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HNB3209-Prevalence Of Annual Influenza Vaccination

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  • Course Code: HNB3209
  • University: Victoria University
  • Country: Australia

Question:

Discuss about the Annual influenza vaccination among the elderly populations in Australia.

 

 

Answer:

Annual Influenza Vaccination

Annual influenza vaccination in Australia has been a recommended practice since 1999 specifically for the old aged individuals of sixty-five years and above. Statistics reveal that the Commonwealth government has offered to give a free vaccine to the mentioned group which is not funded publicly (Demicheli, 2018). However, an exemption has always been made to individuals who are vulnerable to severe influenza communication. This group includes the healthcare providers who attend to the infected patients as well as family members who facilitate intensive care way from hospitals. Also, the Aboriginal group of individuals is given a special consideration where individual aged between 15-50 years are diagnosed with high infection risks enrolled in the immunization program (Coleman, 2018).

However various factors influence the uptake of the free and recommended influenza vaccination. They include the cost, convenience, and awareness. The factors, among others, act as barriers for the influenza vaccination initiative to the specified groups. Data collected on research on influenza vaccination prevalence reveal that high rates of awareness on the benefits of influenza vaccination increase the turnout individuals (Belongia, 2016). This aspect controls the spread of the infection among the vulnerable individuals as well as the old aged Australians. The statistics also reveal the convenient vaccination procedures have a higher probability of improving uptake. Also, the cost of the free vaccination initiative affects the rate of annual influenza vaccination on the old aged Australians as well (Simpson, 2016). Therefore, this paper will discuss the prevalence of annual influenza vaccination among the old aged and vulnerable Australians, and the cultural safety measures in the community. 

 


In Australia, the funding of vaccines is done by the government to regulate the spread of influenza among the aging adults and children in the specific Australian population. Vaccination is initiated under the Australian national immunization program and through other private means. In the past two decades, new vaccines established to control the flu have revealed it effectiveness through practical experiments subjected to the infected patients. The flu vaccine recommended for people aged sixty-five years and above should have Fluad or Fluzone High-Dose (Doherty, 2018). The vaccine is designed to increase protection against influenza A/H3N2 which is severe and most common in old individuals in Australia. This remedy, furthermore, compensates for the loss of immunity against the B strain. This strain, however, is not included in the young patients’ vaccine since they already possess it in their body systems.

Some of the quadrivalent vaccines of influenza for the elderly available in Australian healthcare systems include FluQuadri 0.5 ml, Fluarix Tetra ml, Afluria Quad 0.5ml and influence Tetra 0.5ml. The Fluzone High Dose 0.5ml and the Fluad 0.5ml are categorized under the trivalent influenza vaccines for the elderly Australians (Connolly, 2018). The vaccination is conducted between June and September when the flu is circulating at a high rate. Protection lasts for a whole season. However, optimal protection is guaranteed in the first three to four months.

Vaccines administered during the annual influenza vaccination in Australia are booster vaccines. As mentioned earlier, their impact on protection last for one season which is a period of three to four months. The shots are timely administered between the June and September when the prevalence of the infection is high (Darvishian, 2014). The effectiveness and efficacy of the influenza vaccines depend primarily on the degree of virus strains similarity and the immunocompetence and the age of the recipients. Also, the differences in magnitudes between the trivalent and quadrivalent vaccines based on protection against the B strain remains unpredictable in any season.

Aspects which include annual variation, antigenic mismatch, cross-protection and the pre-existing immunity among recipients dictate the rate of circulation of influenza strains. Recent research in Australian healthcare systems laboratories implies that the quadrivalent vaccines are 54% effective hence reliable in controlling the infection. On the other hand, the trivalent vaccines with the HA contents are 24% more effective than standard trivalent vaccines (Bijlsma, 2014).

The annual immunization recommendation has been a major focus of the Australian healthcare system. Health workers in Australian health facilities concur that annual immunization among the old population is one of the most effective techniques for preventing infections by the influenza strains. Specifically, influenza vaccination among adults with sixty-five years and above began in 1999 (Doherty, 2016). Research conducted by scholars reveal that unlike the younger individuals, older people are at a higher risk of contracting the disease as well as spreading it. Their immunity is weak, and this condition is evident through the high prevalent cases on respiratory and circulatory chronic infections among the same population. It can be proved by research which implies that influenza vaccination among healthy recipients under sixty-five years old is 70-90% effective (Schmid, 2016).

