Vaccines for Older Adults: Current Practices and Future Opportunities

Description

Many infectious diseases are more frequent and are associated with high morbidity and mortality in older adults. Vaccination is the most efficient strategy to prevent infections, and older adults are an important target population for vaccination in order to promote health in this age group. Age-related changes in the immune system as well as other factors, such as comorbidities, obesity or frailty, influence vaccine-induced immune responses in old age. Awareness that vaccines developed for children might not be optimal for adults, and particularly for the older population, has only arisen in the recent past. Vaccination against influenza, pneumococcal disease, and herpes zoster is specifically recommended for older adults in many countries, and various strategies have been pursued in order to optimize these vaccines. However, there are still many pathogens, which severely affect the older population, but for which no vaccines are currently available. Extensive research and development are ongoing to further improve existing vaccines and to design novel vaccines in order to provide protection for this vulnerable age group. In order to exploit the full protective potential of vaccines it is essential to improve vaccine uptake and overcome vaccine hesitancy by providing information and education to stakeholders, health care professionals, and the general public. This book is relevant for researchers working on age-related changes in the immune system or on vaccine development, for health care professionals treating older patients, and for the stakeholders and decision makers involved in vaccination recommendations and implementation.

Informations

• Publié par: S. Karger AG
• Date de parution: 09 avril 2020
• Nombre de lectures: 1
• EAN13: 9783318066784
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Vaccines for Older Adults: Current Practices and Future Opportunities
Interdisciplinary Topics in Gerontology and Geriatrics
Vol. 43
Series Editor
Tamas Fulop Sherbrooke, QC
 
Vaccines for Older Adults: Current Practices and Future Opportunities
Volume Editor
Birgit Weinberger Innsbruck
17 figures, 9 in color, and 11 tables, 2020
_______________________ Birgit Weinberger Institute for Biomedical Aging Research University Innsbruck Rennweg 10 AT–6020 Innsbruck (Austria)
Library of Congress Cataloging-in-Publication Data
Names: Weinberger, Birgit, editor.
Title: Vaccines for older adults : current practices and future opportunities / volume editor, Birgit Weinberger.
Other titles: Interdisciplinary topics in gerontology and geriatrics ; v. 43. 2297-3508
Description: Basel ; New York : Karger, 2020. | Series: Interdisciplinary topics in gerontology and geriatrics, 2297-3508 ; vol. 43 | Includes bibliographical references and index. | Summary: “This book summarizes age-related changes of the immune system and their impact on immune responses to vaccination, as well as other factors influencing vaccine-induced immune responses in old age. It gives an overview of vaccines which are currently available for older adults and of novel technologies and targets which hopefully will lead to more and improved vaccines for this vulnerable population”-- Provided by publisher.
Identifiers: LCCN 2019059866 | ISBN 9783318066777 (hardcover ; alk. paper) | ISBN 9783318066784 (ebook)
Subjects: MESH: Vaccines | Aged | Vaccination | Immunity--physiology | Aging--physiology | Age Factors
Classification: LCC QR189 | NLM W1 IN679 v.43 2020 | DDC 615.3/72--dc23
LC record available at https://lccn.loc.gov/2019059866
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents® and PubMed/MEDLINE.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2020 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland)
www.karger.com
Printed on acid-free and non-aging paper (ISO 9706)
ISSN 2297–3508
e-ISSN 2297–3486
ISBN 978–3–318–06677–7
e-ISBN 978–3–318–06678–4
 
