Vaccination is essential in protecting us from catching diseases and falling severely ill if we catch them. But which vaccines do you and your elderly loved ones need? Are they safe? What is the best way to get vaccinated in Singapore?
In this guide, we explain how vaccines work and why they help us and our ageing loved ones prevent health complications. A large part of the article is dedicated to discussing each of the recommended vaccines for the age group of 65 and above, but we also include vaccination recommendations for adults under the age of 65 when relevant.
Table of Contents
1. Why is Vaccination Important for Seniors?
With an average life expectancy of 84 years, the senior population in Singapore continues to grow. According to a report published by the Ministry of Social and Family Development, the population aged 65 years and above increased from 9.0% of total population in 2010 to 15.2% in 2020, and is projected to reach 22.1% in 2030.
As we age, our immune function gradually weakens. We may also have one or more chronic conditions such as diabetes or a cardiovascular disease, which puts additional stress on our immune system. As a result, we are more likely to catch, and spread, infections. Recovery often takes longer and the risk of complications may increase when an ageing person falls sick. Vaccinations can help to strengthen our immunity to fight off high-risk infections.
Vaccination bolsters our immune function by providing ‘training’ to the body’s natural defences in advance. The immune system becomes more alert and effective in combating pathogens when exposed to them. If bacteria or viruses manage to break through, vaccinated seniors are less likely to become severely ill or experience complications. As such, vaccinations can also help to reduce the chance for the elderly to pass an infection to their loved ones, or to be unnecessarily hospitalised.
2. How Vaccines Work
Vaccines contain a weakened form of pathogen or bacteria from a specific illness. By exposing the body to a weaker version of an illness, vaccines prompt the immune system to identify and attack these pathogens. The body learns how to respond, create the appropriate antibodies, and remove specific harmful substances. In short, immunity is developed.
Generally, vaccines do not cause individuals to become sick. They simply mimic the mechanism of an infection to elicit an immune response, which prepares the body to recognise and fight future infections. However, upon vaccination, some individuals may experience symptoms such as body aches or a mild fever within two days. This is a typical immune response and is not a cause for alarm.
3. Types of Vaccines
Advances in pathology and biotechnology constantly expand our knowledge about vaccines and improve their effectiveness. Here are a few of the most common types in use:
- Live attenuated vaccine - This type of vaccine more closely resembles actual infections since it uses weakened, live pathogens from an illness. It results in long-lasting immunity but is typically not recommended for individuals with weaker immune systems. Examples of vaccines using this technology include the measles, mumps, and rubella (MMR) vaccine and chickenpox vaccine .
- Inactivated vaccine - This vaccine uses dead pathogens that still trigger immune responses. While inactive vaccines are safer for immunocompromised individuals, immunity is often short-term. This means that individuals will likely need routine follow-up shots. Examples are Hepatitis A vaccine, polio vaccine, and some types of influenza vaccines.
- Subunit vaccine - This type of vaccine uses a piece of the pathogen to induce an immune response. It does not use the whole actual virus or bacteria, and this helps immunocompromised individuals develop immunity safely. Vaccines commonly using this technology include pneumococcal vaccine, Hepatitis B vaccine, shingles vaccine, and certain types of influenza vaccines.
- Messenger RNA (mRNA) vaccines and viral vector vaccines: The most recent vaccine development using these technologies was to combat Covid-19. These technologies deliver information of the virus, not the virus itself, to trigger an immune response.
Common Misconceptions about Vaccines
Misinformation regarding vaccines is widespread, which poses a harmful threat to the general population’s health. Some common misconceptions about vaccines typically come from:
- The belief that immunisation is ineffective
- Exaggerated side effects
- Faulty generalisations
- Disproven medical sources
For years, many have argued for natural immunity, improved hygiene, and balanced nutrition for protection. However, scientific evidence has proven that relying on these practices alone create higher health risks and poorer outcomes. Additionally, without vaccination, eradicated diseases are likely to resurface.
Seniors may have concerns whether vaccines are safe for them, and if their weaker immune systems can withstand the side effects of vaccines. Let us find out.
The Safety of Vaccines
Generally, vaccines are safe to use. Vaccines in use in Singapore are studied, approved and closely monitored by the Health Sciences Authority (HSA). The most common scenario when someone is not recommended for vaccination is when he/she had a severe allergic reaction to a vaccine in the past. A few vaccines may contain traces of egg or other ingredients, and they may not be suitable for a person with serious allergies with these ingredients. Consult your doctor if you wish to get vaccinated and have a history of allergy following a vaccination.
