Seasonal influenza immunisation: Strategies for older adults

Abstract

Adults over the age of 60-65 years suffer disproportionally from seasonal influenza, experiencing high rates of complications, exacerbation of underlying medical comorbidities, and excess mortality. Thus, older adults are an important priority for influenza immunisation campaigns. Unfortunately, older adults generally display lower immune responses to standard influenza vaccines because of immunosenescence, with resulting suboptimal vaccine effectiveness. Thus, the development of improved vaccines that heighten immune responses and improve effectiveness is an important medical need. To this end, enhanced influenza vaccines specifically targeting this age group have been developed, which seek to overcome the inherent limitations in the immune responses of older adults. Both the licensed high-dose trivalent influenza vaccine (hdTIV) containing fourfold higher antigen contents than standard vaccine, and the MF59 -adjuvanted trivalent influenza vaccine (aTIV) have been proven to be safe and well-tolerated while enhancing the immune response. Healthcare providers for populations of older adults should be advised to routinely use these enhanced influenza vaccines in seasonal immunisation campaigns to provide improved immunity against influenza and its consequences in this particularly susceptible age group.

Impfen im Alter – Pflicht oder Kür?

“…Rund 90 % der Todesfälle entfallen auf die 60-Jährigen und Älteren. Die hohe Krankheitslast der Influenza ist bei Älteren vor allem durch Infektionen mit Influenza A (H3/N2) bedingt [4]. Die STIKO empfiehlt die quadrivalente Influenza-Vakzine (QIV).…”

Immunogenicity and Protective Efficacy of Influenza A DNA Vaccines Encoding Artificial Antigens Based on Conservative Hemagglutinin Stem Region and M2 Protein in Mice

“…Both humoral and cell-mediated responses contribute to organism protection against the influenza virus [13,14], but the proportion of their contribution is not obvious hitherto.…”

AuNP-M2e + sCpG vaccination of juvenile mice generates lifelong protective immunity to influenza A virus infection

“…This seems to be predominantly caused by immunosenescence, or the decreased efficiency of the immune system as a result of aging [24]. In response to influenza this is characterized as decreased antibody-mediated and cellular immunity and decreased responsiveness to vaccines, as decreased thymus function limits the induction of new and memory responses to antigens [24–26]. Adults over 65 typically experience altered clinical presentation of influenza A with reduced fever symptoms but increased respiratory symptoms, including coughing and wheezing [26].…”

“…In response to influenza this is characterized as decreased antibody-mediated and cellular immunity and decreased responsiveness to vaccines, as decreased thymus function limits the induction of new and memory responses to antigens [24–26]. Adults over 65 typically experience altered clinical presentation of influenza A with reduced fever symptoms but increased respiratory symptoms, including coughing and wheezing [26]. These patients also have increased rates of deadly complications, namely pneumonia to which people over 65 are already at increased risk [26, 27].…”

“…Adults over 65 typically experience altered clinical presentation of influenza A with reduced fever symptoms but increased respiratory symptoms, including coughing and wheezing [26]. These patients also have increased rates of deadly complications, namely pneumonia to which people over 65 are already at increased risk [26, 27].…”