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Poscia A, Paolorossi G, Collamati A, Costantino C, Fiacchini D, Angelini C, Bernabei R, Cimini D, Icardi G, Siddu A, Silenzi A, Spadea A, Vetrano DL. Enhancing routine immunization efforts for older adults and frail individuals: Good practices during the SARS-CoV-2 pandemic in Italy. Hum Vaccin Immunother 2024; 20:2330152. [PMID: 38533904 DOI: 10.1080/21645515.2024.2330152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/10/2024] [Indexed: 03/28/2024] Open
Abstract
Infectious diseases pose a significant burden on the general population, particularly older adults who are more susceptible to severe complications. Immunization plays a crucial role in preventing infections and securing a healthier aging, but actual vaccination rates among older adults and frail individuals (OAFs) remains far from recommended targets. This study aims to collect and share good practices implemented in several Italian local health districts during the SARS-CoV-2 pandemic to ease routine immunization for OAFs. A 28-items questionnaire has been developed to collect information on organization aspect of immunization services and local good practices implemented before and during the SARS-CoV-2 pandemic. Twelve Public Health managers representative of 9 Italian Regions were further interviewed between January and March 2021. Despite literature suggests several effective interventions to increase vaccine demand, improve vaccine access, and enhance healthcare providers' performance, our survey highlighted substantial heterogeneity in their implementation at local level. Seven good local practices have been identified and described: mass vaccination centers; vaccination mobile units; drive-through vaccination; co-administration; tailored pathways; cooperation among providers involved in vaccination; digitization. Our survey pointed out valuable strategies for enhancing routine immunization for OAFs. Providers should combine effective interventions adequate to their specific context and share good practices.
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Affiliation(s)
| | - Giulia Paolorossi
- Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, Ancona, Italy
| | | | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro", University of Palermo, Palermo, Italy
| | | | - Claudio Angelini
- Public Health Department, AST Ascoli Piceno, Ascoli Piceno, Italy
| | - Roberto Bernabei
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Andrea Siddu
- General Directorate for Health Prevention, Ministry of Health, Ministero della Salute, Rome, Italy
| | - Andrea Silenzi
- General Directorate for Health Prevention, Ministry of Health, Ministero della Salute, Rome, Italy
| | - Antonietta Spadea
- UOC Vaccinations, Department of Prevention, Local Health Authority Roma1, Rome, Italy
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Centre, Stockholm, Sweden
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2
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Weil-Olivier C, Taha MK, Leng S, Dinleyici EC, Bonanni P, Moya E, Leischker A, Yezli S. Invasive meningococcal disease in older adults: current perspectives and call for action. Eur Geriatr Med 2024; 15:729-741. [PMID: 38709380 PMCID: PMC11329530 DOI: 10.1007/s41999-024-00969-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/27/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE Invasive meningococcal disease (IMD) is a devastating condition. While most attention is directed towards disease in children and adolescents, IMD poses an important cause of morbidity and mortality in adults ≥60 years. While immunization is a critical component of healthy ageing strategies, meningococcal immunization is not routinely offered to older adults. The aim of this review was to summarize clinical and epidemiological aspects of IMD and available immunization strategies, with a particular focus on disease in older individuals, to emphasize the importance of this rather neglected area. METHODS An expert working group was established to evaluate clinical and epidemiological data to raise awareness of IMD in older individuals, and develop suggestions to improve the existing burden. RESULTS Routine child and adolescent meningococcal immunization has substantially reduced IMD in these targeted populations. Consequently, prevalence and proportion of IMD among those ≥60 years, mostly unvaccinated, is increasing in developed countries (accounting for up to 25% of cases). IMD-related mortality is highest in this age-group, with substantial sequelae in survivors. IMD due to serogroups W and Y is more prevalent among older adults, often with atypical clinical features (pneumonia, gastrointestinal presentations) which may delay timely treatment. CONCLUSIONS IMD in older adults remains overlooked and greater awareness is required at clinical and societal levels. We encourage clinicians and immunization policy makers to reconsider IMD, with a call for action to remedy existing inequity in older adult access to protective meningococcal immunization.
