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Impfungen im höheren Lebensalter

Vaccination in advanced age

  • Arzneimitteltherapie
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Zusammenfassung

Infektionskrankheiten sind auch in den entwickelten Ländern für bis zu 5 % der Todesfälle verantwortlich. Hinzu kommt eine zunehmende Infektanfälligkeit alter Menschen aufgrund der physiologischen Alterung des Immunsystems. Das Prinzip der Impfung beruht auf einer zielgerichteten Aktivierung des menschlichen Immunsystems. Prinzipiell wird zwischen einer passiven Immunisierung, also der Applikation spezifischer Antikörper gegen einen Erreger, und der aktiven Immunisierung unterschieden. Bei der aktiven Immunisierung, also der Impfung, werden abgeschwächte (attenuierte) bzw. abgetötete Erreger oder Erregerbestandteile (Antigene) verabreicht. Nach einer von der Impfung abhängigen Latenzzeit wird der volle Impfschutz erreicht; für eine gewisse Zeit bleibt die Immunität dann bestehen. Im Gegensatz zu Totimpfstoffen besteht bei der Impfung mit Lebendimpfstoffen grundsätzlich das Risiko einer Infektion mit dem applizierten Impfstamm. Bei der passiven Immunisierung werden Antikörper appliziert. In der Regel erfolgt die passive Immunisierung bei Personen, die Kontakt mit einem infektiösen Patienten hatten und bei denen keine oder keine sichere Immunität gegen die entsprechende Krankheit besteht.

Abstract

Infectious diseases are responsible for up to 5% of fatalities even in developed countries. In addition, there is an increasing susceptibility for infections in elderly people due to physiological aging of the immune system. The principles of vaccination are based on a targeted activation of the human immune system. Principally, a distinction is made between passive immunization, i.e. the application of specific antibodies against a pathogen and active immunization. In active immunization, i.e. vaccination, weakened (attenuated) or dead pathogens or components of pathogens (antigens) are administered. After a latency period that depends on the vaccine, complete immune protection is achieved and immunity is maintained for a certain period of time. In contrast to dead vaccines, by the use of live vaccines there is always a risk for infection with the administered vaccine. In passive immunization antibodies are administered. As a rule passive immunization is carried out in persons who have had contact with an infected person and in whom no or uncertain immunity against the corresponding disease is present. Based on the recommendations of the Standing Committee on Vaccination (STIKO), influenza, pneumococcal, herpes zoster, early summer meningoencephalitis (FSME) and travel vaccines are described.

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Authors and Affiliations

  1. Lehrstuhl für Geriatrie, Universität Witten/Herdecke, Witten, Deutschland

    H. J. Heppner MHBA

  2. Geriatrische Klinik und Tagesklinik, Helios Klinikum Schwelm, Dr.-Moeller-Str. 15, 58332, Schwelm, Deutschland

    H. J. Heppner MHBA

  3. Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Deutschland

    H. J. Heppner MHBA

  4. Klinik für Geriatrie, Alexianer Krefeld, Krefeld, Deutschland

    A. Leischker

  5. Institut für Virologie und Antivirale Therapie, Universitätsklinikum Jena, Jena, Deutschland

    P. Wutzler

  6. Klinik für Geriatrie, Universitätsklinikum Jena, Jena, Deutschland

    A. Kwetkat

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  1. H. J. Heppner MHBA
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Correspondence to H. J. Heppner MHBA.

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Interessenkonflikt

H.J. Heppner erhielt Vortragshonorare der Firmen Pfizer Pharma GmbH, Bayer Health Care, Novartis Pharma und Astellas Pharma. A. Leischker erhielt Vortragshonorare der Firmen Pfizer Pharma GmbH und Sanofi. A. Kwetkat erhält ein Forschungsstipendium des Forschungskollegs Geriatrie der Robert Bosch Stiftung, Stuttgart, und eine Forschungsförderung als „unrestricted grant“ der Firma Pfizer. Sie ist Mitglied im PCV-13-Adult Advisory Board der Firma Pfizer Pharma GmbH und erhielt Vortragshonorare von den Firmen Pfizer, MSD und Novartis. P. Wutzler gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Heppner, H.J., Leischker, A., Wutzler, P. et al. Impfungen im höheren Lebensalter. Internist 59, 205–212 (2018). https://doi.org/10.1007/s00108-017-0358-1

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  • DOI: https://doi.org/10.1007/s00108-017-0358-1

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