Aging Clinical and Experimental Research
199 Aging Clin Exp Res, Vol. 21, No. 3 (Aging Clin Exp Res 2009; 21: 199-200)
Key words: European advocacy, healthy aging, vaccine.
Correspondence: Jean-Pierre Michel, MD, Department of Rehabilitation and Geriatrics, Geneva Medical School and University Hospitals,
Chemin Pont Bochet, 3 Thonex-Geneve, CH 1226, Switzerland. E-mail: [email protected]
Received and accepted March 9, 2009.
Vaccinations: “not just for kids”
(1)
Jean-Pierre Michel
Department of Rehabilitation and Geriatrics, Geneva Medical School and University Hospitals,
Thonex-Geneve, Switzerland
Vaccines which have drastically reduced the burden
of childhood diseases are not yet accepted as contributing
to improving healthy aging (1-3). The non-respect and/or
absence of sustainability in vaccine programs do not enable
maintenance of life-long protection against such
child-hood diseases as diphtheria (4), measles (5) and pertussis
(6), which may result in increasing incidence of these
dis-eases in adults in the future (7). Infectious disdis-eases in
old-er people also remain a significant cause of morbidity
and mortality in the increasing population of adults aged 60
years and older (8, 9). The high burden of infectious
dis-eases in this segment of the population is disproportionate,
as many of these diseases are vaccine-preventable (10).
In 2001, the lower respiratory infections which
rep-resented the fourth most frequent cause of death in
high-income countries – 4.4% of total deaths (11) – are three
times more lethal in old than in young adults (12).
Sur-prisingly, tetanus is still a current active disease, with
210 cases in Portugal between 1993 and 2002 (13), 175
in England between 1984 and 2000 (14) and 158 in
Poland between 1998 and 2005 (15, 16) affecting
es-sentially adults over 55 years of age. In the 1990s, a
diph-theria epidemic in the newly independent states of the
for-mer Soviet Union claimed over 3000 lives, essentially
among persons aged 35 to 50 years (4). The notification
incidence of pertussis in the Netherlands also increased
no-tably between 1998-2001 and 2002-2005 in the older
population group (6). The annual incidence of Herpes
zoster in the general population is estimated at 3.6-14.2
cases/1000, and the recurrence risk is multiplied by 8 to
10 in adults over the age of 60 (17, 18).
Without a specific disease-preventable vaccine
pro-gram for adults aged 60 years and older, these
infec-tious diseases will keep their upper morbidity and mortality
ranks in the next few decades (19), whatever diagnostic and
therapeutic progress is made, because the worldwide
pro-portion of adults over the age of 60 will increase from 10%
in 2002 to 21% in 2050 (20). During the same period, the
increase will reach +60% in Europe (21).
These data explain why the two European geriatric and
gerontological societies (European Union Geriatric
Medicine Society [EUGMS] and the International
Asso-ciation of Gerontology and Geriatrics – European Region
[IAGG-ER]) decided to promote preventive aspects in
geriatric medicine, concerning both life
threatening-dis-eases (influenza, pneumococcal pneumonia and
tetanus/diphtheria) and diseases which adversely impact
patients’ quality of life (pertussis and herpes zoster).
Longer life expectation necessitates careful adaptation
of vaccine guidelines to contribute to healthy aging (22).
This special issue of Aging Clin Exp Res advocates the
need for a life-course vaccine program based on:
- Better knowledge of the process of immunosenescence
(see Grubeck-Loebenstein et al.) (23);
- Better understanding of the reasons for low vaccine
cov-erage in older European citizens (see Samson et al.) (24);
- A detailed inventory of the consequences of infectious
dis-eases and the potential benefits of their specific
vac-cine prevention (influenza: Gavazzi et al. (25),
pneumo-coccal pneumoniae: Chidiac et al. (26), tetanus:
Top-inkova et al. (27), and Herpes zoster: Johnson (28));
- The need for new educational tools (Belmin et al.) (29)
to contribute toward ensuring the willingness to vaccinate
and be vaccinated (Baeyens et al.) (30) to reach WHO
and EC vaccine goals (Gusmano et al.) (31).
The main focus of this European clinical vaccine
ad-vocacy (Michel et al.) (32) is to complement existing
in-formation and increase the acceptance of vaccinating
all adults aged 60 and older, their family members, and
healthcare professionals.
EDITORIAL
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sent
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11 – aare
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Vaccinations: not just for kids
Aging Clin Exp Res, Vol. 21, No. 3 200
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12
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