The European Immunization Awareness week slogan ‘Protect Promote Immunize’ needs to be seen across the life course. Vaccination programmes focus in the main on children with the aim of vaccinating individuals as early as possible to prevent vaccine preventable disease but also to minimise the spread of infection and stop disease. Many vaccines however, are recommended across the life course and immunisation should be part of health care at all stages of life and in all settings.
With an increasing ageing population and clear evidence that older people are still at risk of morbidity and mortality from vaccine-preventable diseases. Making Every Contact Count (MECC) strategies need to include a check on vaccination history and opportunities to discuss immunisation.
There are many reasons why people may have missed out on vaccines in childhood. It is only relatively recently that The UK have implemented vaccination programmes en-mass, in the way we do now, trying to make sure we offer to everyone eligible and tracking and monitoring the uptake closely. So just because a vaccine was available from a certain date it won’t mean that all children born after that time will have had the vaccine. There are also many others who may have missed out on vaccination for example migrants and frequent travellers. Similarly there have always been people who have refused vaccination and this is not new. The term ‘Conscientious objectors’ comes from the exemption clause in the 1898 British Vaccination Act. While individual’s views must be respected people can, and frequently do, change their mind and opportunities to offer vaccination should be available.
There are many vaccines specifically recommended for older adults, such as, the influenza pneumococcal and shingles vaccines. There are also many opportunities at other stages of life for adults. Pregnant women for example have many opportunities to access health care during their pregnancy and this provides a chance to check on the immunisation history and advise on how women can make sure they are up to date. There are also vaccines specifically recommended in pregnancy; influenza, given during the flu season as pregnant women are at higher risk of complications that can threaten both mother and baby. Maternal vaccination with pertussis (whooping cough) helps protect babies during the first few months of life.
Adults require protection against vaccine-preventable disease when travelling. This may include specific vaccines relevant to the country they are visiting it is also a chance to check on the routine vaccines recommended in the routine schedule. Some occupational groups will also require certain vaccines.
Although it is recognised that the immune response to vaccines declines with age there is good evidence that they can still reduce the impact of disease and should be actively promoted.
In the UK we should be proud of our immunisation programme and in the uptake achieved in the population. There is a need to make sure the emphasis is maintained thought life and all opportunities taken to make sure people are fully immunised!