By Ellen Kirk-Macri, RN, CDE and Susan C. Jenkins
Many Canadians think that vaccines are just for children. Too many don’t realize that the protection vaccinations can decrease over time and a booster shot may be necessary, putting older people at greater risk for some diseases and for severe complications. According to the US National Institute of Health, adults age 60 and older are more than 2.6 times more likely to die from a vaccine-preventable disease than someone between 20 and 59 years old.
As a caregiver, you have an opportunity to educate your clients, their families, and visitors and to encourage them to make sure that their vaccinations are up to date. Don’t forget, healthcare providers need vaccinations, too!
In addition to vaccinations for diseases that are more common among older people (e.g., herpes zoster), adults should also keep their routine vaccinations up-to-date. Don’t rely on clients’ recollections about their vaccination history; get verification whenever possible. Health Canada reported recently that while most adults believed they had received all necessary vaccinations, in fact, less than 10% were actually up to date on their immunizations.
Adult vaccination recommendations vary slightly from province to province, but the Canadian Immunization Guide offers a general overview.
|Guide to Adult Vaccines|
|Vaccine||Who Should Receive It|
|Diphtheria||Everyone, every 10 years|
|Hepatitis A||People with medical, occupational, or lifestyle risks; travellers to high-risk areas|
|Hepatitis B||People with medical, occupational, or lifestyle risks|
|Herpes zoster||People 60 and older (may be administered to people age 50 and older)|
|HPV (human papilloma virus)||Females and males 9 to 26 years of age (may be administered to females or males 27 years and older who are at ongoing risk of exposure)|
|Influenza||Annually, especially for people at high risk of complications|
|Measles||People who have not had the vaccine or the disease|
|Meningococcal||People with specific medical conditions and those living in communal residences|
|Mumps||People who have not had the vaccine or the disease|
|Pertussis||Everyone, once in adulthood|
|Pneumococcal||Everyone 65 and old who has a strong immune system; people younger than 65 who are living in long-term care facilities; people with specific medical conditions|
|Rubella||People who have not had the vaccine or the disease|
|Tetanus||Everyone, every 10 years|
|Varicella||People who have not had the vaccine or the disease|
|Source: Adult Immunization: What Vaccines do You Need? Immunize Canada. https://immunize.ca/adults|
Easing the Process
Some clients may be reluctant to get vaccinations due to fear of pain associated with the injection. Here are a few simple steps you can take to make the process easier.
- Allow the person to get comfortable. Some people may prefer to sit up; others may want to lie down.
- Ask the person to take a slow, deep breath and then to exhale slowly.
- Try to distract the person by talking about something that interests him/her, playing music, or putting on the television.
- Topical anaesthetics such as EMLA®, AMETOPTM Gel, or Maxilene® can reduce the pain from a vaccination, but they must be applied according to the manufacturer’s instruction long enough prior to the injection so they will have time to numb the skin.
Ellen Kirk-Macri is a registered nurse and certified diabetes educator. Susan C. Jenkins is a freelance writer and editor specializing in medicine, pharmacy, and healthcare. She can be reached at email@example.com