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Affiliation(s)
| | - Muhamed-Kheir Taha
- Institut Pasteur, Invasive Bacterial Infections Unit, National Reference Centre for Meningococci and Haemophilus Influenza, Université Paris Cité, Paris, France
| | - Sean Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Center on Aging and Immune Remodeling, Baltimore, Maryland, USA
| | - Ener Cagri Dinleyici
- Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Türkiye
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Elena Moya
- Europe Regional Coordinator, The Confederation of Meningitis Organizations (CoMO), Madrid, Spain
| | - Andreas Leischker
- Working Group "Vaccination", German Geriatric Society, and Department for Geriatrics, Asklepios Hospital Wandsbek, Hamburg, Germany
| | - Saber Yezli
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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3
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Ciarambino T, Crispino P, Buono P, Giordano V, Trama U, Iodice V, Leoncini L, Giordano M. Efficacy and Safety of Vaccinations in Geriatric Patients: A Literature Review. Vaccines (Basel) 2023; 11:1412. [PMID: 37766089 PMCID: PMC10537287 DOI: 10.3390/vaccines11091412] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
With the progressive lengthening of the average age of the population, especially in some countries such as Italy, vaccination of the elderly is a fixed point on which most of the public health efforts are concentrating as epidemic infectious diseases, especially those of the winter, have a major impact on the progression of severe disease, hospitalization, and death. The protection of the elderly against acute infectious diseases should not only limit mortality but also have a positive impact on the fragility of these people in terms of less disability and fewer care needs. However, vaccination of the elderly population differs in efficacy and safety compared to that of other population categories since aging and the consequent loss of efficiency of the immune system lead to a reduction in the immunogenicity of vaccines without achieving a lasting antibody coverage. There are various strategies to avoid the failure of immunization by vaccines such as resorting to supplementary doses with adjuvant vaccines, increasing the dosage of the antigen used, or choosing to inoculate the serum relying on various routes of administration of the vaccine. Vaccination in the elderly is also an important factor in light of growing antibiotic resistance because it can indirectly contribute to combating antibiotic resistance, reducing theoretically the use of those agents. Furthermore, vaccination in old age reduces mortality from infectious diseases preventable with vaccines and reduces the same rate of resistance to antibiotics. Given the importance and complexity of the topic, in this review, we will deal with the main aspects of vaccination in the elderly and how it can influence mortality and healthcare costs, especially in those countries where population aging is more evident. Therefore, we conducted a systematic literature search in PubMed to identify all types of studies published up to 31 May 2023 that examined the association between vaccination and the elderly. Data extraction and quality assessment were conducted by two reviewers (PC and TC) who independently extracted the following data and assessed the quality of each study.
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Affiliation(s)
- Tiziana Ciarambino
- Internal Medicine Department, Hospital of Marcianise, ASL Caserta, 81031 Caserta, Italy
- Direzione di Staff Direzione Generale Tutela per la Salute Regione Campania, 80143 Naples, Italy; (P.B.); (U.T.)
| | - Pietro Crispino
- Internal Medicine Department, Hospital of Latina, ASL Latina, 04100 Latina, Italy;
| | - Pietro Buono
- Direzione di Staff Direzione Generale Tutela per la Salute Regione Campania, 80143 Naples, Italy; (P.B.); (U.T.)
| | | | - Ugo Trama
- Direzione di Staff Direzione Generale Tutela per la Salute Regione Campania, 80143 Naples, Italy; (P.B.); (U.T.)
