Older age is not a contraindication

Older age is not a contraindication for any vaccine, but nurses should be familiar with the general contraindications and precautions of vaccines used in travel health. In particular yellow fever vaccine has been associated with the risk of
serious adverse events including systemic illness resembling clinical yellow fever and neurologic disease. Systemic and neurologic adverse events are rare. Data from the Vaccine Adverse Event Reporting System in the US estimate the approximate rate for the general US population to be between 0.4 and 0.8 per 100,000 doses (Staples et al 2010). The risk factors are only partially understood, but both systemic and neurologic disease have been observed at a higher rate in those aged over 60 years, possibly due to age-related deterioration of the immune system (Monath 2012). A careful risk assessment should be made, taking into consideration the risk of yellow fever at the destination and referring to specialist sources of advice as appropriate (NaTHNaC 2012). Other travel vaccines should be offered to older travellers after a risk assessment. Many vaccine-preventable illnesses, including hepatitis A, carry a greater risk of complications in older people. Recommendations are the same as for adult travellers generally. However, response to vaccinations may take longer in older individuals and the efficacy of some vaccines may be compromised due to the diminished immune response in older people (Gautret et al 2012). In addition older travellers should be made aware of the importance of additional avoidance measures, such as precautions about food, water and personal hygiene.