Profiling Vaccines for an Immunosenescent and Multimorbid Population

  • Rino RappuoliEmail author
Part of the Practical Issues in Geriatrics book series (PIG)


Vaccines have contributed substantially to the gain in life expectancy achieved in the last few centuries. Nowadays, new target groups for vaccination are garnering increasing attention, such as the elderly and pregnant women, as they have the potential to yield substantial health benefits from vaccination. In the last few decades, new advanced technologies have made it possible to produce vaccines that were previously unthinkable. For example, genome sequencing has made it possible to discover novel vaccine antigens derived directly from genomic information. Recombinant DNA, glycoconjugation and reverse vaccinology are part of an explosion of new technologies in immunology and synthetic biology, opening broad new horizons in vaccine technology. In the future, we may achieve the production of fully synthetic vaccines. Systems biology is helping to enhance our understanding of the immune system, and how these new vaccines may elicit protection, while in the approach termed “systems vaccinology,” high-dimensionality studies of cellular and molecular responses to vaccines have been proposed to help formulate hypotheses regarding the mechanisms of immunosenescence and to identify potential biomarkers worthy of investigation. Recent advances in adjuvant technology are a further major component of vaccine development. All these new technologies and approaches have enabled significant progress in our knowledge of immune response and how it can be stimulated. The future may bring vaccines for illnesses previously considered impossible to prevent and in populations with immunosenescence.


Vaccination Immunosenescence Adjuvants Genome sequencing Reverse vaccinology Systems biology Systems vaccinology Immune response 


  1. 1.
    Kontis V, Bennett JE, Mathers CD, Li G, Foreman K, Ezzati M. Future life expectancy in 35 industrialised countries: projections with a Bayesian model ensemble. Lancet. 2017;389(10076):1323–35.CrossRefGoogle Scholar
  2. 2.
    Rappuoli R, Mandl CW, Black S, De Gregorio E. Vaccines for the twenty-first century society. Nat Rev Immunol. 2011;11(12):865–72.CrossRefGoogle Scholar
  3. 3.
    Rappuoli R, Bottomley MJ, D’Oro U, Finco O, De Gregorio E. Reverse vaccinology 2.0: human immunology instructs vaccine antigen design. J Exp Med. 2016;213(4):469–81.CrossRefGoogle Scholar
  4. 4.
    Parikh SR, Andrews NJ, Beebeejaun K, Campbell H, Ribeiro S, Ward C, et al. Effectiveness and impact of a reduced infant schedule of 4CMenB vaccine against group B meningococcal disease in England: a national observational cohort study. Lancet. 2016;388(10061):2775–82.CrossRefGoogle Scholar
  5. 5.
    Dormitzer PR, Grandi G, Rappuoli R. Structural vaccinology starts to deliver. Nat Rev Microbiol. 2012;10(12):807–13.CrossRefGoogle Scholar
  6. 6.
    Liljeroos L, Malito E, Ferlenghi I, Bottomley MJ. Structural and computational biology in the design of immunogenic vaccine antigens. J Immunol Res. 2015;2015:156241.CrossRefGoogle Scholar
  7. 7.
    McLellan JS, Chen M, Leung S, Graepel KW, Du X, Yang Y, et al. Structure of RSV fusion glycoprotein trimer bound to a prefusion-specific neutralizing antibody. Science. 2013;340(6136):1113–7.CrossRefGoogle Scholar
  8. 8.
    Germain RN. Will systems biology deliver its promise and contribute to the development of new or improved vaccines? What really constitutes the study of “systems biology” and how might such an approach facilitate vaccine design. Cold Spring Harb Perspect Biol. 2017;10(8). Scholar
  9. 9.
    Goronzy JJ, Weyand CM. Understanding immunosenescence to improve responses to vaccines. Nat Immunol. 2013;14(5):428–36.CrossRefGoogle Scholar
  10. 10.
    Fourati S, Cristescu R, Loboda A, Talla A, Filali A, Railkar R, et al. Pre-vaccination inflammation and B-cell signalling predict age-related hyporesponse to hepatitis B vaccination. Nat Commun. 2016;7:10369.CrossRefGoogle Scholar
  11. 11.
    Di Pasquale A, Preiss S, Tavares Da Silva F, Garcon N. Vaccine adjuvants: from 1920 to 2015 and beyond. Vaccines (Basel). 2015;3(2):320–43.CrossRefGoogle Scholar
  12. 12.
    Vesikari T, Knuf M, Wutzler P, Karvonen A, Kieninger-Baum D, Schmitt HJ, et al. Oil-in-water emulsion adjuvant with influenza vaccine in young children. N Engl J Med. 2011;365(15):1406–16.CrossRefGoogle Scholar
  13. 13.
    Mannino S, Villa M, Apolone G, Weiss NS, Groth N, Aquino I, et al. Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy. Am J Epidemiol. 2012;176(6):527–33.CrossRefGoogle Scholar
  14. 14.
    Didierlaurent AM, Laupeze B, Di Pasquale A, Hergli N, Collignon C, Garcon N. Adjuvant system AS01: helping to overcome the challenges of modern vaccines. Expert Rev Vaccines. 2017;16(1):55–63.CrossRefGoogle Scholar
  15. 15.
    Rts SCTP, Agnandji ST, Lell B, Soulanoudjingar SS, Fernandes JF, Abossolo BP, et al. First results of phase 3 trial of RTS,S/AS01 malaria vaccine in African children. N Engl J Med. 2011;365(20):1863–75.CrossRefGoogle Scholar
  16. 16.
    Lal H, Cunningham AL, Godeaux O, Chlibek R, Diez-Domingo J, Hwang SJ, et al. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. N Engl J Med. 2015;372(22):2087–96.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.GlaxoSmithKline Vaccines S.r.l.SienaItaly

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