Vaccinations may be accompanied by a few mild symptoms like low-grade fever, fatigue, and swelling or pain at the injection site. They can be managed with over-the-counter fever and pain relievers. Age is not proven to affect the efficacy of vaccines or commonality of side effects. In other words, the elderlies are not expected to experience more side effects or less protection from vaccines compared to younger adults.
Fewer than 1% of vaccinated individuals experience more serious complications, but in most cases, these too can be treated promptly. For this reason, you are often required to stay at the clinic or vaccination site for observation after the injection is done.
While there are risks involved in any medical decisions, the benefits of vaccination often outweigh its risks. The effectiveness of vaccines is backed by concrete scientific evidence from years of research. However, it is always advisable to gather as much valid information as possible, and consult your doctor about your specific health status to make a well-informed decision for yourself and your loved ones.
4. Highly Recommended Vaccines for the Elderly
Below are some of the important vaccines and the regular schedule for seniors aged 65 and above to ensure their safety against high-risk and vaccine-preventable diseases:
- Flu vaccine (quadrivalent) - 1 dose every year
- Pneumococcal vaccine (PCV13 & PPSV23) - 1 dose. Booster is recommended on individual basis. PCV13 is given first followed by PPSV23 one year later (or earlier depending on any pre-existing medical condition)
- Shingles vaccine (Shingrix) - 1 dose followed by another dose after 2-6 months
- Tdap vaccine (Boostrix) - 1 dose and a booster every 10 years
Highly recommended vaccines for the elderlies in Singapore include the flu vaccine, pneumococcal vaccine, shingles vaccine and Tdap vaccine
Existing health conditions may change one’s vaccination routine from the standard schedule for their age group. Please note that above dosage recommendations are based on the information published by the National Adult Immunisation Schedule (NAIS) and Health Promotion Board. This should not be used in place of professional consultation from your doctor or medical advisor.
Below we will discuss each of the vaccines, what and who it is for and answer the common questions we are asked about them.
5. Flu Vaccine
What is the flu vaccine?
The flu vaccine, or influenza vaccine, flu shot, or flu jab as it is called, protects against the seasonal flu and its possible clinical symptoms and outcomes. Though the flu is common, it is considered highly contagious and its complications can be severe or even fatal for an elderly if not adequately prevented or taken care of. These complications may include pneumonia, bronchitis, meningitis (brain infection), or infection of the sinus or ear.
While vaccinated individuals may still catch the flu after vaccination, they are likely to only experience mild symptoms and recover quickly. Moreover, vaccinated individuals who are 65 and older are reported to have fewer cases of hospitalisation and clinical visits. The recommended dosage is 1 flu shot each year, or each season in some cases.
Who is it recommended for?
The National Adult Immunisation Schedule (NAIS) recommends the flu vaccine for all seniors aged 65 and above, as well as younger adults with compromised immunity and children. Take the flu shot if you:
- Are 65 years old and above
- Are under 65 years old but have diabetes or heart diseases
- Have other chronic diseases such as respiratory disease (asthma, COPD), kidney disease, liver failure or certain autoimmune diseases
- Experience immunosuppression due to cancers, chemotherapy, organ transplant or other conditions
- Stay at long-term care facilities
- Travel frequently
Other people who should take the flu vaccine are pregnant women, and infants between 6 months and 5 years of age.
Common questions about the flu vaccine
- How long is it effective for?
It takes about 2 weeks after the flu shot to develop immunity, which will then give you protection for 3 to 6 months. Flu is seasonal and new strains of influenza virus might come into circulation each season. The flu vaccine is reformulated each year, which is another reason you need a flu shot annually. In Singapore, there are usually 2 flu seasons in a year, occurring from December to February and then from May to July. It is advisable to get the flu shot at the beginning of the flu season. Be sure to consult your family doctor for your personal schedule.
- Are there different types of flu vaccine? Which type should I take?
Yes, there are different types of flu vaccines. In Singapore, the quadrivalent vaccine is commonly recommended and administered. It protects against 4 types of influenza virus A and B that are expected to be circulating during the upcoming season.
- Are subsidies available for the flu shot?
CHAS card holders can take advantage of subsidised flu vaccination at any CHAS clinics. You can also tap into your MediSave for your flu shot.
The flu vaccine is recommended once yearly for all seniors above 65 years old, younger adults with chronic conditions, frequent travellers, and pregnant women.
6. Pneumococcal Vaccine
What is the pneumococcal vaccine?
Pneumococcal vaccine prevents individuals from developing pneumococcal diseases. This group of diseases is caused by Streptococcus pneumoniae bacteria, and include conditions such as pneumonia, meningitis (brain infection), and septicemia (blood infection).
