[Influenza: special aspects in old age]

Area of Science:

• Immunology
• Public Health
• Geriatrics

Background:

• Influenza affects up to 20% of the German population annually, with a disproportionate impact on individuals aged 60 and older, who account for 90% of influenza-related deaths.
• Immunosenescence, the aging of the immune system, increases susceptibility to infections and alters typical symptoms in the elderly, potentially delaying diagnosis and treatment.
• This age-related immune decline can also reduce the effectiveness of standard influenza vaccinations.

Purpose of the Study:

• To highlight the significant burden of seasonal influenza, particularly influenza A (H3N2), on the elderly population in Germany.
• To discuss the implications of immunosenescence on infection susceptibility, symptom presentation, and vaccine efficacy in older adults.
• To inform about current vaccination recommendations for seasonal influenza in Germany, emphasizing strategies for improved prevention in the elderly.

Main Methods:

• Review of epidemiological data on influenza prevalence and mortality in Germany.
• Discussion of the immunological changes associated with immunosenescence.
• Analysis of vaccine efficacy and recommendations from the Standing Vaccination Committee (STIKO).

Main Results:

• Seasonal influenza A (H3N2) poses a substantial risk to the elderly in Germany, contributing to high morbidity and mortality.
• Immunosenescence complicates influenza diagnosis and treatment in older adults and diminishes the effectiveness of conventional vaccines.
• Adjuvanted vaccines or those with higher antigen content show promise for enhancing immune response and are suitable for the elderly.

Conclusions:

• Influenza vaccination is strongly recommended for individuals aged 60 and over, as well as other at-risk groups, by the STIKO.
• For the 2018/19 season, the STIKO recommended quadrivalent (tetravalent) influenza vaccines for broader protection.
• Strategies to improve influenza prevention in the elderly, including the use of enhanced vaccines, are crucial given the challenges posed by immunosenescence.