Abstract
Despite the marked reduction in mortality from infectious diseases during the twentieth century, infections remain a major cause of morbidity and mortality in the elderly. Pneumonia, for example, is the second leading cause of death in octogenarians (Kohn, 1982). Influenza occurs more frequently in the elderly and is often an antecedent of bacterial pneumonia and death (Ailing et al., 1981). Although other factors are certainly involved, such as the presence of underlying disease or the use of immunosuppressive medicines, it is reasonable to assert that age-related immune deficiency contributes to the predisposition to certain infections, such as influenza, in the elderly. This chapter reviews current influenza vaccination recommendations for the elderly and presents indications of the shortcomings or successes of such vaccines. Because age-related changes in immune functions may well account for the diminished antibody response to vaccine, selected research strategies designed to augment vaccine response are also discussed.
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Ailing, D. W., Blackwelder, W. C., and Stuart-Harris, C. H., 1981, A study of excess mortality during influenza epidemics in the United States, 1968–1976, Am. J. Epidemiol 113: 30–43.
Arden, N. H., Patriarca, P. A., and Kendal, A. P., 1986a, Experiences in the use and efficacy of inactivated influenza vaccine in nursing home, in: Options for the Control of Influenza ( A. P. Kendal and P. A. Patriarca, eds.), Liss, New York, pp. 155–168.
Arden, N. H., Patriarca, P. A., Lui, K-J., Harmon, M. W., Brandon, F., and Kendal, A. P., 1986b, Safety and immunogenicity of a 45 mg supplemental dose of inactivated split-virus influenza B vaccine in the elderly, J. Infect. Dis. 153: 805–806.
Arroyo, J. C., Postic, B., Brown, A., Harrison, K., Birgenheier, R., and Dowda, H., 1984, Influenza A/Philippines/2/82 outbreak in a nursing home: Limitation of influenza vaccination in the aged, Am. J. Infect. Control 12: 329–334.
Barker, W. H., and Mullooly, J. P., 1980, Influenza vaccination of elderly persons: Reduction in pneumonia and influenza hospitalizations and deaths, JAMA 244: 2547–2549.
Brandriss, M. W., Betts, R. F,, Mathur, U., and Douglas, R. G., 1981, Responses of elderly subjects to monovalent A/USSR/77/(HINI) and trivalent A/USSR/77(HINI)-A Texas/77 (H3N2)™B/Hong Kong/72 vaccines, Am. Rev. Respir. Dis. 124: 681–684.
Callard, R. E., Basten, A., and Waters, L. K., 1977, Immune function in aged mice. II. B-cell function, Cell. Immunol. 31: 26–36.
Centers for Disease Control, 1977, Influenza vaccine: Recommendations of the Public Health Service Committee on immunization practices, Ann. Intern. Med. 87: 316–318.
Centers for Disease Control, 1986, Recommendations for prevention and control of influenza: Recommendations of the Immunization Practices Advisory Committee, Ann. Intern. Med. 105: 399–104.
Chang, M. P., Makinodan, T., Peterson, W. J., and Strehler, B. L., 1983, Role of T-cells and adherent cells in age-related decline in murine interleukin-2 production, J. Immunol. 129: 2426–2430.
Compans, R. W., Jones, L. U., and Melsen, L. R., 1986, Organization and assembly of influenza virus proteins, in: Options for the Control of Influenza ( A. P. Kendal and P. A. Patriarca, eds.), Liss, New York, pp. 23–38.
Cromwell, H. A., Brandon, F. B., McLean, I. W., and Sadusk, J. F., 1969, Influenza immunization: A new vaccine, JAMA 210: 1438–1442.
D’Agastaro, G., Frasca, D., Garovini, M., and Doria, G., 1980, Immunorestoration of old mice by injection of thymus extract. Enhancement of t-cell-t-cell cooperation in the in vitro antibody response, Cell. Immunol. 53: 207–213.
D’Alessio, D. J., Cox, P. M., and Dick, E. C., 1969, Failure of inactivated influenza vaccine to protect an aged population, JAMA 210: 485–489.
Ershler, W. B., Moore, A. L., and Hacker, M. P., 1982, Specific in vivo and in vitro antibody response to tetanus toxoid immunization, Clin. Exp. Immunol. 49: 552–558.
Ershler, W. B., Moore, A. L., and Socinski, M. A., 1984a, Influenza and aging: Age-related changes and the effects of thymosin on the antibody response to influenza vaccine, J. Clin. Immunol. 4: 445–454.
