As people age, they become more susceptible to complications from illnesses like flu and pneumonia. In this report by SADE OGUNTOLA, experts say that the best way to prevent these complications is to get the appropriate vaccines.
Life expectancy has risen dramatically over the last century and population projections foresee that the Nigerian population will continue to age in future decades. But it has also come with its challenges due to increased risks of many diseases because of a lower immunity.
Diseases such as influenza, pneumococcal disease and herpes zoster have long been recognised as causing a high burden in the elderly. Unfortunately, vaccination of elderly that has shown to be beneficial in many industrialised countries has not been widely implemented in low and medium countries like Nigeria.
“At the extremes of life, the immunity is low. There is a decrease in the level of immunity with ageing. The elderly are prone to some infections, so they need to be vaccinated. This had been done in developed countries, there are vaccinations for the elderly,” said Dr Femi Olowookere, Director, Chief Tony Anenih Geriatric Centre, University College Hospital (UCH), Ibadan,
The geriatric centre, in February, commenced a pneumococcal vaccination programme for its teeming clients.
Thousands of elderly people end up in the hospital because of pneumococcal disease. It can cause severe infections of the lungs (pneumonia), bloodstream (bacteremia), and lining of the brain and spinal cord (meningitis).
Vaccines are the best way to fight off pneumococcal disease and its complications that can lead to long-term illness, hospitalisation, and even death.
For elderly with an ongoing health condition, like diabetes or heart disease, getting vaccinated is especially important. Vaccines can protect from serious diseases (and related complications) so they can stay healthy as they age.
According to Dr Olowookere, “some of them were worried if they actually need vaccination. But they need to have something to help their immunity. One of the common infections they are susceptible to develop is chest infection, so it is good for them to take the pneumococcal vaccine.”
Dr Lawrence Adebusuyi, an expert in geriatric medicine, said from his experience, the commonest chest infection they develop is pneumonia, an infection of the lungs that can be caused by a variety of germs, including viruses, bacteria, and fungi.
He stated: “in the developed countries, they give them the influenza vaccine and the pneumococcal vaccine. The pneumococcal vaccine is a single shot and it is for life. Howbeit, adults with certain medical problems may need a booster in five years.
“We do not have winter, so there is no need for influenza vaccine but we have pneumococcal infection which causes pneumonia. So that is the reason for the hospital to bring in the pneumococcal vaccine to immunise the elderly.”
Dr Adebusuyi, however, lamented that though pneumococcal vaccination has been put in the National Programme of Immunisation for children, the elderly were not considered for such an intervention even though both have a low level of immunity and as such, more susceptible to common infections such as pneumonia.
He said that the pneumococcal vaccine is far cheaper than the cost they will incur when they fall sick and need to be admitted into the hospital to be treated. This is aside the indirect cost to the elderly person’s care giver.
“Such a person can never regain the preadmission functionality. The reason for geriatric practice or care of the elderly is to improve functionality, you must do everything to improve functionality,” he declared.
Nonetheless, he said that pneumococcal vaccine may not always prevent pneumonia but it can lessen the illness and the need to go to hospital.
According to Dr Adebusuyi, immunisations the elderly should be given should include that for tetanus, hepatitis B, yellow fever and shingles. These vaccines can be taken at any time in the year, but hepatitis B vaccine can only be given after confirming that the individual is not already immunised against hepatitis.
Dr Adebusuyi said: “We have had a number of patients that had shingles or what is called herpes zoster infection at the Chief Tony Anenih Geriatric Centre. I still treated a patient with shingles two weeks ago.”
Shingles (also called herpes zoster) is a disease that causes a painful, blistering rash. The itchy skin rash is usually on the chest, but can also be on the trunk, back, legs or face.
The herpes zoster vaccine can protect against shingles. The vaccine cuts the risk of shingles by half. People who have had the chicken pox are at risk for herpes zoster since it’s caused by the same virus.
After a bout of chicken pox, the virus can live in nerve endings and be reactivated as shingles later in life, most commonly after the age of 60.
Assistant director of Nursing, Public Health, UCH, Ibadan, Mrs Marliyat Bello, stated that the elderly are important part of our community and so, ensuring they take the pneumococcal vaccine to reduce their chances of developing vaccine preventable infections, is important, to improve their quality of life and longevity.
According to Mrs Bello: “When you live a healthy, happy and pain-free life, even when death comes, it will be a peaceful exit. Just a shot of it protects them for the remaining part of their lives.
“The hospital has procured enough vaccines that can prevent all these streptococcal illnesses like tonsillitis, otitis media (ear infection) and pneumonia.
“Of course, there are elderly people that do not hear well and many people assume that it is part of ageing. Even if it is part of ageing, do we need to make them suffer? Just a shot of it protects them for the remaining part of their lives.”