Immunisation is vital for seniors as immunity naturally declines with age, increasing vulnerability to severe infections.

In Singapore, vaccines recommended to protect older adults from serious disease and complications include:

• Influenza,
  
  
• Pneumococcal, and
  
  
• Shingles (herpes zoster) are recommended to protect older adults

Despite their importance, vaccination uptake among seniors remains low.

Influenza vaccination coverage among those aged 65–74 is about 32.4%, while pneumococcal vaccination coverage has improved to 35% in 2023, up from 11.9% in 2017.

To strengthen protection, Singapore recently added the Shingrix shingles vaccine and the PCV20 pneumococcal vaccine to the National Adult Immunisation Schedule, making them eligible for subsidies.

Ultimately, improving vaccination rates empowers seniors to stay protected, independent, and better prepared for future health challenges.

If you have any questions about immunisation for seniors, don’t miss this valuable opportunity to speak with our Family Physician Dr Aloysius Lam from SingHealth Polyclinics, and gain expert insights on protecting the health of our ageing population.

Dr Aloysius Lam is a Family Physician at SingHealth Polyclinics. He graduated from Lee Kong Chian School of Medicine in 2018 and obtained his Master of Medicine (Family Medicine) in 2023. 

He is currently an active member of SingHealth Polyclinics’ Infection Prevention and Infectious Disease (IPID) Committee Workgroup.

1. Question by Shermin

Hi Dr Lam,

I don't know if I ever had chicken pox and my family members also cannot remember whether I had chicken pox.  Should I still go for Shingles vaccination?  I am a 62 years old female and in general good health.

Thank you.

Answer by Dr Aloysius Lam

Dear Shermin,

You can absolutely receive the shingles vaccine even if you are uncertain about whether you had chickenpox in the past.

Research has shown that most adults over the age of 25 years have gotten chickenpox, even if they do not recall having the infection. As such the shingles vaccine is still highly recommended if you are above the age of 60 years.

While blood tests can determine your immunity status if you have specific concerns, the Ministry of Health, Singapore, does not require immunity verification before administering the zoster vaccine.

2. Question by Syed

Hi Doctor,

I took the shingles vaccine Zostavax on 25 Feb 2022. 

Is 3 years timeframe safe for us take up the new shingles vaccine? Thank you.

Answer by Dr Aloysius Lam

Dear Syed,

In general, we recommend the new Shingrix vaccine 5 years after receiving the Zostavax vaccine.

This is because the effectiveness of Zostavax immunity wanes substantially within a few years and is minimal by year 5.

In terms of minimum spacing interval between Shingrix and Zostavac, the Ministry of Health Singapore recommends a minimum interval of 8 weeks.

3. Question by Adeline

Dear Dr Lam,

I’m a 61-year-old female and would like to know if there are any side effects for the shingles jab?

I’ll also be travelling to Australia to do confinement for my daughter who requested that I do Whooping Cough immunisation since I’ll be looking after the baby as well.

How do I go about getting the jabs?

Looking forward to your reply. Thank you.

Answer by Dr Aloysius Lam

Dear Adeline,

Common side effects of the Shingrix vaccine include pain, redness and swelling at the injection site, muscle pain, tiredness, headaches, stomach upset and fever. These side effects are typically mild and last for 2 to 3 days.

You can get the Shingles and whooping cough vaccines at your GP clinic or Polyclinics.

The Tdap vaccine, which protects against whooping cough is currently not part of Singapore’s Adult Immunisation Schedule. As such, it is currently not subsidised.

4. Question by Kaushal

Hi Dr,

I am 81 years old male and like to travel to nearby countries. 

Is it okay to take Flu vaccination every 6-7 months?

Thank you for your advice.

Answer by Dr Aloysius Lam

Dear Kaushal,

There is usually no need to administer the flu vaccine every 6 months. Instead, it is recommended on an annual basis.

Annual flu vaccination is strongly recommended because influenza presents unique challenges that require yearly protection.

Unlike some diseases where a single vaccine provides long-lasting immunity, the flu virus constantly evolves and mutates, creating new strains each year that can evade your previous immune defences.