Ershler, W. B., Moore, A. L., Hacker, M. P., Nimomiya, J., Naylor, P., and Goldstein, A. L., 1984b, Specific antibody synthesis in vitro. II. Age-associated thymosin enhancement of antitetanus antibody synthesis, Immunopharmacology 8: 69–77.
Ershler, W. B., Moore, A. L., Roessner, K., and Ranges, G. E., 1985a, Interleukin-2 and aging: Decreased IL-2 production in healthy older people does not correlate with reduced helper cell numbers or antibody response to influenza vaccine and is not corrected in vitro by Thymosin Alpha One, Immunopharmacology 10: 11–17.
Ershler, W, B., Hebert, J. C., Blow, A. J., Granter, S. R., and Lynch, J., 1985b, Effect of thymosin alpha one on specific antibody response and susceptibility to infection in young and aged mice, Int. J. Immunopharmacol. 7: 465–471.
Fedson, D. S., 1987, Influenza and pneumococcal immunization strategies for physicians, Chest 91: 436–443.
Frasca, D., Garavini, M., and Doria, G., 1982, Recovery of t-cell functions in aged mice injected with synthetic thymosin alpha one, Cell. Immunol. 72: 384–391.
Frasca, D., Adorini, L., Mancini, C., and Doria, G., 1986, Reconstitution of t-cell functions in aging mice by thymosin alpha one, Immunopharmacology 11: 155–163.
Gerbase-DeLima, M., Meredith, P., and Walford, R. L., 1975, Age-related changes, including synergy and suppression in the mixed lymphocytes reaction in long-lived mice, Fed. Proc. 34: 159–161.
Gillis, S., 1983, Interleukin 2: Biology and biochemistry, J. Clin. Immunol. 3: 1–13.
Gillis, S., Kozak, R., Durante, M., and Weksler, M. E., 1981, Immunologic studies of aging: Decreased production and response to T-cell growth factor by lymphocytes from aged humans, J. Clin. Invest. 67: 937–942.
Goldstein, A. L. (ed.), 1984, Thymic Hormones and Lymphokines. Basic Chemistry and Clinical Applications, Plenum, New York.
Gravenstein, S., Miller, B. A., Duthie, P., Drinka, P. J., Prathipatti, K., Odiet, F. M., Schicker, J. M., Siewert, M. E., and Ershler, W. B., 1987, Enhancement of anti-influenza antibody response in elderly men by thymosin alpha one, Clin. Res. 35: 346a.
Gravenstein, S., Miller, B. A., and Ershler, W. B., 1988, Immunogenicity of an influenza virus hemagglutinin-diphtheria toxoid conjugate vaccine in elderly outpatients: A placebo controlled dose response study, Clin. Res. 36: 338a.
Gravenstein, S., Duthie, E. H., Miller, B. A., Roecker, E., Drinka, P., Prathipati, K., and Ershler, W. B., 1989, Augmentation of influenza antibody response in elderly men by thymosin alpha one, J. Am. Geriatrics Soc. 37: 1–8.
Gross, P. A., Quinnan, G. V., Weksler, M. E., Gaerlan, P. F., and Denning, C. R., 1988, Immunization of elderly people with high doses of influenza vaccine, J. Am. Geriatr. Soc. 36: 209–212.
Howells, C. H. L., Vesselinova-Jenkins, C. K., Evans, A. D., and James, J., 1975, Influenza vaccination and mortality from bronchopneumonia in the elderly, Lancet 1: 381–383.
Kendal, A. P., Patriarca, P. A., and Arden, N. H., 1985, Policies and outcomes for control of influenza among the elderly in the USA, Vaccine 3: 274–276.
Kilbourne, E. D., 1987, Influenza, Plenum, New York.
Kishumoto, S., Tomino, S., Mitsuya, H., Fujiwara, H., and Tsuda, H., 1980, Age-related decline in the in vitro and in vivo synthesis of anti-tetanus antibody in humans, J. Immunol. 125: 2347–2352.
Kohn, R. R., 1982, Causes of death in very old people, JAMA 247: 2793–2797.
LaForce, F. M., 1987, Immunization, immunoprophylaxis and chemoprophylaxis to prevent selected infections: A report of the U.S. preventive service task force, JAMA 257: 2464–2470.
Landesman, S. H., and Schiffman, G., 1981, Assessment of antibody response to pneumococcal vaccine in high risk population, Rev. Infect. Dis. 3: 184–197.
Laver, W. G., and Valentine, R. C., 1969, Morphology of the isolated hemagglutinin and neuraminidase subunits of influenza virus, Virology 38: 105–119.