| | - Vincenzo Iodice
- ASL Caserta, Direttore Sanitario Aziendale, 81100 Caserta, Italy
| | - Laura Leoncini
- ASL Caserta, Direttore Sanitario, P.O. Marcianise, 81025 Marcianise, Italy
| | - Mauro Giordano
- Department of Advanced Medical and Surgical Science, University of Campania, L. Vanvitelli, 81100 Naples, Italy;
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4
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Pham TH, Beck E, Postma MJ, Németh B, Ágh T, de Waure C, Salisbury DM, Nutma N, van der Schans J. Country score tool to assess readiness and guide evidence generation of immunization programs in aging adults in Europe. Front Public Health 2023; 10:1080678. [PMID: 36699900 PMCID: PMC9869118 DOI: 10.3389/fpubh.2022.1080678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
Objectives Delaying of policies for immunization of aging adults, low vaccine uptake, and the lack of supportive evidence at the national level could diminish the value in health and economics of such programs. This study aims to develop a "country score tool" to assess readiness and to facilitate evidence generation for aging adult immunization programs in Europe, and examine the comprehensiveness, relevance, acceptability, and feasibility of the tool. Methods The tool was developed in two phases. First, a modified Delphi process was used to construct the tool. The process included a literature review, stakeholder consultations, and a three-round Delphi study. The Delphi panel included researchers, supra-national and national decision-makers of immunization programs recruited from five countries, using snowball sampling method. The consensus was predefined at the agreement rate of 70%. Pilot testing of the tool was conducted in the Netherlands, Germany, Serbia, and Hungary involving researchers in the field of health technology assessment. After assessing the countries' readiness, researchers evaluated four features, namely comprehensiveness, relevance, acceptability, and feasibility of the tool via an online survey that included 5-scale Likert questions. The percentages of affirmative answers including "agree" and "totally agree" choices were presented. Results The review identified 16 tools and frameworks that formed the first version of our tool with 14 items. Eight experts were involved in the Delphi panel. Through three Delphi rounds, four items were added, one was dropped, and all others were amended. The consensus was achieved on the tool with 17 items divided into decision-making and implementation parts. Each item has a guiding question, corresponding to explanations and rationales to inform assessment with readiness scores. Eight researchers completed the pilot testing. The tool was rated as comprehensive (75%), relevant (100%), acceptable (75%), and feasible (88%) by participants. Conclusion Through a thorough and transparent process, a country score tool was developed helping to identify strengths, weaknesses, and evidential requirements for decision-making and implementation of immunization programs of aging adults. The tool is relevant for different European contexts and shows good comprehensiveness, acceptability, and feasibility.
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Affiliation(s)
- Thi Hao Pham
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands,Asc Academics, Groningen, Netherlands,Thi Hao Pham ✉
| | - Ekkehard Beck
- Department of Vaccines Value Evidence, GlaxoSmithKline, Wavre, Belgium
| | - Maarten J. Postma
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands,Department of Economics, Econometrics & Finance, University of Groningen, Groningen, Netherlands,Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
| | | | - Tamás Ágh
- Syreon Research Institute, Budapest, Hungary
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - David M. Salisbury
- Royal Institute International Affairs, Chatham House, London, United Kingdom
| | - Nynke Nutma
- RIVM, The Dutch National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Jurjen van der Schans
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands,Department of Economics, Econometrics & Finance, University of Groningen, Groningen, Netherlands,*Correspondence: Jurjen van der Schans ✉
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5
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Childers-Strawbridge S, Eiden AL, Nyaku MK, Bhatti AA. Attitudes and Beliefs around the Value of Vaccination in the United States. Vaccines (Basel) 2022; 10:vaccines10091470. [PMID: 36146548 PMCID: PMC9501875 DOI: 10.3390/vaccines10091470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/24/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the benefits of immunization, differences in attitudes persist toward vaccines. We captured individuals’ perceptions of vaccines and vaccination across the United States (US) to inform vaccine-related policy development. A survey was completed by 5000 respondents from 10 states. Respondents were screened for inclusion, which included individuals ≥ 18 years of age that had received a vaccine or were unvaccinated but indicated a favorable or neutral attitude towards vaccinations. Participants were excluded if they indicated they did not support the idea of vaccinations. Questions explored perceptions of vaccines for all age groups. Among unvaccinated individuals, the most common concerns were about safety (38%). Most respondents (95%) highlighted the importance of state immunization programs for disease prevention. Access to health and immunization records and immunization information systems were important to 96% and 88% of respondents, respectively, for future health planning. Doctors and healthcare professionals (HCPs) were considered trusted sources for vaccine information (95%). Overall, respondents recognized the importance of vaccination, but documented concerns among the unvaccinated indicated a need for greater promotion regarding vaccine safety. Doctors and HCPs, as trusted information sources, should continue to and increasingly advocate for the importance of immunization to increase vaccine uptake.