Individuals in these categories include children from the aboriginal community as well as healthcare facilitators and student in Australian healthcare facilities. It is also recommended that the health care providers should receive the annual vaccination to reduce the risk of infection from the affected patients and to the healthy patients.

Two major contraindications are absolute for most of the elderly individuals in Australia. They include; anaphylaxis which is dictated by any component in the vaccine and anaphylaxis that follows previous doses of any administered influenza vaccine. Anaphylaxis is a condition influenced by acute allergic reactions to which hypersensitivity has risen in the body (Matthews, 2018).

Research reveals that individuals with allergies associated with eggs can be vaccinated safely with influenza vaccines. The remarks result from tested incidences which proves that anaphylactic risks associated with influenza vaccines are very low to patients. Statistics of a conducted research in 2012 implies that 4172 of patients with egg-associated allergies who had reported severe cases of egg allergic reactions in previous years reported no cases about the inactivated influenza vaccine (Dawson, 2018).

Another study included 800 patients approximately 160 patients had a history of egg-related allergic reactions. However, only 17 individuals experienced adverse vaccination incidences revealing an improvement from the previous outcomes (MacIntyre, 2016). Therefore, the Australian healthcare system reveals that people in the specified groups of vaccination with histories of anaphylaxis or other contraindication issues can receive a full-dose vaccine in the Australian immunization settings (Menzies, 2016). 

 


As revealed earlier, professional nurses, as well as the nursing students in Australia, are given special consideration in matters of annual influenza vaccination. However, research proves that the uptake of the recommended vaccination among the healthcare practitioners remains sub-optimal (Jamotte, 2018). The research reveals that only about 36% of the nurses receive the annual influenza vaccine (Chong, 2018). This factor can, therefore, explain why influenza has been a significant burden among Australians as well as the Australian health care system.

Vaccination remains one of the most effective techniques for controlling influenza among the aging population of Australia. However, the decreasing number of vaccinated health care facilitators increase the risk of influenza prevalence in Australia. Emphases are made by the Australian government as well as the World Health Organization because the rate of infection among health care facilitators is increasing.

Moreover, the efficacy low among old Australian populations irrespective of whether or not the effective vaccination procedures have been initiated. The cases of low efficacy are characterized by the decreased level of immunity among individuals hence increasing their vulnerability to infections (Beyer, 2017). Such results and implications, however, have been used in the establishment of strategies for minimizing and controlling the prevalence of influenza among healthcare providers and Australians aged sixty-five years and above. Palache (2017) implies that the strategy of vaccinating nurses was established in 2010 by the Australian Health Care System. Though, the rate of transmission is still high among the health care providers in Australia. Compared to other developed countries, the prevalence of influenza infection is still high as vaccination is lower than 80% and 17-58% in other countries (Grohskopf, 2016).

Correspondingly, the government bestows the responsibility of vaccination to employees in Australian healthcare systems.  Then, the efforts of monitoring the spread of the infection are established by the selected employers such as senior practitioners. They ensure that nurses are vaccinated before they interact with influenza patients. On the other hand, nursing schools ensure that students are vaccinated before they engage with infected patients in their practice sessions (Heinrich, 2015).

Efforts of enrolling the elderly individuals, children, health care providers and expectant women in Australia rise as a result of increased vulnerability of the community to infections. Immunity in elderly individuals decreases with time. Normally, the body forms a strong defensive mechanism against the pathogen, but it weakens with age. Hence, pathogens act differently concerning age and other factors like nutrition and vulnerability (Imai, 2018). However, some individuals are special in that they cannot be subjected to vaccination due to medical reasons.

Similarly, young children have weak immunity mechanisms, and this situation increases their vulnerability to many infections including Influenza. Therefore, the initiative of offering free immunization to individuals in specific groups aims at increasing resistance as well as reducing the high incidence and prevalence rates of infections. Immunization, thus, helps the vulnerable populations and the community at large since the spread of infection to very young and old individuals who cannot be enrolled in the vaccination programs due to medical reasons (Toizumi, 2018). 

