When does immunity drop off?

3 minute read

Professor Robert Booy explains how age-related decline in immunity contributes to increased risk of illness.

GPs need more convincing about the reality of age-related decline in immunity.

It seems like simple common sense that immunity decreases with age. But how early does immunity begin to decrease? 

Professor Robert Booy, Australian infectious disease specialist, explains that this age-related decline in immunity contributes to increased risk of illness in adults.1-3

“Some healthcare professionals think of immunity decreasing around 70 or 80 years of age, but the reality is that, in clinical terms, the immune system in many people actually starts to decline from about 50 years1-3. This means it’s important to start protecting adults from infectious diseases early on,” said Professor Booy.

Professor Booy, who has worked in vaccinology, epidemiology and infectious disease for over 30 years, says vaccination uptake in adults is low in comparison to children.

“We know that vaccination plays a key role in improving the overall health and wellbeing of older adults1-3 so we really need to focus on getting the rates much higher within that age group,” said Professor Booy.

“Accepting that immunity declines with age is an important step in helping adults stay healthier. GPs have a big role to play in this.”

Recent research has shown that when GPs do proactively discuss vaccines with adult patients about 75% of them end up getting vaccinated.4

However, a new survey5 by The Medical Republic of over 100 healthcare professionals has suggested some GPs are not convinced about the reality of age-related decline in immunity.

Surprisingly, 1 in 4 respondents were unsure of the effects of aging on the immune system (25%) and 5% suspect that immunity does not decline significantly with age.

Nearly one in five GPs said they were either unsure, would rarely consider the age-related decline in immunity, or would tend not to take it into account when giving advice to their elderly patients.

Professor Booy says these results are quite concerning given the impact that age-related decline in immunity can have on the health outcomes of Australian adults.

“Accepting that immunity declines with age is a very important consideration to make when providing advice to patients,” said Professor Booy.

“Given its relevance to a range of conditions with serious health consequences – everything from whooping cough to shingles – and the focus the COVID-19 pandemic has placed on it, I’m hoping that GPs will play a key role in educating patients about it in the future.”


  1. Kandeil W, Atanasov P, Avramioti D et al. The burden of pertussis in older adults: what is the role of vaccination? A systematic literature review. Expert Rev Vaccines. 2019;18(5):439-455
  2. Weiskopf D, Weinberger B & Grubeck-Loebenstein B. The aging of the immune system. European Society for Organ Transplantation 22. 2009 1041–1050.
  3. Weinberger B. Vaccines for the elderly: current use and future challenges. Immunity & Ageing. 2018, 15:3.
  4. Bayliss J, Randhawa R, Oh K. Perceptions of vaccine preventable diseases in Australian healthcare: focus on pertussis. Human Vaccines & Immunotherapeutics. 2021, 17(2), 344-3503
  5. ‘Assessing healthcare professionals understanding of age-related decline in immunity’, TMR survey commissioned by GSK Australia in December 2020/January 2021. 115 general practitioners surveyed.

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