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6
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Redondo Margüello E, Trilla A, Munguira ILB, Jaramillo López-Herce A, Cotarelo Suárez M. Knowledge, attitudes, beliefs and barriers of healthcare professionals and adults ≥ 65 years about vaccine-preventable diseases in Spain: the ADult Vaccination drIverS and barriErs (ADVISE) study. Hum Vaccin Immunother 2022; 18:2025007. [PMID: 35172691 PMCID: PMC8993072 DOI: 10.1080/21645515.2021.2025007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Since 2018, Spanish National Immunization Guidelines include vaccination recommendations for adults ≥65 years. To determine whether health-care professionals and the ≥65 years target group value the need for these recommendations, a cross-sectional study was conducted to capture and describe their knowledge, attitudes, beliefs and behaviors about vaccination. Online surveys were administered to representative groups of general practitioners (GPs), primary care nurses and adults ≥65 years from six major cities (and surrounding rural areas) in Spain. Main topics were attitudes and awareness of vaccines, perceptions about vaccination in adults ≥65 years, and impact of the COVID-19 pandemic on vaccination uptake. A total of 286 health-care professionals (185 GPs, 101 nurses) and 400 adults aged ≥65 years participated in the survey. GP and nurse groups agreed strongly about the importance of influenza and pneumococcal vaccination in the target population. Longer patient visit times were identified as a key factor toward promoting vaccination. The ≥65 years sample group, especially those ≥75+ years and/or with chronic diseases, was reasonably positive about the effectiveness and benefits of vaccines. Lower vaccination rates for the pneumococcal than influenza vaccine (29% vs. 80%) in the ≥65 years sample group suggest that efforts are needed to improve pneumococcal vaccine uptake. Aligning with other published works, GPs have a key role in promoting vaccination in the target population. The COVID-19 pandemic appears to have heightened awareness about the importance of vaccination among health-care professionals and adults ≥65 years.
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Affiliation(s)
| | - Antoni Trilla
- Servicio de Medicina Preventiva del Hospital Clinic de Barcelona, Barcelona, Spain
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Antonelli-Incalzi R, Blasi F, Conversano M, Gabutti G, Giuffrida S, Maggi S, Marano C, Rossi A, Vicentini M. Manifesto on the Value of Adult Immunization: "We Know, We Intend, We Advocate". Vaccines (Basel) 2021; 9:vaccines9111232. [PMID: 34835163 PMCID: PMC8625332 DOI: 10.3390/vaccines9111232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 12/11/2022] Open
Abstract
Immunization through vaccination is a milestone achievement that has made a tremendous contribution to public health. Historically, immunization programs aimed firstly to protect children, who were disproportionally affected by infectious diseases. However, vaccine-preventable diseases can have significant impacts on adult mortality, health, and quality of life. Despite this, adult vaccinations have historically been overlooked in favor of other health priorities, because their benefits to society were not well recognized. As the general population is aging, the issue of vaccination in older adults is gaining importance. In high-income countries, recommendations for the routine vaccination of older adults have been gradually introduced. The Italian National Immunization Plan is considered to be among the most advanced adult vaccination plans in Europe. However, available data indicate there is low adherence to vaccination recommendations in Italy. The COVID-19 pandemic has exposed the damage that can be caused by an infectious disease, especially among adults and individuals with comorbidities. The aim of this “Manifesto”, therefore, is to provide an overview of the existing evidence on the value of adult vaccination, in the Italian context, with a call to action to healthcare providers and health authorities.
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Affiliation(s)
- Raffaele Antonelli-Incalzi
- Geriatric Unit, Campus Bio-Medico University, 00128 Rome, Italy;
- Italian Society of Gerontology and Geriatrics, 50129 Florence, Italy
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy;
- Respiratory Unit and Adult Cystic Fibrosis Center, Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Michele Conversano
- Department for Public Health, Local Health Unit Taranto, 74121 Taranto, Italy;
| | - Giovanni Gabutti
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Sandro Giuffrida
- Department of Prevention, Local Health Unit Reggio Calabria, 89124 Reggio Calabria, Italy;
| | - Stefania Maggi
- Aging Branch, Institute of Neuroscience, National Research Council, 35128 Padova, Italy;
| | | | - Alessandro Rossi
- Italian Society of General Medicine and Primary Care, 50142 Florence, Italy;
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8
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Laupèze B, Del Giudice G, Doherty MT, Van der Most R. Vaccination as a preventative measure contributing to immune fitness. NPJ Vaccines 2021; 6:93. [PMID: 34315886 PMCID: PMC8316335 DOI: 10.1038/s41541-021-00354-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 05/07/2021] [Indexed: 02/07/2023] Open
Abstract
The primary goal of vaccination is the prevention of pathogen-specific infection. The indirect consequences may include maintenance of homeostasis through prevention of infection-induced complications; trained immunity that re-programs innate cells to respond more efficiently to later, unrelated threats; slowing or reversing immune senescence by altering the epigenetic clock, and leveraging the pool of memory B and T cells to improve responses to new infections. Vaccines may exploit the plasticity of the immune system to drive longer-term immune responses that promote health at a broader level than just the prevention of single, specific infections. In this perspective, we discuss the concept of “immune fitness” and how to potentially build a resilient immune system that could contribute to better health. We argue that vaccines may contribute positively to immune fitness in ways that are only beginning to be understood, and that life-course vaccination is a fundamental tool for achieving healthy aging.
