It is well known that Thailand has entered an aging society, which means a significant increase in the elderly population. Most elderly or adults tend to have lower immunity compared to when they were young, resulting in more severe symptoms and a higher risk of complications when infected. Therefore, we should emphasize preventive health care for the elderly, whether it is infectious diseases or chronic non-communicable diseases (NCDs).
Common Infectious Diseases
Infectious diseases can be transmitted from person to person, such as influenza, chickenpox, measles, and rubella, and from animals to humans, such as avian influenza, Middle East respiratory syndrome (MERS), rabies, monkeypox, or even infections from the environment, such as fungal infections and melioidosis.
In tropical countries like Thailand, another important infection is insect-borne infections, especially from mosquitoes, such as dengue fever, malaria, chikungunya fever, or Zika virus infection.
Many infections can be prevented by vaccination, such as rabies, smallpox, polio, influenza, COVID-19 viral infections, and shingles.
Adult Vaccination… as Important as Childhood Vaccination
Many people may think that vaccination is mainly for disease prevention or immunity building in children. Nowadays, childhood vaccinations have increased in variety, while adult vaccines are also increasingly developed because preventing infections is very beneficial compared to the health problems caused by infections.
Moreover, the elderly are considered a vulnerable group similar to children. Many vaccines given during childhood lose effectiveness over time, making some infections possible in the elderly even if they were vaccinated in the past. Additionally, those with chronic diseases such as diabetes, chronic kidney disease, liver disease, or those on immunosuppressive drugs are also vulnerable groups at risk of infection.
Infections in Vulnerable Groups Cause Major Health Problems
Infections vary among different population groups. In vulnerable groups, infections can occur easily, be severe, and take longer to recover. Many infectious diseases cause mild symptoms in healthy individuals but can be severe in those with weak health, requiring hospitalization and potentially leading to disability or death.
Why Are Booster Vaccinations Necessary?
Generally, vaccines require booster shots to maintain immunity at a high enough level to prevent disease. Over time, immunity decreases.
Lack of booster doses or insufficient vaccination coverage in the population can cause diseases that have not been seen for a long time to re-emerge.
Examples of disease re-emergence include the diphtheria outbreak in Northeastern Thailand in 2012, the rubella outbreak in Japan in 2018, and the monkeypox outbreak in many countries worldwide in 2022 after the smallpox vaccination was discontinued in 1980.
Vaccination Recommendations for Adults
According to international and Thai public health recommendations, some vaccines are booster shots to restore waning immunity, some are recommended for the elderly or immunocompromised individuals, and some are recommended for populations at risk due to lifestyle or occupational exposure to prevent disease before exposure, such as rabies vaccination for veterinarians, diphtheria, pertussis, tetanus, and influenza vaccines for military personnel who train and live in groups, bacterial infection vaccines for patients requiring splenectomy, and many other vaccines as exemplified below.
|
Population Group |
Recommended Vaccines |
| Aged 19 years and older | Tetanus, measles, rubella, mumps, hepatitis B vaccines |
| Aged 50 years and older | Pneumococcal infection vaccine* |
| Aged 65 years and older | Diphtheria, pertussis, tetanus, hepatitis B, pneumococcal infection vaccines |
| Pregnant women | Diphtheria, pertussis, tetanus, influenza vaccines |
| Healthcare personnel | Diphtheria, pertussis, tetanus, chickenpox, measles, rubella, mumps vaccines |
| Patients with chronic lung disease, chronic kidney disease, chronic liver disease | Diphtheria, pertussis, tetanus, influenza, hepatitis B, pneumococcal infection vaccines |
| Individuals without a spleen, splenectomy, or non-functioning spleen | Diphtheria, pertussis, tetanus, influenza, hepatitis B, pneumococcal infection vaccines |
| Individuals on long-term immunosuppressive therapy | Diphtheria, pertussis, tetanus, influenza, hepatitis B, pneumococcal infection vaccines |
*Pneumococcal infection is a bacterial infection causing pneumonia, meningitis, and bloodstream infection.
In addition to the general recommended vaccines above, there are optional vaccines such as chickenpox vaccine, hepatitis A vaccine, shingles vaccine, and HPV vaccine, which is a major cause of cervical cancer. Choosing which vaccine to receive can be discussed with a doctor to consider suitability and readiness of the vaccine recipient to gain the maximum benefit for both health and peace of mind.
Dr. Phatthaya Riangchan
Infectious Disease Specialist
Internal Medicine Center, Phyathai Nawamin Hospital