5. Question by Magdaline

Dear Dr. Lam,

I had Hepatitis B (Hep B) vaccinated sometime in year 1990, about 35 years ago.

In year 2021, I went for a normal health screening at a GP, which included the Hep B blood test. It was noted the Hep B antibody came down to a level of reactive 23 mIU/mL (Ref range > 10 reactive).

After about 3 years, i.e. 2024, I made an appointment with Polyclinic to get this Hep B jab, thinking after 3 years, the antibody should have been gone down much lower than the screened result in 2021.  (I haven't gone for another health screening since then).

I brought this 2021 health screening report to show the nurse who was to administer the jab, however, she told me so long as there are antibody remains, I was not allow to get a booster. 

I did a search from internet and found an article mentions that senior above 59 are not necessary to have Hep B jab anymore, unless that senior is vulnerable to certain health conditions.

Hence, I would much appreciate it for your clarification or advice whether should a senior, whose age almost reaching 58, can go for a Hepatitis B booster? Thank you.

Answer by Dr Aloysius Lam

Dear Magdaline,

You are protected against Hepatitis B when the Hepatitis B antibody level is > 10 mIU/mL

In general, Hepatitis B antibody levels above 10 mIU/mL indicates that a person is already immune to hepatitis B.

However, sometimes certain situations may require a person to keep their antibody levels at a much higher level. Examples, ongoing exposure to hepatitis B carrier, such as sexual partner or healthcare workers.

I would advise you to consult your doctor for further discussion if in doubt.

6. Question by KM

Hi Dr Lam,

I went to see the doctor for an annual COVID vaccination. 

The doctor told me that I also need a second shot of Pneumococcal Vaccination despite my telling him that I have already a 2nd shot of the Pneumococcal Vaccination.

However, the doctor told me that there was no showing of the second shot on record.

So, I took both the COVID and Pneumococcal shots.

Question: Is it harmful that I have 3 Pneumococcal shots?

Thank you for your advice.

Answer by Dr Aloysius Lam

Dear KM,

In general, doctors rely on written or electronic records to check your vaccination history. Many international guidelines recommend basing vaccination decisions on these records rather than on memory alone.

If you are very certain that you have received doses of pneumococcal vaccine previously, you may choose not to take another dose. This should be decided after discussing with your doctor, as your protection may not be complete if those earlier doses were actually missed.

If you are uncertain whether you received the earlier doses, and there is no documentation, it is usually better to take the vaccine again and have it properly recorded.

Getting extra doses of most vaccines is generally safe. Your immune system may respond more strongly to the additional doses, so you may experience some temporary side effects such as fever, or pain and swelling at the injection site.

These side effects are usually mild and go away on their own. Overall, the benefits of being protected through vaccination far outweigh the possible side effects.

7. Question by Miss Tan

Dear Dr Aloysius Lam,

I was injected Pneumovax23 (pneumococcal vaccine, polyvalent, MSD) in June 2007.

On that day, I was also injected influenza vaccine.

Before my subtotal pancreatectomy 16 days later.

When can I have pneumococcal vaccine again? And which type?

I am 64 years 5 months old now. Perhaps I should wait till I reach 65 years old or so?

Thank you for your advice.

Answer by Dr Aloysius Lam

Hi Miss Tan, 

The type of pneumococcal vaccine you need, and when you should get it, depends on a few factors.

This includes whether you have other medical conditions and whether your spleen was removed during the subtotal pancreatectomy you had 18 years ago.

A newer pneumococcal vaccine called Prevenar 20 (PCV 20) has been recently introduced to our National Adult Immunisation Schedule. This vaccine can be used in place of Pneumovax 23.

If your spleen was removed during the surgery, or if you have other medical conditions that weaken your immune system or put you at higher risk of severe pneumonia, it is recommended that you receive a single dose of Prevenar 20 (PCV 20) now, without waiting until the age of 65. 

If your spleen was not removed and you do not have any other medical conditions that weaken your immune system or increase your risk of severe pneumonia, you may wait until you are 65 years old before receiving the Prevenar 20 (PCV 20) vaccine.

Ref: G25