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9
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Vora A, Di Pasquale A, Kolhapure S, Agrawal A. Vaccination in Older Adults: An Underutilized Opportunity to Promote Healthy Aging in India. Drugs Aging 2021; 38:469-479. [PMID: 34125424 PMCID: PMC8200323 DOI: 10.1007/s40266-021-00864-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 11/25/2022]
Abstract
Over the last 50 years, the Indian population aged 50 years and above (older adults) has quadrupled and is expected to comprise 404 million people in 2036, representing 27% of the country's projected population. Consequently, the contribution of chronic disease to older adults' total burden of diseases in India is likely to escalate. Disease burden is notably amplified by immunosenescence, a deterioration of the immune system that develops with age, leading to increasing susceptibility to infectious diseases and other comorbidities. Older adults with infectious diseases have a higher incidence and likelihood of life-threatening comorbidities such as coronary artery disease, arrhythmia, stroke, myocardial infarction, hypertension, dyslipidemia, and diabetes mellitus. Therefore, immunization of older adults through vaccination might greatly reduce the burden imposed by vaccine preventable infectious diseases in this population. Here, we review evidence relevant to the disease burden among adults aged ≥ 50 years in India, and existing vaccination recommendations. Furthermore, we suggest a set of routine vaccinations for healthy older adults in India. There is a clear mandate to recognize the contributions of older adults to society and embrace strategies promoting healthy aging, which is described by the World Health Organization as the process of developing and maintaining functional ability and well-being in older age. Increasing vaccination awareness and coverage among older adults is an important step in that direction for India.
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Affiliation(s)
- Agam Vora
- Department of Chest and TB, Dr. R. N. Cooper Municipal General Hospital, Mumbai, India
| | | | | | - Ashish Agrawal
- Medical Affairs Department, GlaxoSmithKline Pharmaceuticals Ltd., 205, 2nd Floor, 62 Navketan Building, Secunderabad, Hyderabad, 500003, India.
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10
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Sultana J, Mazzaglia G, Luxi N, Cancellieri A, Capuano A, Ferrajolo C, de Waure C, Ferlazzo G, Trifirò G. Potential effects of vaccinations on the prevention of COVID-19: rationale, clinical evidence, risks, and public health considerations. Expert Rev Vaccines 2020; 19:919-936. [PMID: 32940090 DOI: 10.1080/14760584.2020.1825951] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), has quickly spread around the world. Areas covered This review will discuss the available immunologic and clinical evidence to support the benefit of the influenza, pneumococcal, and tuberculosis vaccines in the context of COVID-19 as well as to provide an overview on the COVID-19-specific vaccines that are in the development pipeline. In addition, implications for vaccination strategies from a public health perspective will be discussed. Expert opinion Some vaccines are being considered for their potentially beneficial role in preventing or improving the prognosis of COVID-19: influenza, pneumococcal and tuberculosis vaccines. These vaccines may have either direct effect on COVID-19 via different types of immune responses or indirect effects by reducing the burden of viral and bacterial respiratory diseases on individual patients and national healthcare system and by facilitating differential diagnoses with other viral/bacterial respiratory disease. On the other hand, a large number of candidate vaccines against SARS-CoV-2 are currently in the pipeline and undergoing phase I, II, and III clinical studies. As SARS-CoV-2 vaccines are expected to be marketed through accelerated regulatory pathways, vaccinovigilance as well as planning of a successful vaccination campaign will play a major role in protecting public health.
