindications: people who have had a severe allergic reaction (anaphylaxis) to any component of the vaccine or the previous dose.
  • Meningitis ACWY
  • Indications: Protection of diseases caused by the bacterium Meningococcus ACWY, which causes meningitis and generalized disease. Indicated in outbreaks and trips to risk areas
  • Outline: single dose. Adverse Reactions: Swelling, hardening, pain and redness at the site of application, loss of appetite, irritability, drowsiness, headache, fever, chills, tiredness and muscle pain (10% of those vaccinated). Gastrointestinal symptoms (including diarrhea, vomiting and nausea), large application site hematoma, skin rashes, and joint pain (between 1% and 10%). Insomnia, decreased sensitivity of the skin at the site of application, vertigo, itching, muscle pain, pain in the hands and feet, and malaise (0.1% to 1%)

Contraindications: people who had severe allergic reaction to some component of the vaccine.

  • Viral triple (measles, mumps and rubella)
  • Indications: protection of these three diseases, which are highly contagious and transmitted through the respiratory tract. Indicated in outbreaks, travel to risk areas and other situations of increased risk
  • Scheme: two doses, with a minimum interval of one month
  • Adverse effects: burning, redness and other local manifestations (less than 0.1% of vaccinated). High fever - greater than 39.5 ° C - occurs five to 12 days after vaccination, with one to five days of duration (5% to 15% of vaccinated). Headache, irritability, low fever, tearing and redness of the eyes, and coryza five to 12 days after vaccination (0.5% to 4%). Red spots on the body started between the seventh and the 14th day after vaccination, with a stay of about two days (5% of the vaccinated). Swollen glands appear in less than 1% of those vaccinated from seven to 21 days after being vaccinated. All general symptoms are more frequent after the first dose of the vaccine.

Joint pain or benign transient arthritis started one to 21 days after application (25% of women vaccinated after puberty). Inflammation of the parotid glands started 10 to 21 days after vaccination (0.7% to 2% of vaccinated). Encephalitis started between the 15th and the 30th day after the first vaccination dose (one every 1 million-2.5 million). Meningitis, usually benign, may also occur between days 11 and 32.

  • Contraindications: pregnant women, people with impaired immunity due to illness or medication, history of anaphylaxis after previous dose of the vaccine or any component of the formula . Allergic to the egg, as a precaution, should be vaccinated in a hospital environment.
  • Where to take?
  • Vaccine

Health clinics

Vaccination clinics

Influenza


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Yes *Yes In the Reference Centers for Special Immunologicals (CRIES) for some comorbiditiesYes
Acellular bacterial triple of the adult type (dTpa) and / or double-type adult (dT)Yes, dTYes, dTpa **
Hepatitis BYesNo
Herpes ZosterYes
Yellow feverYesYes
Hepatitis AIn Reference Centers for Special Immunology (CRIES) for some comorbiditiesYes
Meningitis ACWYNoYes
Viral tripleNoYes
* Health posts have and trivalent influenza vaccine (3V). The private network also has the dTpa-VIP, which adds the inactivated polio virus to the formula.Isabella Ballalai - president of the Brazilian Society of Immunizations (SBIm)SBIm Family
SBIm - Elderly Immunization Schedule