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Immunosenescence and vaccine failure in the elderly

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Abstract

An age-related decline in immune responses in the elderly results in greater susceptibility to infection and reduced responses to vaccination. This decline in immune function affects both innate and adaptive immune systems. A meeting of experts in immunology and gerontology in Paris, France, in April 2008, considered current understanding of immunosenescence and its clinical consequences. Essential features of immunosenescence include: reduced natural killer cell cytotoxicity on a per cell basis; reduced number and function of dendritic cells in blood; decreased pools of naive T and B cells; and increases in the number of memory and effector T and B cells. In particular, an accumulation of late differentiated effector T cells, commonly associated with cytomegalovirus infection, contributes to a decline in the capacity of the adaptive immune system to respond to novel antigens. Consequently, vaccine responsiveness is compromised in the elderly, especially frail patients. Strategies to address the effects of immunosenescence include ensuring that seroprotective antibody levels against preventable infectious diseases are maintained throughout adulthood, and improving diet and exercise to address the effects of frailty. New vaccines are being developed, such as intradermal and high-dose vaccines for influenza, to improve the efficacy of immunization in the elderly. In the future, the development and use of markers of immunosenescence to identify patients who may have impaired responses to vaccination, as well as the use of end-points other than antibody titers to assess vaccine efficacy, may help to reduce morbidity and mortality due to infections in the elderly.

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Authors and Affiliations

  1. Institute for Biomedical Aging Research, Austrian Academy of Sciences, Rennweg 10, A-6020, Innsbruck, Austria

    Beatrix Grubeck-Loebenstein

  2. Laboratory of Immunology, Dipartimento di Scienze e Tecnologie Biomediche, Università degli Studi di Milano, Italy

    Silvia Della Bella

  3. Department of Medical and Surgical Specialities and Public Health, University of Perugia, Italy

    Anna Maria Iorio

  4. University Hospitals of Geneva, Switzerland

    Jean-Pierre Michel

  5. Centre for Medical Research, ZMF, University of Tübingen, Germany

    Graham Pawelec

  6. Department of Immunology, University of Cordoba, Spain

    Rafael Solana

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  1. Beatrix Grubeck-Loebenstein
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  2. Silvia Della Bella
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  3. Anna Maria Iorio
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Correspondence to Beatrix Grubeck-Loebenstein.

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Grubeck-Loebenstein, B., Della Bella, S., Iorio, A.M. et al. Immunosenescence and vaccine failure in the elderly. Aging Clin Exp Res 21, 201–209 (2009). https://doi.org/10.1007/BF03324904

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