Vaccinations for people aged 65 years and over

Why do I need to be vaccinated? 

As you get older you lose some of the immunity that you had when you were younger. Your immune system becomes less effective in protecting against disease. This means that, compared with when you were younger:

• you are more likely to catch infections
• they are more likely to be severe
• you are more likely to take longer to recover
• you are more likely to develop complications of the infections and may need to be treated in hospital.

Some infections and their complications may also make it more difficult for you to carry out your activities of daily living for a long time after the infection.

A number of infections can be particularly serious as you get older. A safe and effective way to protect yourself against these infections is to be vaccinated against them. 

Vaccination not only protects you from getting the disease, it can also help to prevent the spread of the infection in the community. The more people in the community who are immune to a disease, the more difficult it is for that disease to spread.

Vaccinations are particularly important if you have ongoing medical conditions, such as diabetes or heart disease, or if you missed any immunisations as a child, as you may experience more severe infections and complications in these cases.

Occasionally people do get an infection despite being vaccinated against it. However, in these cases, the infection is usually a less serious form of the disease. You are also less likely to develop complications even if you get the disease. 

Which vaccinations do I need?

Influenza vaccination

What is influenza?

Influenza (or the flu) is a highly contagious disease caused by infection with the influenza virus. It is easily spread from person to person by sneezing or coughing, or touching contaminated objects with the virus on them. 

If you catch influenza when you are older, you may have different symptoms than when you were younger. Fever is less common whereas cough, wheezing, chest pain and feeling confused are more common. If you have other medical conditions, such as chronic obstructive pulmonary disease (COPD), they may worsen when you get influenza, and some older people may develop serious complications such as pneumonia, a heart attack or heart failure. People over the age of 65 years are much more likely to die from influenza-related causes than younger people. 

How can I protect myself against influenza?

Annual influenza vaccination is strongly recommended for people aged 65 years and older. Vaccination is needed every year, as the virus strains keep changing and a new vaccine must be made to match these. As well as protecting you against influenza, vaccination also reduces the risk of both having to be hospitalised for treatment and developing complications. Getting the influenza vaccine each year does not weaken the immune system. 

Two new enhanced influenza vaccines are available for older people. One of these is available free of charge to people 65 years and over on the National Immunisation Program (NIP). You cannot get influenza from the vaccine because it does not contain any live virus – it is an inactivated vaccine. The most common side effects of enhanced influenza vaccination are swelling, redness and pain at the injection site.

Vaccination against pneumococcal disease

What is pneumococcal disease?

Pneumococcal disease is an infection caused by the bacterium Streptococcus pneumoniae (also called pneumococcus). Many people carry pneumococcus in their nose and throat and may have no symptoms, but the bacteria can spread within the body and cause pneumonia, meningitis (infection of the brain covering) and septicaemia (blood infection). The infection can be spread from person to person by coughing or sneezing or contact with mucus from the throat or mouth of an infected person. 

How can I protect myself against pneumococcal disease?

Because older people are particularly susceptible to pneumococcus infection, vaccination against it is recommended when you reach 65 years of age.

A single dose of pneumococcal vaccine, which is effective against 23 of the most common strains of pneumococcus infecting older people, is available free of charge under the NIP for people aged 65 years and older. Aboriginal and Torres Strait Islander people can receive the vaccine from the age of 50 years under the NIP.

If you have other risk factors, you may need more doses or a different version of the vaccine. Your doctor will advise you on the vaccine and doses recommended for you.

The pneumococcal vaccine contains no live bacteria, and so you cannot get pneumococcal disease from the vaccination. The most common side effects of pneumococcal vaccination are soreness, swelling and redness at the injection site.

Shingles vaccination

What is shingles?

