An old problem with new solutions: Strategies to improve vaccine efficacy in the elderly

Bell, Matthew R.; Kutzler, Michele A.

doi:10.1016/j.addr.2022.114175

Cited by 9 publications

(13 citation statements)

References 195 publications

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“…Interestingly, this association was not observed when the effects of the third vaccine dose were analyzed. The impact of age on vaccine efficacy is a well-known issue [ 48 , 49 ]. More often, in the elderly, the outcome of infections [ 50 , 51 ] is more severe and may have serious clinical consequences as the efficacy of the immune response and the ability to properly respond to vaccines decline with age.…”

Section: Discussionmentioning

confidence: 99%

Systemic and Mucosal Humoral Immune Response Induced by Three Doses of the BNT162b2 SARS-CoV-2 mRNA Vaccines

et al. 2022

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BNT162b2 (BioNTech/Pfizer) was the first SARS-CoV-2 mRNA vaccine approved by the European Medicines Agency. We monitored the long-term humoral responses of healthcare workers (HCWs) who received three vaccine doses. A total of 59 healthcare workers were studied: 47 were never SARS-CoV-2-infected (naïve-HCWs), and 12 (infected-HCWs) recovered from COVID-19 before the first vaccine. Serum and saliva were collected at baseline (before the first dose), just before the second dose, 1, 3, 6, and 9 months after the second dose, and 10 days after the third vaccine. SARS-CoV-2-specific IgG and IgA were evaluated in serum and saliva, respectively, and the presence of neutralizing antibodies (NAb) was analyzed in serum. SARS-CoV-2-specific IgG peaked one month after the second vaccine in naïve-HCWs but right before this timepoint in infected-HCWs. IgG titers significantly decreased during follow-up and at month 9 were still detectable in 50% of naïve-HCWs and 90% of infected-HCWs. NAb were significantly decreased 6 months after the second vaccine in naïve-HCWs and 9 months after this dose in infected-HCWs. Salivary SARS-CoV-2-specific IgA titers were significantly higher in infected-HCWs and were undetectable 9 months after the second vaccine in 43% of the naïve-HCWs alone. The third vaccine greatly increased humoral IgG and mucosal IgA in both groups. Two BNT162b2 doses induced strong systemic and humoral immune responses; to note, these responses weakened over time, although they are more prolonged in individuals who had recovered from COVID-19. The third vaccine dose quickly boosts systemic and mucosal humoral responses.

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Section: Discussionmentioning

confidence: 99%

Systemic and Mucosal Humoral Immune Response Induced by Three Doses of the BNT162b2 SARS-CoV-2 mRNA Vaccines

et al. 2022

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“…Although this study confirmed the safety and effectiveness of vaccination for the elderly, the strategy of vaccination for the young cannot be simply translated to the elderly population, and how to further improve the efficacy and safety of vaccination for the elderly needs to be concerned. It is recommended that the elderly should be vaccinated with adjuvants to enhance the humoral response and increase the antibody titer and serum conversion rate in the elderly [ 51 ]. Without affecting safety, high-dose vaccination can enhance the humoral response of elderly patients and improve the efficacy [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of COVID-19 Vaccination in Older Adults: A Systematic Review and Meta-Analysis

et al. 2022

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Objective: To analyze the differences in efficacy and safety of different types of novel coronavirus pneumonia (COVID-19) vaccines in different age groups (young adults and elderly). Methods: Randomized controlled trials (RCTs) on COVID-19 vaccine in PubMed, Embase, Web of Science, and Cochrane library were searched by computer, and eight eligible studies were analyzed. Meta-analysis was performed using Stata 16.0 and RevMan5.4 software. Results: The mean geometric titer (GMT) of the virus in the elderly was significantly higher than that in the placebo group (SMD = 0.91, 95% CI (0.68, 1.15), p < 0.01), presenting no obvious difference compared with the young adults (SMD = 0.19, 95% CI (0.38, 0.01), p = 0.06). Meanwhile, the effect of multiple vaccinations was better than that of single vaccination (SMD = 0.83, 95% CI (0.33, 1.34), p < 0.01). However, the number of adverse events (AEs) in the elderly was lower than that in the young adults (OR = 0.35, 95% CI (0.29, 0.42), p < 0.01). Conclusions: The immunization effect of COVID-19 vaccine in the elderly is obvious, especially after multiple vaccinations, and the incidence of AEs in the elderly is low, which proves that the vaccination of the elderly is safe and effective.

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“…Age has a major influence on the vaccine response. With age, the ability to develop an immune response following vaccination and the resistance against infections decrease gradually, leading to a reduction in vaccine efficacy in the older adults [ [88] , [89] , [90] , [91] ]. Influenza vaccine efficacy is lower in the older adults than in young adults, which could be attributed to the reduction in antibody production and T cell immune response owing to the reduced migration of dendritic cells to draining lymph nodes.…”

Section: Gut Microbiota As a Natural Adjuvant For Respiratory Vaccinesmentioning

confidence: 99%

Dietary intervention with functional foods modulating gut microbiota for improving the efficacy of COVID-19 vaccines

Oh¹,

Seo²

2023

Heliyon

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An old problem with new solutions: Strategies to improve vaccine efficacy in the elderly

Cited by 9 publications

References 195 publications

Systemic and Mucosal Humoral Immune Response Induced by Three Doses of the BNT162b2 SARS-CoV-2 mRNA Vaccines

Systemic and Mucosal Humoral Immune Response Induced by Three Doses of the BNT162b2 SARS-CoV-2 mRNA Vaccines

Efficacy and Safety of COVID-19 Vaccination in Older Adults: A Systematic Review and Meta-Analysis

Dietary intervention with functional foods modulating gut microbiota for improving the efficacy of COVID-19 vaccines

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