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Older Australians not protected against pertussis: Study


Matt Woodley


2/12/2020 4:23:52 PM

The new research also found GP recommendations can play a key role in increasing adult vaccination coverage for the disease.

Doctor talking with patient.
Nearly three quarters of adult respondents proceeded to be vaccinated when GPs proactively raised the topic.

The findings were derived from four surveys conducted between 2014 and 2018, involving more than 400 GPs and 6500 patients.
 
They found discussions around adult vaccination against pertussis only occurred in less than 10% of general practice encounters, with GPs tending to focus primarily on vaccinating those in close contact with young children.
 
UNSW epidemiologist Professor Mary-Louise McLaws is a proponent of adult vaccination against pertussis, having contracted the disease herself later in life.
 
‘When I say that protecting adults from diseases that are vaccine-preventable is important, I’m not just talking as a professional epidemiologist but also as someone with a personal experience of pertussis,’ Professor McLaws said.
 
‘The cough is insidious. It becomes more and more persistent, gets worse at night and hangs around for weeks.
 
‘It stayed with me for three months.’
 
According to the surveys, when adult vaccination was discussed, only around half of GPs spontaneously recalled talking about pertussis vaccination. It was also revealed that GPs were twice as likely to recommend pertussis vaccination for grandparents compared to adults of a similar age who were not in contact with children.
 
However, while there is room for improvement, Dr Rodney Pearce, GP and Chair of the Immunisation Coalition, said the protection of adults – particularly older Australians – has come into sharp focus in recent times.
 
‘People aged over 65 are at increased risk of complications if they contract pertussis,’ he said.
 
‘So as per the current guidelines from the Australian Technical Advisory Group on Immunisation (ATAGI), healthcare professionals need to be framing their recommendations around the health of older adults, independent of contact with young children.
 
‘It has been shown through COVID-19 that older adults have lower immunity and higher vulnerability to infectious diseases such as pertussis.
 
‘GPs are uniquely placed to increase vaccination coverage via their advice to patients about pertussis at a time when many older adults are feeling particularly vulnerable.
 
Unvaccinated adults identified a lack of GP recommendation (52%) and lack of awareness of the need for adult vaccination (26%) as the two top reasons for not being vaccinated.
 
When GPs did proactively discuss vaccines, nearly three quarters of adult respondents proceeded to be vaccinated, and a recommendation from a GP was found to be a strong predictor for an adult to receive a pertussis vaccine.
 
Research co-author Associate Professor Michael Nissen, Director of Scientific Affairs and Public Health at GSK Greater China Intercontinental (GCI), said the results are concerning given as few as one in nine people have received a pertussis vaccine in adolescence or adulthood.
 
‘Despite evidence of disease burden from pertussis in adults and correlations between older age and hospitalisation rates from the disease, we still have relatively low immunisation rates in adulthood for pertussis,’ he said.
 
‘The drivers seem to be low awareness and low GP recommendation for adult vaccination. We definitely have two key factors to work on there.’
 
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