Shingles (or herpes zoster) is a serious disease caused by reactivation of the virus that causes chickenpox – the varicella zoster virus. The first infection with the virus causes chickenpox. The virus then hides in the nerve root next to your spinal cord and is kept in check by the immune system. When a person’s immune system is weakened (e.g. with ageing, some medical conditions or when taking certain medicines), the virus can be reactivated and cause damage to the nerve root. It then travels along the nerves to the skin, causing shingles.

People with shingles develop a blistering, painful rash in a narrow strip on one or other side of their body, commonly on their chest or abdomen. The associated pain can significantly affect quality of life. Shingles can also lead to serious complications, the most common being ongoing severe pain called postherpetic neuralgia that can last for several years. This is more common the older you are, is very difficult to treat, can lead to spells in hospital and has a significant effect on your quality of life. Other complications of shingles can include stroke and, depending where the rash is located, hearing loss and blindness.

How can I protect myself against shingles?

Vaccination against shingles is the only way to protect against both the disease and postherpetic neuralgia. Shingles vaccination is recommended for adults aged 60 years or older, and is particularly recommended for those aged 70 to 79 years. It is available free of charge on the NIP at age 70 years or, until 2021, if you are aged 71 to 79 years. 

Your doctor will let you know if you can have this vaccine as it should not be given if you have specific uncommon medical conditions that significantly reduce your immunity (this is called being immunocompromised). A new vaccine is on the horizon that can be used in people who are immunocompromised but this will not be available for some years. 

In the meantime, however, as the disease is so serious, you should not delay in having the currently available vaccine if your doctor advises it is safe for you to do so. You should ask your doctor whether this vaccine is safe for you. Shingles vaccine can be given at the same time as other vaccines, such as influenza or pneumococcal vaccine. 

The shingles vaccine is a live vaccine containing virus particles that have been greatly weakened and altered. In older people with a normal immune system, the risk of getting shingles from the vaccination is extremely low. The most common side effects of the vaccine are minor swelling and redness at the injection site. 

Booster vaccinations against pertussis, tetanus and diphtheria

Booster vaccinations against whooping cough (pertussis), tetanus and diphtheria are recommended if you have not had one in the past 10 years. A booster vaccine is an extra dose of a vaccine that you had when you were younger. If you missed having vaccinations for these infections when you were younger, you will need a full course of the vaccine. Your doctor will advise you on the vaccine recommended for you. 

A vaccine is available that protects against all three infections. It is not covered under the NIP, so you would have to pay for this vaccine.

The vaccine is not a live vaccine, and so you cannot get these diseases from vaccination. The most common side effects are pain and a hardened area or swelling at the injection site.

Pertussis

Whooping cough, or pertussis, is a highly contagious disease caused by infection with the bacterium Bordetella pertussis. It is spread by breathing in aerosols if you are close to an infected person. The infection can be serious, particularly in young infants and in older people, and it can result in complications such as pneumonia, brain damage and even death. 

The risk of getting whooping cough is high, and any protection that you might have had when you were younger wanes over time. For this reason, booster vaccinations against pertussis are recommended for people aged 65 years and older if they have not been given one in the past 10 years. Vaccination is also important if you have contact with infants, who are at a high risk of contracting the infection. 

An additional advantage of having the pertussis vaccine is that you also get a boost to your immunity against tetanus and diphtheria, as the three vaccines are combined. 

Tetanus 

Tetanus is a serious disease caused by a bacterium found in soil called Clostridium tetani. These bacteria can enter an exposed wound, where they produce a toxin that causes painful muscle spasm, especially around the neck and jaw (lockjaw). This can be life-threatening. 

A booster dose against tetanus is recommended for adults who have not had vaccine with tetanus in it in the past 10 years, or who have a tetanus-prone wound.

Diphtheria 

Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. The infection causes an upper respiratory tract infection that can result in an obstruction in the throat. The bacterium also produces a toxin that can cause heart failure and paralysis.

A booster dose against diphtheria is recommended for adults who have not had a vaccine with diphtheria in it in the past 10 years. See Box for Further Information.   MT