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[Influenza: special aspects in old age].

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|June 29, 2018
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Summary

Influenza significantly impacts the elderly in Germany, increasing infection risk and reducing vaccine effectiveness due to immunosenescence. Enhanced vaccines are recommended for this vulnerable population.

Keywords:
Immunologic adjuvantsImmunosenescenceOrthomyxoviridaeQuadrivalent influenza vaccineRecommendations, health planning

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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.