Contents
Preface
Weinberger, B. (Innsbruck)
Immunosenescence and Other Risk Factors Affecting Vaccination Success in Old Age
How Inflammation Blunts Innate Immunity in Aging
Goldberg, E.L.; Shaw, A.C.; Montgomery, R.R. (New Haven, CT)
Natural Killer Cells, Aging, and Vaccination
Witkowski, J.M. (Gdansk); Larbi, A. (Singapore/Tunis); Le Page, A.; Fülöp, T. (Sherbrooke, QC)
Changes in T Cell Homeostasis and Vaccine Responses in Old Age
Wong, G.C.L. (Singapore); Strickland, M.C. (Singapore/Southhampton); Larbi, A. (Singapore/Sherbrooke, QC/Tunis)
Age-Related Changes in B Cells Relevant to Vaccine Responses
Dunn-Walters, D.K.; Stewart, A.T.; Sinclair, E.L.; Serangeli, I. (Guildford)
Comorbidities in the Elderly and Their Possible Influence on Vaccine Response
Kwetkat, A. (Jena); Heppner, H.J. (Witten/Schwelm)
The Impact of Obesity and Metabolic Syndrome on Vaccination Success
Frasca, D.; Blomberg, B.B. (Miami, FL)
Current Vaccines for the Older Population
Influenza Vaccination: Accelerating the Process for New Vaccine Development in Older Adults
McElhaney, J.E. (Sudbury, ON); Andrew, M.K. (Halifax, NS); Haynes, L.; Kuchel, G.A. (Farmington, CT); McNeil, S.A. (Halifax, NS); Pawelec, G. (Sudbury, ON/Tübingen)
Vaccines to Protect Older Adults against Pneumococcal Disease
van de Garde, M.D.B.; Knol, M.J.; Rots, N.Y.; van Baarle, D.; van Els, C.A.C.M. (Bilthoven)
Herpes Zoster and Its Prevention by Vaccination
Johnson, R.W. (Bristol); Levin, M.J. (Aurora, CO)
Vaccination of Adults and the Older Population against Tetanus, Diphtheria, Pertussis, and Tick-Borne Encephalitis: The Importance of Booster Vaccinations throughout Life
Weinberger, B. (Innsbruck)
Vaccines for Older Travelers
Jilg, W. (Regensburg)
The Future of Vaccines for the Older Population
Vaccination against Respiratory Syncytial Virus
Green, C.A. (Oxford/Birmingham); Drysdale, S.B. (Oxford/London); Pollard, A.J. (Oxford); Sande, C.J. (Oxford/Kilifi)
Vaccination Against Nosocomial Infections in Elderly Adults
Anderson, A.S.; Scully, I.L.; Pride, M.W.; Jansen, K.U. (Pearl River, NY)
Novel Technologies to Improve Vaccines for Older Adults
Laupèze, B.; van der Most, R. (Wavre); Del Giudice, G. (Siena)
Strategies to Improve Vaccine Uptake throughout Adulthood
Ecarnot, F. (Besançon); Maggi, S. (Padua); Michel, J.-P. (Geneva)
Author Index
Subject Index
 
Weinberger B (ed): Vaccines for Older Adults: Current Practices and Future Opportunities. Interdiscip Top Gerontol Geriatr. Basel, Karger, 2020, vol 43, pp VI–IX (DOI:10.1159/000504488)
Preface
Demographic changes lead to an increase in the number and percentage of older persons worldwide. It is estimated that by 2080 the median age of the population in Europe will increase by 4.2 years, and the proportion of older persons (>65 years) will increase from 19.2 to 29.1% during this time. The proportion of the very old (>80 years) will increase even more, from 5.4 to 12.4%. In view of these developments, it is of utmost importance to the individual person as well as to society as a whole to promote healthy aging and ensure quality of life for the older population.
Many infectious diseases show increased incidence and severity with age. In addition to the acute event of infection, which is often associated with high morbidity and mortality in older age groups, there can be severe additional, often long-term consequences. Exacerbations of underlying chronic diseases during or shortly after infections are frequent, and many older patients will not recover fully after serious infections. In the worst-case scenario, this leads to a loss of independence, which might necessitate admission to long-term care. Vaccines are the most efficient strategy to prevent infectious diseases, and the tremendous success of childhood vaccination programs in reducing the burden of many infectious diseases worldwide is undisputed. Prevention of infections affecting the older population by vaccination is an important measure to achieve the overall goal of promoting health in this age group.
This book summarizes age-related changes of the immune system and their impact on immune responses to vaccination, as well as other factors influencing vaccine-induced immune responses in old age. It gives an overview of vaccines which are currently available for older adults and of novel technologies and targets which hopefully will lead to more and improved vaccines for this vulnerable population.
The immune system is a complex network of different cell types and soluble factors, with intricate interactions not only amongst its components but also with the rest of the body. The innate immune system consists of several cell types with distinct roles in early immune responses and antigen presentation. Alterations in receptor expression, signaling, transcriptional programming and cytokine production and responsiveness are contributing to age-related functional defects in neutrophils, monocytes/macrophages and dendritic cells. Natural killer cells, which recognize and eliminate infected and tumor cells, show age-related changes in their phenotype and subset composition as well as their functions, which includes cytotoxicity and cytokine production. The aged adaptive immune system is characterized by a diminished repertoire and diversity. Age-associated changes in hematopoiesis and involution of the thymus lead to decreased output of newly generated naïve T cells. At the same time, antigen-experienced T cells, and particularly highly differentiated effector T cells accumulate. Signaling defects, limited proliferative capacity of exhausted or senescent-like T cells, and alterations in cytokine production contribute to decreased T cell function in old age. The output of naïve B cells is also decreased, and the composition of the B cell compartment changes