 


Various elderly patients may have issues with the influenza vaccine patients. De Serres (2017) implies that some of these incidences may occur when the vaccine failed in their system, caused contraindications or where awareness about the virus have not been efficient. Such situations occur in communities that reside in remote areas of Australia where resources of public awareness and health care services are limited. Based on a case study of a sixty-eight year old Aboriginal patient that resided in the northern parts of Australia, it was revealed that he neglected the annual influenza vaccination. He claimed that the vaccine would cause health implications that he did not possess.

The theory introducing the attenuated influenza vaccine in a healthy individual to trigger immunity could have misled the individual (O’Grady, 2015). Therefore, providing a surveillance evidence on the vaccine safety to the patient could change his point of view on the vaccine safety. Some evidence of safety revealed in 2017 shows that low rates of adverse events have been experienced. Only 6.6% of the elderly and young populations subjected to annual vaccination experienced adverse events. Among the vaccinated health care providers, only 0.4% were diagnosed with adverse events of influenza vaccination.

Another infections associated with influenza vaccination is the Guillain-Barre syndrome (Dunbar, 2015). Providing evidence of its prevalence in 1976 and how the situation has been regulated in 2018 would increase the awareness level in the patient. For example, it is estimated that only one out of a thousand individuals have the probability of contacting the Guillain-Barre syndrome as a result of the annual influenza vaccination in Australia.

Negative attitude and disparities established by nursing professionals might be a primary cause of why the rate of annual vaccination is still sub-optimal among the elderly and aboriginal populations in Australia (Nolan, 2016). Also, the vaccine recipients have beliefs, cultures, and values that dictate their behavior and response to health care issues and awareness. Therefore, Cultural safety in service delivery enables patients’ recovery, treatment and disease prevention procedures in the healthcare facility located in Australian Urban and rural settings. 

 


Cultural safety improves vaccination practice by ensuring that cost-effective services, quick, and effective vaccination approaches irrespective of the origin or race of the patient have been offered. Research reveals that indigenous Australians have been discriminated against while seeking health care service in the public health facilities of Australia. Some professional nurses provide care to patients that share a similar cultural atmosphere as them (Chotpitayasunondh, 2016). Therefore, cultural safety in alignment with nursing policies of care assists in increasing the awareness, effectiveness, and convenience in annual influenza vaccination among the selected groups.

Like in other countries, empowerment of patients have gained much attention in the Australian health care system.  Empowerment focusses on sharing of information, shared decision making, doctor-patient communication and safe care among the patients (Orr, 2016). In this manner, the target population in Australia gain the capability of making their own decisions in health matters and control the factors that affect health in their lives. Hence, effective sharing of knowledge about annual influenza vaccination among the old aged groups can help in solving the barriers to effective healthcare. Also, it promotes community development especially in rural settings dominated by aboriginal populations (Bennett, 2016).

In conclusion, this paper shed lights on annual influenza vaccination among the elderly populations in Australia. Increased vulnerability and age among individuals under the age of sixty-five years and above has summoned the intervention of the Australian healthcare in combatting the spread of influenza infection in Australia. Moreover, health care providers are also enrolled in the same program to minimize the prevalence and incidence of the infection among themselves and uninfected patients. Other factors such as empowerment and cultural safety assist in influenza prevention by fostering herd immunity as well as increasing the rate of vaccination. 

 

References

Belongia, E. A., Simpson, M. D., King, J. P., Sundaram, M. E., Kelley, N. S., Osterholm, M. T., & McLean, H. Q. (2016). Variable influenza vaccine effectiveness by subtype: a systematic review and meta-analysis of test-negative design studies. The Lancet Infectious Diseases, 16(8), 942-951.

Beyer, W. E. P., Palache, A. M., Boulfich, M., & Osterhaus, A. D. M. E. (2017). Rationale for two influenza B lineages in seasonal vaccines: A meta-regression study on immunogenicity and controlled field trial Wong, P. K., Bagga, H., Barrett, C., Hanrahan, P., Johnson, D., Katrib, A., ... & White, R. (2017). A practical approach to vaccination of patients with autoimmune inflammatory rheumatic diseases in Australia. Internal medicine journ 

Coleman, B. L., Fadel, S. A., Fitzpatrick, T., & Thomas, S. M. (2018). Risk factors for serious outcomes associated with influenza illness in high?versus low?and middle?income countries: Systematic literature review and meta?analysis. Influenza and other respiratory viruses, 12(1), 22-29.