There are different types of pneumococcal vaccines. In Singapore, medical experts typically recommend the PPSV23 pneumococcal vaccine (Pneumovax 23). However, elderly individuals and high-risk patients may also be given the PCV13 version of the vaccine (Prevenar 13). The PCV13 vaccine provides protection against 13 pneumococcal bacteria strains while the PPSV23 protects against 23 strains that are the most common causes of pneumococcal diseases. Some people may benefit from more lasting protection when taking the PCV13 before the PPSV23, compared to taking the PPSV23 alone. Consult your doctor for your personal advice.
Who is the pneumococcal vaccine recommended for?
You should get the pneumococcal vaccine if you belong to any of these categories:
- Age 65 years upwards
- Adults with underlying medical conditions such as chronic lung disease, heart disease, diabetes mellitus, cancers, and other conditions resulting in a compromised immune system
- Adults with jobs putting them at high risk of lung disease
Common questions about the Pneumococcal vaccine
- How long is the pneumococcal vaccine effective for?
One shot of the PPSV23 vaccine is often recommended once in a lifetime. However, if you have underlying medical conditions such as diabetes, chronic lung disease or are immunocompromised, booster doses may be required at least five years apart.
The decision for a booster dose should be discussed with your family physician. Your doctor may also recommend taking both the PCV13 and PPSV23 vaccines for better protection, in which case, the PCV13 is given first, followed by the PPSV23 after a year.
- Are subsidies available for the pneumococcal vaccines?
Pneumococcal vaccines are included in the National Adult Immunisation Schedule and are available at subsidised prices for eligible individuals at all CHAS clinics. MediSave can also be used. You can check your eligibility for CHAS subsidies here.
Pneumococcal vaccines are recommended for seniors above 65 years old and younger adults with chronic respiratory conditions or weakened immunity.
7. Shingles Vaccine
The shingles vaccine prevents the development of shingles, also known as herpes zoster, a painful rash that appears on a localised area of the body or face. This infection is caused by the reactivation of the chickenpox virus that is dormant in the body after your recovery from chickenpox. The recurrence causes shingles and it can happen without proper vaccination. Statistically, ageing individuals are more likely to contract shingles, which makes it essential for them to be vaccinated against it.
Shingles majorly affects the nerves, resulting in pain, burning and tingling sensation, and blisters. One of the complications of shingles is post-herpetic neuralgia (PHN), leading to persistent pain and irritation even after the rashes are long gone. It is estimated to affect 1 in 5 adults contracting shingles, and it may take up to a year to fully recover from this complication. The good news is that shingles vaccine also protects against post-herpetic neuralgia.
Shingrix, the shingles vaccine available in Singapore, requires 2 doses taken 2 to 6 months apart.
Who is the shingle vaccine recommended for?
The shingles vaccine is recommended for the following groups of people:
- Individuals aged 50 years and above
- People aged 19 years and above who are immunosuppressed or on chemotherapy
Common questions about the shingles vaccine
- Is the shingles vaccine the same as the chickenpox vaccine?
No, the shingles vaccine (Shingrix) is not the same as the chickenpox vaccine (Varicella). Though shingles is caused by the same virus that causes chickenpox (varicella-zoster virus), they are not the same condition. Chickenpox mostly affects children, but adults may catch it too, especially if not vaccinated against chickenpox. Shingles affects adults who had chickenpox in the past, more commonly senior adults. Chickenpox is highly infectious while shingles is not. The vaccines to prevent the two diseases are different.
- I received the chickenpox vaccine before, do I need the shingles vaccine?
Everyone who has chickenpox is at risk of developing shingles at a later stage. Receiving the chickenpox vaccine (Varicella) before does not stop you from getting the shingles vaccine (Shingrix).
- I had shingles before, do I still need the shingles vaccine?
You may get shingles more than once and therefore still benefit from getting the shingles vaccine after recovering from shingles. However, check with your doctor for your personal advice.
- How long are shingles vaccines effective for?
The latest shingles vaccine is reported to keep the immunity strong and protect against shingles for 7 to 10 years.
- Are subsidies available for the shingles vaccine?
The shingles vaccine (Shingrix) is not eligible for subsidy under CHAS. But you can use MediSave to fund the vaccination. The chicken pox vaccine (Varicella), however, is available at subsidised price for CHAS card holders who have not been vaccinated or lack evidence of past infection or immunity. Check your eligibility for it here.
