Why flu prevention matters as Singapore’s population ages

Advertorial As the immune system weakens with age, influenza can carry greater risks. An expert explains why vaccination should be part of routine preventive care for older adults. Some older adults may believe that being generally healthy reduces the need for vaccination, but preventing infections remains an important part of healthcare. (Photos: Sanofi, Shutterstock) New: You can now listen to articles. This audio is generated by an AI tool. For many older adults, ageing well means having the freedom to keep doing the things that give meaning to life – be it meeting friends, travelling or simply going about daily life independently.But staying active later in life is not just about good nutrition, exercise or regular health screenings. Preventing infectious diseases is another part of that equation.Vaccination is an important pillar of healthy ageing, said Dr Litjen Tan, chief policy and partnership officer at Immunize.org, a United States-based organisation that aims to improve immunisation coverage and vaccine confidence.Flu, pneumonia, respiratory syncytial virus and shingles are all vaccine-preventable, and when you are older, these infections can hit much harder, so vaccination should be one of the first things that comes up, he added. According to Dr Litjen Tan, healthcare professionals can help address vaccine hesitancy among older adults by making vaccination a routine part of preventive care. WHY INFLUENZA BECOMES RISKIER WITH AGE Age itself is an important risk factor for severe respiratory infections, including influenza, said Dr Tan. As people age, the immune system becomes less effective at fighting infections – a process known as immunosenescence. This means even otherwise healthy older adults may be vulnerable to infections.This helps explain why influenza can have consequences beyond several days of fever and fatigue. It can trigger inflammation in the body and lead to serious complications such as pneumonia and myocardial infarction, commonly known as a heart attack. Despite these risks, Dr Tan said a key barrier to vaccination among some older adults is the belief that being fit or generally healthy means it is unnecessary. He said: “If you're aged 65, your immune system is waning and you are already at risk.”Other barriers include concerns about side effects, doubts about how well vaccines work and the perception that influenza is not particularly serious, he added. The World Health Organization recommends a life-course approach to immunisation, with vaccination seen as a health intervention at all stages of life. FROM CHILDHOOD IMMUNISATION TO LIFELONG PREVENTION According to Dr Tan, vaccination has traditionally been viewed as a childhood intervention. However, this is changing as populations age and the World Health Organization advocates a life-course approach to immunisation. This approach considers vaccination as a health intervention across different stages of life rather than only in childhood. This shift is particularly relevant to Singapore, where one in four citizens is expected to be aged 65 and above by 2030.For Dr Tan, putting a life-course approach into practice means making vaccination readily available where adults already receive care, encouraging healthcare professionals to routinely discuss recommended vaccinations and having policies that support uptake.Singapore already has some of this infrastructure in place, said Dr Tan, pointing to Healthier SG, the National Adult Immunisation Schedule (NAIS) and the wider primary care system. Under NAIS, influenza vaccination is among the vaccinations recommended for adults aged 65 and above.There are signs of progress: Influenza vaccination uptake among Singapore residents aged 65 and above rose from around 18 per cent in 2020 to about 42 per cent in 2024. But the figures also showed the remaining gap: More than half of residents in this age group remained unvaccinated against influenza. Influenza can cause complications beyond fever and fatigue, including pneumonia. MAKING VACCINATION PART OF ROUTINE HEALTHCARE CONVERSATIONSClosing the gap may depend partly on what happens during routine healthcare visits. These encounters can give many older adults an opportunity to raise questions or share concerns about vaccination.Dr Tan said trusted healthcare professionals can play a crucial role in addressing vaccine hesitancy. Doctors, nurses, pharmacists and other healthcare professionals who regularly interact with older patients need to answer questions and discuss vaccination as part of preventive care.Family members can also support older adults who have concerns about vaccinations, said Dr Tan. This could mean listening to their concerns, accompanying them to appointments or helping them raise questions with healthcare professionals.Dr Tan suggested asking about influenza vaccination during routine healthcare visits, such as a blood pressure check or follow-up appointment, rather than waiting for the subject to arise. The aim, he said, is for vaccination to become part of the same routine preventive health conversation as other measures associated with ageing well.“When you are talking about smoking cessation, weight control and healthy exercise, vaccination has to come up in that conversation. It is just as important,” he said. For more information, visit the Sanofi website. MAT-SG-2600212-1.0-09/2026