Levine, M., Beattie, B. L., McLean, D. M., and Corman, D., 1987, Characterization of the immune response to trivalent influenza vaccine in elderly men, J. Am. Geriatr. Soc. 35: 609–615.
Low, T. L. K., and Goldstein, A. L., 1984, Thymosin, peptidic moieties and related agents, in: Immune Modulation Agents and Their Mechanisms ( R. L. Fenichel and M. A. Chingos, eds.), Dekker, New York, pp. 135–162.
Lui, K. J., and Kendal, A. P., 1987, Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985, Am. J. Public Health 77: 712–716.
Makinodan, T., and Kay, M. M. B., 1980, Age influence on the immune system, Adv. Immunol. 29: 287–329.
Miller, R. A., and Stutman, O., 1982, Enumeration of IL-2 secretory helper T-cells by limiting dilution analysis and demonstration of unexpectedly high levels of IL-2 production per responding cell, J. Immunol. 128: 2258–2264.
Miller, B. A., Gravenstein, S., Carlson, J., and Ershler, W. B., 1987, Influenza-diphtheria conjugate vaccine study in the elderly, Gerontologist 27: 86a.
Phair, J., Kauffman, C. A., Bjornson, A., Adams, L., and Linnemann, C., 1978, Failure to respond to influenza vaccine in the aged: Correlation with B-cell number and function, J. Lab. Clin. Med. 92: 822–828.
Pisciotta, A. V., Westring, D. W., DePrey, C., and Walsh, B., 1967, Mitogenic effect of phytohemag-glutinin at different ages, Nature (Lond.) 215: 193–194.
Profeta, M. L., Guidi, G., Meroni, P. L., Palmieri, R., Palladino, G., Cantone, V., and Zanussi, C., 1987, Influenza vaccination with adjuvant RU41740 in the elderly, Lancet 1: 973.
Ruben, F. L., 1982, Prevention of influenza in the elderly, J. Am. Geriatr. Soc. 30: 577–580.
Ruben, F. L., Johnston, F., and Streiff, E. J., 1974, Influenza in a partially immunized aged population: Effectiveness of killed Hong Kong vaccine against infection with the England strain, JAMA 230: 863–866.
Setia, U., Serventi, I., and Lorenz, P., 1985, Factors affecting the use of influenza vaccine in the institutionalized elderly, J. Am. Geriatr. Soc. 33: 856–858.
Shulof, R. S., Lloyd, M. J., Cleary, P. A., Palaszynski, S. R., Mai, D. A., Cox, J. W., Alabaster, O., and Goldstein, A. L., 1985, A randomized trial to evaluate the immunorestorative properties of synthetic thymosin alpha one with lung cancer, J. Biol. Respir. Modif. 4: 147–158.
Strassburg, M. A., Greenland, S., Sorvillo, F. J., Lieb, L. E., and Habel, L. A., 1986, Influenza in the elderly: Report of an outbreak and a review of vaccine effectiveness reports, Vaccine 4: 38–44.
Stuart, W. H., Dull, B., Newton, L. H., McQueen, J. L., and Schiff, E. R., 1969, Evaluation of monovalent influenza vaccine in a retirement community during the epidemic of 1965–1966, JAMA 209: 232–238.
Thoman, M., and Weigle, W. O., 1981, Lymphokines and aging: Interleukin 2 production and activity in aged animals, J. Immunol. 127: 2102–2106.
Thoman, M., and Weigle, W. O., 1982, Cell mediated immunity in aged mice: An underlying lesion in IL-2 synthesis, J. Immunol. 128: 2358–2361.
Van Der Veen, J., Van Der Werf, P. A. M., Masurel, N., and Polak, M. F., 1977, Influenza in a partially vaccinated community of elderly persons, Ned. T. Geneesk. 121: 1259–1262.
Virelizier, J-L., Postlethwaite, R., Schild, G. C., and Allison, D. C., 1974, Antibody response to antigenic determinants of influenza virus hemagglutinin. I. Thymus dependence of antibody formation and thymus independence of immunological memory, J. Exp. Med. 140: 1559–1570.
Wilcox, H. N. A., 1975, Thymus dependence of the antibody response to tetanus toxoid in mice, Clin. Exp. Immunol. 22: 341–347.
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© 1990 Plenum Press, New York
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Ershler, W.B. (1990). Influenza and Aging. In: Goldstein, A.L. (eds) Biomedical Advances in Aging. GWUMC Department of Biochemistry Annual Spring Symposia. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0513-2_51
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DOI: https://doi.org/10.1007/978-1-4613-0513-2_51
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