Prioritizing Pneumococcal Vaccination for Older Adults to Foster Healthy AgeingJuly 21, 20213 min read
Pneumonia is a leading cause of morbidity and mortality amongst older adults. In fact, deaths due to pneumonia are increasing in older adults. The Global Burden of Disease Study finds that deaths due to pneumonia in this age group have increased by approximately 60% over the last two decades. Additionally, pneumonia regularly results in hospitalization and significant morbidity, such as frailty, exacerbation of pre-existing comorbidities and overall decline in health. There remains a misconception that pneumonia is a disease only affecting old people, when in fact many forms of pneumonia are preventable via vaccination. The bacterial pathogen Streptococcus pneumoniae is a leading cause of pneumonia and does disproportionally result in greater morbidity and mortality in older populations. Two types of vaccines are available to protect against pneumonia due to Streptococcus pneumoniae, yet there remains very little awareness of these which can prevent serious disease and death in older adults.
Pneumococcal vaccination is almost always in routine childhood immunization programs and are considered a critical action in preventing deaths in children under 5 years of age. In contrast, recommendations for older adults vary globally and are lacking overall. Some countries provide pneumococcal vaccination to all adults considered “high-risk” due to pre-existing comorbidities, such as those with immunocompromising conditions or non-communicable diseases. In many countries, vaccine recommendations for older adults are specified by arbitrary age cut-offs, such as 60 or 65 years and older. Even in countries where pneumococcal vaccination is recommended for older adults in national programs and free, uptake in this group is consistently below target and there is low awareness amongst the general public.
Poor vaccination policy and low awareness amongst the general public is particularly concerning as we learn about the process of immune decline which occurs with ageing. This process, termed immunosenescence, is a normal function of ageing and makes older adults more susceptible to contracting and experiencing adverse health effects from infectious diseases. A newly published article, co-authored by the International Federation on Ageing’s (IFA) Secretary General, Dr. Jane Barratt, proposes changes to pneumococcal vaccine policy for older adults, considering the decline in immune function which occurs with age.
The article suggests a new approach for pneumococcal vaccination in adults which firstly, recognizes older adults as an immunocompromised group and, secondly, prioritizes a life course approach to vaccination. The epidemiological, biological and clinical evidence, as outlined in the article, supports a re-framing of pneumococcal vaccination as a response to the medical needs of older adults due to their immunocompromising condition.
Additionally, it is critically important to prioritize a life-course approach to vaccination and recognize it as a key component of healthy ageing. This approach involves expanding vaccination programs beyond childhood to support immunization for all ages. The WHO defines healthy ageing as “developing and maintaining the functional ability that enables well-being in older age”. In alignment with its Immunization Agenda 2030 and the United Nations Decade of Healthy Ageing, pneumococcal vaccination should be considered a key prevention effort which enables older people to maintain good health and well-being and continue to do what they have reason to value.
The IFA’s 15th Global Conference on Ageing entitled “Rights Matter” provides a global platform to mobilize action and advocate for immunization policies and practices, which consider factors such as immunosenescence and prioritize vaccination as a key component of healthy ageing. Visit the conference website to register for the pre-conference Vaccines4Life Summit “Driving Policy to End Immunisation Inequity: The Future of Adult Vaccination and Lessons Learned from the Coronavirus Pandemic” and the Presidential Symposium on Adult Vaccination “Together Towards Tomorrow: Post-pandemic Action on Adult Vaccination”.
Additionally, this World Pneumonia Day, taking place on November 12, IFA calls for the recognition of the high-burden of pneumonia in older adults and a life-course approach to pneumococcal vaccination.
To learn more about vaccination policy for older people and a life-course approach to vaccination, contact these experts.
• Dr. Luis M. Gutierrez Robledo, Director General, National Institute of Geriatrics, National Institute of Health
• Dr. Mine Durusu-Tanriover, Professor of Internal Medicine, Hacettepe University
• Dr. Gaëtan Gavazzi, Professor, Faculty of Medicine, Grenoble-Alpes University
Dr. Luis M. Gutierrez Robledo Director General
Dr. Gutiérrez is a Mexican scholar trained in France in geriatric medicine and the biology of aging
Dr. Mine Durusu-Tanriover Professor of Internal Medicine
Prof Mine Durusu Tanriover works closely with regional and global scientific community on adult vaccination, influenza and COVID-19.
Gaëtan Gavazzi, M.D., Ph.D. Professor
Prof. Gavazzi specializes in Geriatrics, Internal Medicine and Healthy Ageing.