Darvishian, M., Bijlsma, M. J., Hak, E., & van den Heuvel, E. R. (2014). Effectiveness of seasonal influenza vaccine in community-dwelling elderly people: a meta-analysis of test-negative design case-control studies. The Lancet Infectious Diseases, 14(12), 1228-1239.

De Serres, G., Skowronski, D. M., Ward, B. J., Gardam, M., Lemieux, C., Yassi, A., ... & Carrat, F. (2017). Influenza vaccination of healthcare workers: critical analysis of the evidence for patient benefit underpinning policies of enforcement. PloS one, 12(1), e0163586.

Demicheli, V., Jefferson, T., Ferroni, E., Rivetti, A., & Di Pietrantonj, C. (2018). Vaccines for preventing influenza in healthy adults. Cochrane Database of Systematic Reviews, (2).

Doherty, M., Schmidt-Ott, R., Santos, J. I., Stanberry, L. R., Hofstetter, A. M., Rosenthal, S. L., & Cunningham, A. L. (2016). Vaccination of special populations: protecting the vulnerable. Vaccine, 34(52), 6681-6690. Young, B., Zhao, X., Cook, A. R., Parry, C. M., Wilder-Smith, A., & I-Cheng, M. C. (2017). Do antibody responses to the influenza vaccine persist year-round in the elderly? A systematic review and meta-analysis. Vaccine, 35(2), 212-221.

Doherty, T. M., Connolly, M. P., Del Giudice, G., Flamaing, J., Goronzy, J. J., Grubeck-Loebenstein, B., ... & Schaffner, W. (2018). Vaccination programs for older adults in an era of demographic change. European geriatric medicine, 1-12.

Grohskopf, L. A. (2016). Prevention and control of seasonal influenza with vaccines. MMWR. Recommendations and Reports, 65.al, 47(5), 491-500.s. Vaccine, 35(33), 4167-4176.

Heinrich-Morrison, K., McLellan, S., McGinnes, U., Carroll, B., Watson, K., Bass, P., ... & Cheng, A. C. (2015). An effective strategy for influenza vaccination of healthcare workers in Australia: experience at a large health service without a mandatory policy. BMC infectious diseases, 15(1), 42.

Imai, C., Toizumi, M., Hall, L., Lambert, S., Halton, K., & Merollini, K. (2018). A systematic review and meta-analysis of the direct epidemiological and economic effects of seasonal influenza vaccination on healthcare workers. PloS one, 13(6), e0198685.

Jamotte, A., Chong, C. F., Manton, A., Macabeo, B., & Toumi, M. (2016). Impact of quadrivalent influenza vac Whitaker, J. A., von Itzstein, M. S., & Poland, G. A. (2018). Strategies to maximize influenza vaccine impact in older adults. Vaccine.cine on public health and influenza-related costs in Australia. BMC public health, 16(1), 630.

MacIntyre, C. R., Menzies, R., Kpozehouen, E., Chapman, M., Travaglia, J., Woodward, M., ... & Adair, T. (2016). Equity in disease prevention: Vaccines for the older adults–a national workshop, Australia 2014. Vaccine, 34(46), 5463-5469.

Matthews, I., & Dawson, H. (2018). The impact of dosing schedules on the success of vaccination programmes in elderly populations: A summary of current evidence. Human vaccines & immunotherapeutics, 1-6.

Nolan, T., Chotpitayasunondh, T., Capeding, M. R., Carson, S., Senders, S. D., Jaehnig, P., ... & Chandra, R. (2016). Safety and tolerability of a cell culture derived trivalent subunit inactivated influenza vaccine administered to healthy children and adolescents: A Phase III, randomized, multicenter, observer-blind study. Vaccine, 34(2), 230-236.

O’Grady, K. A. F., Dunbar, M., Medlin, L. G., Hall, K. K., Toombs, M., Meiklejohn, J., ... & Andrews, R. M. (2015). Uptake of influenza vaccination in pregnancy amongst Australian Aboriginal and Torres Strait Islander women: a mixed-methods pilot study. BMC research notes, 8(1), 169.

Orr, E., Bennett, N., Bradford, J., Johnson, S., Bull, A., Richards, M. J., & Worth, L. J. (2016). Hand hygiene monitoring in residential aged care: National and international perspectives with relevance to Australian facilities. Infect 

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