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Promotion of a Lifelong Immunization Program for Healthy Ageing

  • Johan FlamaingEmail author
Chapter
Part of the Practical Issues in Geriatrics book series (PIG)

Abstract

Ageing, frailty, and comorbidity increase the susceptibility to infections and enhance the consequences (morbidity, mortality, and costs) of these infections. Tetanus, pertussis, diphtheria, influenza, pneumococcal disease, and herpes zoster are vaccine preventable diseases (VPDs) frequently occurring in the older population. Immunity against these infections needs to be acquired early in life and tends to wane at higher ages (immunosenescence). During life vaccines can offer protection against VPD directly to the vaccinated person but also indirectly to non-vaccinated persons by herd protection. Vaccine formulations and strategies need to be adapted to yield a long-lasting protection against VPD. Integration of vaccines in a lifelong vaccination program offers the best possibility to obtain this goal. Yet, vaccination uptake in the (older) adult population is inconsistent or low. Vaccination implementation is complex and needs coordination between vaccine recipients, healthcare professionals, and the healthcare systems to improve vaccination coverage.

Keywords

Vaccine preventable disease Immunosenescence Herd protection Vaccination strategies Older persons 

References

  1. 1.
  2. 2.
    Centers for Disease Control and Prevention (2011) VPD Surveillance Manual, 5th edn. Tetanus: Chapter 16–1. https://www.cdc.gov/vaccines/pubs/surv-manual/chpt16-tetanus.pdf. Accessed Sept 2017
  3. 3.
    Williams WW, Lu PJ, O’Halloran A et al (2015) Vaccination coverage among adults, excluding influenza vaccination—United States, 2013. MMWR Morb Mortal Wkly Rep 64:95–102PubMedPubMedCentralGoogle Scholar
  4. 4.
    WHO immunization, vaccines and biologicals: Diphteria. http://www.who.int/immunization/monitoring_surveillance/burden/diphtheria/en/
  5. 5.
    Edmunds WJ, Pebody RG, Aggerback H et al (2000) The sero-epidemiology of diphtheria in Western Europe. ESEN Project. European Sero-Epidemiology Network. Epidemiol Infect 125:113–125CrossRefGoogle Scholar
  6. 6.
  7. 7.
    Ridda I, Yin JK, King C et al (2012) The importance of pertussis in older adults: a growing case for reviewing vaccination strategy in the elderly. Vaccine 30:6745–6752CrossRefGoogle Scholar
  8. 8.
    Williams WW, Lu PJ, O’Halloran A et al (2017) Surveillance of vaccination coverage among adult populations—United States, 2015. MMWR Surveill Summ 66:1–28CrossRefGoogle Scholar
  9. 9.
    Van Damme P, Burgess M (2004) Immunogenicity of a combined diphtheria-tetanus-acellular pertussis vaccine in adults. Vaccine 22:305–308CrossRefGoogle Scholar
  10. 10.
    Fleming DM, Taylor RJ, Haguinet F et al (2016) Influenza-attributable burden in United Kingdom primary care. Epidemiol Infect 144:537–547CrossRefGoogle Scholar
  11. 11.
    Vestergaard LS, Nielsen J, Krause TG et al (2017) Excess all-cause and influenza-attributable mortality in Europe, December 2016 to February 2017. Euro Surveill 22:30506.  https://doi.org/10.2807/1560-7917.ES.2017.22.14.30506 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
  13. 13.
    Poscia A, Stojanovic J, Ricciardi W (2016) The sustainability of influenza vaccination programs: considerations and perspectives from Italy. J Prev Med Hyg 57:E9–E12PubMedPubMedCentralGoogle Scholar
  14. 14.
    Wetenschappelijk Instituut Volksgezondheid, Gezondheidsenquête 2013, rapport 5: preventie. https://his.wiv-isp.be/nl/Gedeelde%20%20documenten/VA_NL_2013.pdf
  15. 15.
    Centers for Disease Control and Prevention (1998 to 2015) Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Streptococcus pneumoniae Google Scholar
  16. 16.
    WHO (2012) Pneumococcal vaccines WHO position paper—2012. Wkly Epidemiol Rec 87:129–144 http://www.who.int/wer/2012/wer8714.pdf?ua=1 Google Scholar
  17. 17.
    Public Health England (2017) Pneumococcal Polysaccharide Vaccine (PPV) coverage report, England, April 2016 to March 2017. Health Protect Rep 11:23 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/624133/hpr2317_PPV.pdf Google Scholar
  18. 18.
    Black CL, Williams WW, Warnock R et al (2017) Pneumococcal vaccination among Medicare beneficiaries occurring after the advisory committee on immunization practices recommendation for routine use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults aged ≥65 years. MMWR Morb Mortal Wkly Rep 66:728–733CrossRefGoogle Scholar