The shingles vaccine is recommended for adults over the age of 50 as well as younger adults with weakened immunity
8. Tdap/ DTaP (Tetanus, Diphtheria and Pertussis) Vaccine
The Tdap/DTaP vaccine protects against 3 infectious diseases - tetanus, diphtheria and pertussis. Medical professionals recommend the Tdap/DTaP vaccine for seniors who come in regular contact with infants. This is because pertussis and diphtheria are highly contagious infections and can be detrimental to health. Getting this vaccine not only protects the elderly but also ensures the safety of other family members.
Pertussis is a highly contagious bacterial infection affecting the respiratory tract. It results in a persistent cough which can be violent in many cases. For this reason, it is also called ‘whooping cough’, and was even called the ‘100-day cough’, because it can take months to recover from. Pertussis is the most common cause of lasting cough among adults.
Diphtheria is a highly contagious infection that commonly affects the nose, throat, and tonsils. It can cause breathing, swallowing and speaking problems. In severe cases, it can lead to damages of the heart, kidneys and nerves.
Tetanus, also known as lockjaw, is a relatively rare bacterial infection but has a high fatality rate. The name ‘lockjaw’ refers to a common symptom of the disease, which is stiffness of the jaw muscles. Muscle contraction may also affect critical functions of the body such as breathing and heart. The bacteria causing tetanus can be found in the soil or dusty areas. It gains access to the body through a cut, open wound or an open skin surface and is not spread from person to person.
There are 2 main types of combination vaccines to protect against these 3 infections. Their names can easily be mistaken - DTaP and Tdap. DTaP contains stronger doses of vaccines and is given first to build immunity, especially in children. Tdap, with lower doses of vaccines than DTap, is often given to adults or children at the age of 10 or 11 to boost immunity.
Who is the Tdap vaccine recommended for?
Seniors aged 65 and above who have not been vaccinated with Tdap in the last 10 years should get the vaccine. However, you are recommended to check with your doctor which type of vaccine is best for you and the appropriate schedule. Other adults may also benefit from getting Tdap vaccine every ten years to protect themselves and their families.
It is also recommended for all pregnant women in their third trimester
Common questions about the Tdap/DTap vaccine
- How long is the Tdap vaccine effective for?
A single dose of the Tdap vaccine is effective for 10 years.
- Since DTaP has stronger vaccine content than Tdap, should I get DTaP for better protection?
Adults are recommended to take the Tdap. It is also reported to be less likely to cause side effects like pain or redness.
- Are subsidies available for the DTaP/Tdap vaccines?
The Tdap vaccine (under the brand of Boostrix) is included in the National Adult Immunisation Schedule and available at subsidised prices for eligible individuals at all CHAS clinics. MediSave can also be used. You can check your eligibility for CHAS subsidies here. For children, DTaP is subsidised under the National Childhood Immunisation Schedule.
The Tdap vaccine is recommended for seniors above the age of 65 who have not been vaccinated with it in the last 10 years.
9. Other Vaccinations Under National Adult Immunisation Schedule (NAIS)
Under NAIS, all adults including seniors above the age of 65 should take vaccination to protect themselves from:
- Hepatitis B: HepB can spread from person to person through blood, semen or other body fluids, causing serious liver diseases including liver inflammation, liver failure and liver cancer. Vaccination requires 3 doses, taken at Month 0, Month 1, and Month 6. Some people with compromised immunity or specific conditions may need a booster dose. CHAS subsidy is available for Hepatitis B vaccine.
- Mumps, Measles and Rubella (MMR): these are contagious viral infections that can lead to serious complications. MMR vaccine consists of 2 doses, taken 4 weeks apart and is subsidised under CHAS.
In addition, we encourage you to enquire your GP doctor or family physician about Hepatitis A Vaccination or Hepatitis A & B combination vaccine.
10. Get Vaccinated with Ninkatec & Charazoi
Vaccination is one of the best ways to maintain good personal and public health – especially for the elderly, who are more susceptible to experiencing complications after contracting illnesses like the flu, pneumonia or shingles. You can choose to get vaccinated at our clinic or in the comfort and convenience of your home. Find out more about
- Home-based vaccination with Ninkatec
- In-clinic vaccination at Charazoi Medical Clinic - We are an accredited and a CHAS clinic.
Chat with us if you would like to book an appointment or have any questions.
11. Takeaway Message
Vaccination provides the necessary protection that our elderly loved ones need as their immune system naturally weakens with age. Receiving vaccinations help you gain better immunity, boost your chance to recover faster, and reduce medical visits and hospital expenses. Not only does vaccination play a major role in safeguarding an ageing individual’s health, but it also protects those around them from getting sick.
Take advantage of CHAS subsidies to save when you get vaccinated at our clinic. Further subsidies and free vaccinations are going to be introduced soon as part of Healthier SG program. Stay tuned and be the first to sign up through our website.
