Elderly vaccination—The glass is half full

Abstract

The shifting global demography and ageing of populations worldwide brings with new challenges for the health care, and an imperative for healthy ageing and preventive health strategies for adults. Immunization is the low hanging fruit for healthy ageing, and yet under-utilized for various reasons, including waning immunity in the elderly, lack of RCT data in this age group, and lack of provider confidence in vaccines for the elderly. The elderly people have a higher incidence of infection and more severe and serious consequences of infection. Diseases such as influenza, pneumococcal disease and herpes zoster have long been recognized as causing a high burden in the elderly, but evidence is also emerging for other infections such as pertussis being a major cause of the morbidity in this age group. Now, there are several vaccines which can prevent major infectious diseases in the elderly. To improve uptake of these vaccines, elderly vaccination should be viewed through a different lens to pediatric vaccination, accepting that vaccines are less immunogenic in the elderly. The population health impact of vaccines in the elderly, despite of immunosenescence and lower immunogenicity, is still likely to be high given the increased disease incidence. Vaccination is an important and readily available means of prevention in the elderly.

Increasing Trends of Herpes Zoster in Australia

“…Decisions around vaccination are complicated by evidence of decreasing efficacy against zoster incidence based on age at vaccination [ 27 ] and waning in efficacy against zoster burden based on time since vaccination [ 30 ]. Waning of vaccine-induced immunity occurs with most vaccines and reflects the natural phenomenon of immunosenescence [ 54 ]. Waning of vaccine-induced immunity is critically important for infant vaccination, who have a full lifespan ahead of them, but is less important for the elderly, when expected lifespan is short.…”

“…Waning of vaccine-induced immunity is critically important for infant vaccination, who have a full lifespan ahead of them, but is less important for the elderly, when expected lifespan is short. The value of vaccines is a function of both immunogenicity and disease burden, and elderly vaccines should be considered within this equation [ 54 ]. Despite lower efficacy with age, HZ vaccination may have value in the older elderly because of higher disease burden [ 54 ].…”

“…The value of vaccines is a function of both immunogenicity and disease burden, and elderly vaccines should be considered within this equation [ 54 ]. Despite lower efficacy with age, HZ vaccination may have value in the older elderly because of higher disease burden [ 54 ]. Given waning vaccine immunity and limited duration of immunity, however, the timing and age of vaccination should be carefully planned to ensure that disease burden is not shifted further into unvaccinated older age groups, who have higher incidence of HZ and PHN.…”

“…Australia, like most developed countries has an ageing population [ 54 ] so healthy ageing and use of available preventive strategies are important. This study shows that the burden of HZ and PHN in the older Australian population is substantial and has been increasing since at least 2000.…”

If There were a Vaccine Against Acute Myocardial infarction, Would You Use it?

“…Despite influenza vaccine being recommended in many countries for patients with CVD [22], it has not made its way into practice as a routine measure to protect patients at risk, with vaccination rates in patients with CVD being low [23]. It has been shown that clinicians in general have a low awareness of adult vaccination and are not strong advocates for vaccination in adults [24,25]. Improved clinician awareness of the benefits of influenza vaccine in prevention of CVD events is needed to take advantage of vaccination as low-hanging fruit for prevention of AMI.…”