[Vaccination in older adults: compulsory or voluntary exercise?]

Area of Science:

• Gerontology
• Immunology
• Public Health

Background:

• Immunosenescence, the aging of the immune system, increases susceptibility to infections in older adults.
• Vaccination is a key preventive strategy, with guidelines like STIKO's (Permanent Vaccination Commission) specifically addressing vaccination for the elderly.
• Age-related immune decline necessitates specialized vaccination approaches.

Purpose of the Study:

• To review current vaccination strategies for older adults in light of immunosenescence.
• To highlight the effectiveness of newer, more immunogenic vaccines in this demographic.
• To address the need for updated vaccination recommendations considering multimorbidity and travel.

Main Methods:

• Review of current STIKO recommendations for adult vaccination.
• Analysis of vaccine effectiveness data for specific vaccines in older adults and those with multimorbidity.
• Consideration of emerging vaccine technologies and their potential impact.

Main Results:

• Certain vaccines, including cell culture-derived quadrivalent influenza vaccine, trivalent adjuvanted vaccine, high-dose influenza vaccine, and adjuvanted herpes zoster subunit vaccine, demonstrate higher immunogenicity and effectiveness in older adults.
• The adjuvanted herpes zoster subunit vaccine shows 90% effectiveness across all age groups.
• Travel vaccination advice for older adults must account for destination and multimorbidity, potentially requiring adjusted schedules and antibody titer monitoring.

Conclusions:

• Enhanced immunogenicity is critical for effective vaccination in older adults and patients with multimorbidity.
• Ongoing development of novel vaccines, such as for pneumococcal and norovirus infections, promises improved prevention.
• Personalized vaccination strategies, including titer monitoring and adjusted schedules, are essential for optimizing protection in aging populations.