Why vaccinations should be considered at every life stage, not just childhood

Most Singaporeans are familiar with the National Childhood Immunisation Schedule (NCIS), either from receiving the recommended vaccinations during childhood or ensuring their children do. However, awareness of the National Adult Immunisation Schedule, which offers guidance on vaccinations against 11 vaccine-preventable diseases for persons aged 18 and above, remains relatively low. 

This discrepancy in awareness is evident in the uptake of pneumococcal vaccination. Among those aged 65 to 74, the uptake was only 26.5 per cent, according to the National Health Population Survey 2022. In contrast, childhood pneumococcal vaccination, which is part of the NCIS, reached 81.5 per cent in 2017, according to a 2023 research study. 

THE 3CS OF VACCINE HESITANCY

Dr Kim Lavoie, a senior researcher in behavioural science, practising clinical health psychologist and Tier 1 Canada research chair in behavioural medicine at the University of Quebec at Montreal, has studied adult vaccine hesitancy extensively. She leads the international iCARE Study project, which assesses population attitudes and adherence to infectious disease prevention measures, including vaccination. 

Dr Lavoie identified complacency, confidence and convenience as key factors behind adult vaccine hesitancy. She explained that the biggest reason, complacency, is tied to low perceived risk: “When people don’t recognise the need to get vaccinated, it undermines their motivation to do so.”

The overwhelming success of vaccines at eradicating once-common diseases has also reduced the perceived need to be vaccinated, she added. For example, without having witnessed the harms caused by polio, measles and mumps, adults might not fully appreciate or understand the necessity of getting vaccinated against these diseases.

“The second factor is confidence. A lot of patients are concerned about side effects, but extensive data show that vaccines are safe,” shared Dr Lavoie. 

Convenience, the third factor, refers to the accessibility and affordability of vaccinations, which vary by country. “When vaccinations are not covered by insurance or healthcare systems, patients might perceive them as unimportant or unnecessary,” she said.  

Dr Lavoie highlighted a fourth possible factor: Confusion over how vaccines work. “A majority think that vaccinations prevent illness entirely. For example, many expected the COVID-19 vaccinations to stop them from getting sick, rather than just mitigating severe illness and hospitalisation. This perception has led to feelings of being misled and undermined trust in vaccines.” 

There is also a belief that too many vaccines can overload the immune system. Dr Lavoie refuted this, noting that babies typically tolerate a six-in-one combination vaccine for a range of illnesses like diphtheria, polio, hepatitis B and haemophilus influenzae type B quite well. 

MORE THAN JUST A PERSONAL DECISION

While many view getting vaccinations as a personal choice, Dr Lavoie underscored that the effects of remaining unvaccinated extend beyond the individual. “A transmissible disease affects communities, not just individuals,” she pointed out.  

For example, influenza is known to cause high rates of illness and hospitalisation among the elderly and those with pre-existing chronic diseases. Every year, influenza leads to the deaths of 290,000 to 650,000 people worldwide due to respiratory complications. 

For herd immunity against a specific disease to be achieved, the target immunisation rate is typically 90 to 95 per cent, she explained. This level of coverage allows for a few cases of the disease to occur without resulting in widespread transmission within the community. 

Additionally, allowing viruses to spread unchecked enables them to mutate and evade vaccines, rendering them ineffective. “This could have serious public health implications as the spread of disease impacts almost all aspects of life. Healthcare systems that aren’t built to sustain the high level of patient traffic could collapse under the strain,” she said.  

A JOINT APPROACH TO LIFE-COURSE VACCINATION

To promote a lifelong vaccination strategy, Dr Lavoie shared that healthcare providers, patients and pharmaceutical companies all have roles to play. 

Healthcare providers should stay informed about the latest vaccine recommendations, communicate them to patients and offer support with the decision-making process. This includes answering patients’ questions and equipping them with medically accurate knowledge. Dr Lavoie noted that as more people turn to online sources for medical advice, patients may struggle to determine the reliability of such information. 

“I aim to equip patients with tools to navigate the online landscape such as checking article references to ensure they come from credible sources like scientific journals,” she said. “Patients should take a proactive approach to seeking out information and regard family doctors as the most trustworthy source, as they have a comprehensive overview of their medical history.” 

Dr Lavoie added that pharmaceutical companies need to continue innovating and conducting research and development into vaccines: “These organisations are the most suitable conduit for informing healthcare providers of the latest evidence through training and education.” 

Dr Lavoie considers vaccines a crucial part of disease prevention, alongside other game-changing medical interventions such as penicillin. “The world needs to shift from a treatment mindset to a prevention mindset when it comes to healthcare. Prevention is more sustainable and cost-effective and leads to a better quality of life.” 

Speak to your healthcare provider to learn more about your recommended vaccinations.

Views expressed by the expert are solely her own. This advertorial is meant for educational purposes only and does not endorse, reference and/or recommend any product. For more information, consult a healthcare professional. Information in this article is valid till June 2026.