Advertisement
Feature Article

Strategies to increase vaccination rates in older people

Michael Woodward, JOHN C.B. LITT, PAUL VAN BUYNDER
OPEN ACCESS

Figures

© PHANIE/BURGER/MEDICAL IMAGES MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY
© PHANIE/BURGER/MEDICAL IMAGES MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY

Abstract

Coverage levels for recommended vaccines in older adults fall well below those in children. An important driver of vaccination is a recommendation from the person’s GP. Tips for talking about vaccines and addressing patient misconceptions and specific practice strategies may help GPs increase vaccination rates among their older patients.

Key Points

  • Vaccination rates for recommended vaccines in older adults fall well below rates seen in children.
  • One of the most influential drivers of vaccination is a recommendation from the person’s GP.
  • GPs can help increase vaccination rates by informing their older patients about the severity of vaccine-preventable diseases and the safety and effectiveness of vaccines.
  • Other strategies to help increase vaccination rates include:
    – co-administration of vaccines
    – opportunistic vaccination
    – patient notification and recall programs.
  • All vaccinations of older people can now be recorded in the expanded Australian Immunisation Register.

Australia has not achieved acceptable vaccination rates in older people for vaccines listed on the National Immunisation Program (NIP). More can be done to achieve vaccine coverage comparable to that in children, of whom about 94% are fully vaccinated. Suggested strategies for GPs to help improve vaccination rates among older people are summarised in Box 1 and discussed in this article. 

Recommend vaccination to all eligible patients

Studies show that the most influential driver of vaccination is a recommendation from the person’s healthcare provider. This can increase the likelihood of vaccination against influenza, pneumococcal disease and herpes zoster (HZ) 11-fold.1-5 However, patient surveys have found that myths and misconceptions about vaccines in older people are common (Table 1).4,5 These myths and misconceptions can act as barriers to vaccination. They include beliefs that:

Advertisement
Advertisement

  • healthy people are not at risk of the disease targeted by the vaccine
  • the disease is not serious
  • the vaccine is ineffective or can itself cause the targeted disease
  • natural immunity is better
  • the risk of adverse effects is too high. 

These misconceptions can be addressed by high-quality educational programs, ranging from one-on-one discussions through to societal-level campaigns. Both healthcare providers and patients need evidence-based information on the risks associated with the various vaccine-preventable diseases, the effectiveness  and safety of the vaccines and ways of achieving high levels of vaccine coverage.

Advertisement
Advertisement

Some suggested GP responses to common patient misconceptions about vaccination are shown in Table 1 and Table 2. Tips for GPs talking with patients about influenza, pneumococcal, HZ and pertussis vaccination are shown in Box 2, Box 3, Box 4 and Box 5. A suggested patient handout about vaccination for people aged 65 years and over appears on page 33 of this supplement.

Advertisement
Advertisement

Other useful resources include the Australian Immunisation Handbook, National Centre for Immunisation Research and Surveillance fact sheets and the Australian and New Zealand Society for Geriatric Medicine position statement on Immunisation of Older People.6-8

Pages

Figures

© PHANIE/BURGER/MEDICAL IMAGES MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY
© PHANIE/BURGER/MEDICAL IMAGES MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY
Associate Professor Woodward is Director of Aged Care Research and a Senior Geriatrician at Heidelberg Repatriation Hospital, Melbourne, Vic. Associate Professor Litt is a Public Health Physician and Associate Professor in the Discipline of General Practice, Flinders University, Adelaide, SA. Professor Van Buynder is a Public Health Physician and Professor at the School of Medicine, Griffith University, Brisbane, Qld.