Vaccines in older age: moving from current practice to optimal coverage—a multidisciplinary consensus conference

Abstract

Vaccines are a key strategy to promote healthy aging, but vaccine coverage remains below target levels in at-risk adults and older individuals. We present here the results of a multidisciplinary consensus conference convened to perform a multidimensional assessment of vaccination in geriatric medicine, with a view to developing a well-defined strategy for the promotion of vaccines in older people. We discuss recommended vaccines in older individuals, and describe the wide regional heterogeneity between regions in the Italian context. The main obstacles to implementation of vaccines in practice are reviewed, as well as potential strategies to remove these barriers. Finally, the importance of including vaccines and vaccination in undergraduate and postgraduate medical education is underlined. The information summarized in this document is expected to help develop educational and promotional initiatives to achieve greater uptake of vaccines among older individuals, as a key means to promote healthy aging.

A scoping review of the changing landscape of geriatric medicine in undergraduate medical education: curricula, topics and teaching methods

“…We recommend that teaching on vaccinations for older adults is included in undergraduate Geriatric Medicine courses. Currently, vaccinations are generally taught to medical students during courses of Paediatrics and Public Health, but not during Internal or Geriatric Medicine courses [ 87 ]. As a result, older adults may not appear as a target population who would benefit from effective vaccinations, including those for influenza, pneumococcus and herpes zoster [ 87 , 88 ] and, now, COVID-19.…”

The well-known and less well-known benefits of vaccines

“…The useful public health paper from Antonelli Incalziet al in this issue [5] underlines with strong arguments and acknowledgeable scientific honesty, the need for increased vaccine awareness among the general public, health care professionals and health care deciders. To succeed in the current era marked by successive new infectious pandemics, vaccine policies must be better harmonized, widely disseminated and constantly updated.…”

“…With the outbreak of a new coronavirus (COVID-2019) that has been rearing its ugly head for several weeks in China and worldwide [1][2][3], the international press and the Coalition for Epidemic Preparedness Innovations have already advocated the urgent need to develop an appropriate vaccine [4]. This request illustrates without a doubt that although current uptake of adult vaccines is still too low in Italy, and in Europe in general [5], vaccines have a powerful (if not magic) perceived efficacy for the general public. Indeed, everyone seems to have understood that vaccines train the immune system to recognize and respond to a pathogen by mounting a rapid and effective immune defence, preventing the establishment of infection or disease, or decreasing the disease severity [6].…”

“…As stressed in the paper by Antonelli Incalzi and colleagues in this issue [5], vaccine hesitancy is linked to "the constant flow of contradictory, distorted or plainly false news about vaccines in the media, and much of this information stems from sources that are not scientifically robust". Disinformation of the public about vaccination is not compensated for by medical and paramedical personnel, in whom there is a notable lack of training, and who are often not updated about the burden of vaccine preventable diseases (VPDs) [7].…”

“…The tremendous positive clinical, social and economic impacts of vaccines on preventable infectious diseases are part of a multidimensional and integrated approach to healthy ageing. In their paper, Antonelli Incalzi et al propose homogeneous and efficacious strategies to scale up vaccination rates from children to seniors in Italy [5], recipes that will be very useful in other European countries. Among the most important recommendations, the following stand out in particular:…”