  19. 19.
    Schröder C, Enders D, Schink T et al (2017) Incidence of herpes zoster amongst adults varies by severity of immunosuppression. J Infect 75:207–215CrossRefGoogle Scholar
  20. 20.
    Drolet M, Brisson M, Schmader KE et al (2010) The impact of herpes zoster and post-herpetic neuralgia on health-related quality of life: a prospective study. CMAJ 182:1731–1736CrossRefGoogle Scholar
  21. 21.
    McLaughlin JM, McGinnis JJ, Tan L et al (2015) Estimated human and economic burden of four major adult vaccine-preventable diseases in the United States, 2013. J Prim Prev 36:259–273CrossRefGoogle Scholar
  22. 22.
    Chen WH, Kozlovsky BF, Effros RB et al (2009) Vaccination in the elderly: an immunological perspective. Trends Immunol 30:351–359CrossRefGoogle Scholar
  23. 23.
    Yao X, Hamilton RG, Weng NP et al (2011) Frailty is associated with impairment of vaccine-induced antibody response and increase in post-vaccination influenza infection in community-dwelling older adults. Vaccine 29:5015–5021CrossRefGoogle Scholar
  24. 24.
    Van Epps P, Tumpey T, Pearce MB et al (2017) Preexisting immunity, not frailty phenotype, predicts influenza postvaccination titers among older veterans. Clin Vaccine Immunol 24:e00498PubMedPubMedCentralGoogle Scholar
  25. 25.
    Falkenhorst G, Remschmidt C, Harder T et al (2017) Effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal disease in the elderly: systematic review and meta-analysis. PLoS One 12:e0169368CrossRefGoogle Scholar
  26. 26.
    van Werkhoven CH, Huijts SM, Bolkenbaas M et al (2015) The impact of age on the efficacy of 13-valent pneumococcal conjugate vaccine in elderly. Clin Infect Dis 61:1835–1838CrossRefGoogle Scholar
  27. 27.
    Nunzi E, Iorio AM, Camilloni B (2017) A 21-winter seasons retrospective study of antibody response after influenza vaccination in elderly (60-85 years old) and very elderly (>85 y.o.) institutionalized subjects. Hum Vaccin Immunother 13(11):2659–2668.  https://doi.org/10.1080/21645515.2017.1373226 CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Jackson ML, Chung JR, Jackson LA et al (2017) Influenza vaccine effectiveness in the United States during the 2015-2016 season. N Engl J Med 377:534–543CrossRefGoogle Scholar
  29. 29.
    Castilla J, Guevara M, Martínez-Baz I et al (2015) Enhanced estimates of the influenza vaccination effect in preventing mortality: a prospective cohort study. Medicine (Baltimore) 94:e1240CrossRefGoogle Scholar
  30. 30.
    Oxman MN, Levin MJ, Johnson GR et al (2005) A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med 352:2271–2284CrossRefGoogle Scholar
  31. 31.
    Cunningham AL, Lal H, Kovac M et al (2016) Efficacy of the Herpes Zoster subunit vaccine in adults 70 years of age or older. N Engl J Med 375:1019–1032CrossRefGoogle Scholar
  32. 32.
    Van Damme P, McIntyre P, Grimprel E et al (2011) Immunogenicity of the reduced-antigen-content dTpa vaccine (Boostrix(®)) in adults 55 years of age and over: a sub-analysis of four trials. Vaccine 29:5932–5939CrossRefGoogle Scholar
  33. 33.
    Lang PO, Aspinall R (2014) Vaccination in the elderly: what can be recommended? Drugs Aging 31:581–589CrossRefGoogle Scholar
  34. 34.
    Grohskopf LA, Sokolow LZ, Broder KR et al (2017) Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2017-18 Influenza Season. MMWR Recomm Rep 66:1–20CrossRefGoogle Scholar
  35. 35.
    Bonanni P, Azzari C, Castiglia P et al (2014) The 2014 lifetime immunization schedule approved by the Italian scientific societies. Italian Society of Hygiene, Preventive Medicine, and Public Health. Italian Society of Pediatrics. Italian Federation of Pediatric Physicians. Italian Federation of General Medical Physicians. Arezzo Service of Legal Medicine. Epidemiol Prev 38:131–146PubMedGoogle Scholar
  36. 36.
    Bonanni P, Bonaccorsi G, Lorini C et al (2017) Focusing on the implementation of 21st century vaccines for adults. Vaccine. pii: S0264-410X(17)31036–8. [Epub ahead of print].  https://doi.org/10.1016/j.vaccine.2017.07.100 CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Geriatric MedicineUZ LeuvenLeuvenBelgium
  2. 2.Division of Gerontology and Geriatrics, Department of Chronic Diseases, Metabolism, and Ageing (CHROMETA)KU LeuvenLeuvenBelgium

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