Influenza Vaccination in Older Adults: Recent Innovations and Practical Applications

被引:54
作者
Andrew, Melissa K. [1 ,2 ]
Bowles, Susan K. [1 ,2 ,3 ]
Pawelec, Graham [4 ,5 ]
Haynes, Laura [6 ]
Kuchel, George A. [6 ]
McNeil, Shelly A. [2 ,7 ]
McElhaney, Janet E. [8 ]
机构
[1] Dalhousie Univ, Div Geriatr Med, Dept Med Geriat, 5955 Vet Mem Lane, Halifax, NS, Canada
[2] Canadian Ctr Vaccinol, Halifax, NS, Canada
[3] Nova Scotia Hlth Author, Dept Pharm, Halifax, NS, Canada
[4] Univ Tubingen, Dept Internal Med 2, Tubingen, Germany
[5] Hlth Sci North Res Inst, Sudbury, ON, Canada
[6] Univ Connecticut, Sch Med, Ctr Aging, Farmington, CT USA
[7] Dalhousie Univ, Dept Med Infect Dis, Halifax, NS, Canada
[8] Northern Ontario Sch Med, Hlth Sci North Res Inst, Sudbury, ON, Canada
基金
美国国家卫生研究院;
关键词
AGED; 65; YEARS; SEASONAL INFLUENZA; UNITED-STATES; PROTECTION; VACCINES; IMMUNIZATION; EFFICACY; RESIDENTS; HOSPITALIZATION; IMMUNOGENICITY;
D O I
10.1007/s40266-018-0597-4
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Influenza can lead to serious illness, particularly for older adults. In addition to short-term morbidity and mortality during the acute infection, recovery can be prolonged and often incomplete. This may lead to persistent declines in health and function, including catastrophic disability, which has dramatic implications for the well-being and support needs of older adults and their caregivers. All of this means that prevention of infection and effective treatment when illness has occurred are of paramount importance. In this narrative review, we discuss the effectiveness of influenza vaccines for the prevention of influenza illness and serious outcomes in older adults. We review evidence of vaccine effectiveness for older adults in comparison with younger age groups, and also highlight the importance of frailty as a determinant of vaccine effectiveness. We then turn our attention to the question of why older and frailer individuals have poorer vaccine responses, and consider changes in immune function and inflammatory responses. This sets the stage for a discussion of newer influenza vaccine products that have been developed with the aim of enhancing vaccine effectiveness in older adults. We review the available evidence on vaccine efficacy, effectiveness and cost benefits, consider the potential place of these innovations in clinical geriatric practice, and discuss international advisory committee recommendations on influenza vaccination in older adults. Finally, we highlight the importance of influenza prevention to support healthy aging, along with the need to improve vaccine coverage rates using available vaccine products, and to spur development of better influenza vaccines for older adults in the near future.
引用
收藏
页码:29 / 37
页数:9
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