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

Zhang, Lei; Jiang, Lihong; Tian, Tian; Li, Wenjing; Pan, Yong‐Bao; Wang, Yongchen

doi:10.3390/vaccines11010033

Cited by 14 publications

(14 citation statements)

References 55 publications

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“…Our findings are consistent with those of several studies suggesting that the elderly may experience fewer adverse events following COVID-19 vaccination than younger people. 37 , 38 Vaccine-related systemic adverse events are related to immune responses, and the incidence of early adverse events is low if the immune response is weak. 39 Lower antibody levels in the elderly after vaccination also confirm this finding.…”

Section: Discussionmentioning

confidence: 99%

Safety, immunogenicity and protective effect of sequential vaccination with inactivated and recombinant protein COVID-19 vaccine in the elderly: a prospective longitudinal study

Liu,

Xie,

Yang

et al. 2024

Sig Transduct Target Ther

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The safety and efficacy of COVID-19 vaccines in the elderly, a high-risk group for severe COVID-19 infection, have not been fully understood. To clarify these issues, this prospective study followed up 157 elderly and 73 young participants for 16 months and compared the safety, immunogenicity, and efficacy of two doses of the inactivated vaccine BBIBP-CorV followed by a booster dose of the recombinant protein vaccine ZF2001. The results showed that this vaccination protocol was safe and tolerable in the elderly. After administering two doses of the BBIBP-CorV, the positivity rates and titers of neutralizing and anti-RBD antibodies in the elderly were significantly lower than those in the young individuals. After the ZF2001 booster dose, the antibody-positive rates in the elderly were comparable to those in the young; however, the antibody titers remained lower. Gender, age, and underlying diseases were independently associated with vaccine immunogenicity in elderly individuals. The pseudovirus neutralization assay showed that, compared with those after receiving two doses of BBIBP-CorV priming, some participants obtained immunological protection against BA.5 and BF.7 after receiving the ZF2001 booster. Breakthrough infection symptoms last longer in the infected elderly and pre-infection antibody titers were negatively associated with the severity of post-infection symptoms. The antibody levels in the elderly increased significantly after breakthrough infection but were still lower than those in the young. Our data suggest that multiple booster vaccinations at short intervals to maintain high antibody levels may be an effective strategy for protecting the elderly against COVID-19.

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Section: Discussionmentioning

confidence: 99%

Safety, immunogenicity and protective effect of sequential vaccination with inactivated and recombinant protein COVID-19 vaccine in the elderly: a prospective longitudinal study

Liu,

Xie,

Yang

et al. 2024

Sig Transduct Target Ther

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“…Injection site pain, fatigue, and headache are the most reported adverse effects. Rarely, thromboembolic phenomena have been reported with mRNA vaccines and viral vector vaccines 6 . Interestingly, metastatic disease, advanced age, and male sex in patients with solid tumors are independent risk factors that have been shown to reduce antibody response following vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…Rarely, thromboembolic phenomena have been reported with mRNA vaccines and viral vector vaccines. 6 Interestingly, metastatic disease, advanced age, and male sex in patients with solid tumors are independent risk factors that have been shown to reduce antibody response following vaccination. Vaccine induced lymphadenopathy has been noted in patients with preexisting breast cancer and melanoma, with persistence of lymphadenopathy for more than 6 weeks in 29% of patients.…”

Section: Discussionmentioning

confidence: 99%

Metastatic prostatic adenocarcinoma presenting as generalized lymphadenopathy unmasked by a COVID booster vaccine

Bharathidasan,

Tran,

Ghafouri

et al. 2023

Clinical Case Reports

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Key Clinical MessageLymphadenopathy following recent immunization is usually regional. Generalized lymphadenopathy should arouse suspicion for alternative underlying pathology. Prostate adenocarcinoma should be considered in the differential diagnosis for malignancy in an elderly male patient. Metastatic prostate adenocarcinoma can have good prognostic outcomes if treatment is started promptly, even in the setting of widespread disease.AbstractGeneralized lymphadenopathy is commonly attributed to infectious causes or malignancy, often lymphoproliferative disorders. We present a rare case of metastatic prostate cancer diagnosed after initially presenting as generalized lymphadenopathy following a coronavirus disease 2019 (COVID) booster vaccination. A 70‐year‐old Hispanic male presented with left lower quadrant abdominal pain, nausea, headache, myalgia, severe constipation, and a right‐sided neck swelling that had been increasing in size since the day of his vaccination. Computed tomography (CT) scans of soft tissue neck, chest, abdomen, and pelvis with contrast showed extensive lymphadenopathy. Ultrasound‐guided biopsy results of the enlarged right supraclavicular node and prostate revealed histopathology consistent with that of prostate acinar adenocarcinoma. He started on bicalutamide for 4 weeks, transitioned to gonadotropin releasing hormone analogue (leuprolide) injections every 3 months and oral androgen receptor signaling inhibitor (abiraterone with prednisone daily). PSA level declined from 121 ng/mL at diagnosis to 1.3 ng/mL after 3 months of therapy, and repeat imaging showed marked improvement in the size of his mediastinal, retroperitoneal, and pelvic lymphadenopathy. To the best of our knowledge, this is the first case reported of a COVID vaccine booster uncovering lymphadenopathy leading to the diagnosis of metastatic prostate cancer.

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“…This tendency might be related to the difference in antigen presentation and modes of action of both vaccine types [ 104 ]. More importantly, according to a recent systematic review and meta-analysis, giving multiple COVID-19 vaccinations to the elderly is considered effective and safe [ 105 ].…”

Section: Recommended Vaccines For the Elderlymentioning

confidence: 99%

Challenges in the Vaccination of the Elderly and Strategies for Improvement

Soegiarto

Purnomosari

2023

Pathophysiology

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In recent years, the elderly has become a rapidly growing proportion of the world’s population as life expectancy is extending. Immunosenescence and inflammaging contribute to the increased risk of chronic non-communicable and acute infectious diseases. Frailty is highly prevalent in the elderly and is associated with an impaired immune response, a higher propensity to infection, and a lower response to vaccines. Additionally, the presence of uncontrolled comorbid diseases in the elderly also contributes to sarcopenia and frailty. Vaccine-preventable diseases that threaten the elderly include influenza, pneumococcal infection, herpes zoster, and COVID-19, which contribute to significant disability-adjusted life years lost. Previous studies had shown that conventional vaccines only yielded suboptimal protection that wanes rapidly in a shorter time. This article reviews published papers on several vaccination strategies that were developed for the elderly to solve these problems: more immunogenic vaccine formulations using larger doses of antigen, stronger vaccine adjuvants, recombinant subunit or protein conjugated vaccines, newly developed mRNA vaccines, giving booster shots, and exploring alternative routes of administration. Included also are several publications on senolytic medications under investigation to boost the immune system and vaccine response in the elderly. With all those in regard, the currently recommended vaccines for the elderly are presented.

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

Cited by 14 publications

References 55 publications

Safety, immunogenicity and protective effect of sequential vaccination with inactivated and recombinant protein COVID-19 vaccine in the elderly: a prospective longitudinal study

Safety, immunogenicity and protective effect of sequential vaccination with inactivated and recombinant protein COVID-19 vaccine in the elderly: a prospective longitudinal study

Metastatic prostatic adenocarcinoma presenting as generalized lymphadenopathy unmasked by a COVID booster vaccine

Challenges in the Vaccination of the Elderly and Strategies for Improvement

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