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Affiliation(s)
- Janet Sultana
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina , Messina, Italy
| | - Giampiero Mazzaglia
- Research Centre on Public Health (CESP), University of Milano-Bicocca , Milano, Italy
| | - Nicoletta Luxi
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina , Messina, Italy
| | - Antonino Cancellieri
- Department of Human Pathology "G. Barresi", University of Messina , Messina, Italy
| | - Annalisa Capuano
- Department of Experimental Medicine, Pharmacology Division, University of Campania "L. Vanvitelli" , Caserta, Italy.,Regional Centre of Pharmacovigilance and Pharmacoepidemiology , Naples, Italy
| | - Carmen Ferrajolo
- Department of Experimental Medicine, Pharmacology Division, University of Campania "L. Vanvitelli" , Caserta, Italy.,Regional Centre of Pharmacovigilance and Pharmacoepidemiology , Naples, Italy
| | - Chiara de Waure
- Department of Experimental Medicine, University of Perugia , Perugia, Italy
| | - Guido Ferlazzo
- Department of Human Pathology "G. Barresi", University of Messina , Messina, Italy
| | - Gianluca Trifirò
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina , Messina, Italy
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11
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Calabrò GE, Tognetto A, Carini E, Mancinelli S, Sarnari L, Colamesta V, Ricciardi W, de Waure C. Strategies to Improve Vaccination among At-Risk Adults and the Elderly in Italy. Vaccines (Basel) 2020; 8:vaccines8030358. [PMID: 32635467 PMCID: PMC7565655 DOI: 10.3390/vaccines8030358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 12/14/2022] Open
Abstract
The World Health Organization (WHO), the United States (US) Centers for Disease Control and Prevention (CDC), the European Center for Disease Control (ECDC), and the immunization guidelines of many countries issue vaccination recommendations for adults and the elderly. However, the uptake of vaccination in these groups is generally low due to several reasons. The present study aimed to identify strategies implemented in Italy in unconventional settings to promote vaccination against influenza, pneumococcal, and herpes zoster virus (HZV) infections among these subjects, i.e., the at-risk adult population and the elderly. We conducted a literature review and a survey of experts. The literature search yielded seven strategies; all of these concerned influenza vaccination, while three also addressed pneumococcal and HZV vaccination. The survey of experts identified 15 strategies; 10 regarded influenza vaccination, while four regarded pneumococcal vaccination and one regarded HZV vaccination. Most of the strategies were implemented in hospital clinics and rest homes. Regarding influenza and pneumococcal vaccinations, the target population mainly comprised at-risk adults, while the elderly represented the main target population for HZV vaccination. Our results show that, in Italy, there are initiatives aimed at promoting vaccination in unconventional settings, but further efforts are required to assess their effectiveness and to further extend them.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, Department of Life Sciences and Public Health; Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.E.C.); (A.T.); (E.C.); (W.R.)
- VIHTALI (Value In Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alessia Tognetto
- Section of Hygiene, Department of Life Sciences and Public Health; Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.E.C.); (A.T.); (E.C.); (W.R.)
| | - Elettra Carini
- Section of Hygiene, Department of Life Sciences and Public Health; Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.E.C.); (A.T.); (E.C.); (W.R.)
| | - Silvia Mancinelli
- Department of Pneumological Sciences, Section of Pneumology, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
| | - Laura Sarnari
- Regional Health Unit ASUR AV 3, Sanitary District of Macerata, 62100 Macerata, Italy;
| | - Vittoria Colamesta
- Section of Hygiene, Department of Life Sciences and Public Health; Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.E.C.); (A.T.); (E.C.); (W.R.)
- UOC Direzione Sanitaria S. Spirito e Nuovo Regina Margherita, Local Health Unit ASL RM1, 00193 Rome, Italy
- Correspondence:
| | - Walter Ricciardi
- Section of Hygiene, Department of Life Sciences and Public Health; Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.E.C.); (A.T.); (E.C.); (W.R.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Chiara de Waure
- Department of Experimental Medicine, University of Perugia, 06132 Perugia, Italy;
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Sahinoz T, Sahinoz S. Investigation of healthy living strategies in elderly who achieved to live long and healthy. Pak J Med Sci 2020; 36:371-375. [PMID: 32292436 PMCID: PMC7150393 DOI: 10.12669/pjms.36.3.1838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective To determine the lifestyles, healthy living strategies and socio-cultural characteristics of elderly people who lived long and healthy. Methods This study was a cross-sectional study. This study was conducted on 472 elderly patients, aged 80 years and over, selected by random sampling method. The socio-demographic characteristics and daily living activities of the elderly were determined by face to face interview technique using the "Elderly Questionnaire" developed by the researchers in 2018. Chi-square test was used for statistical analysis. Results Based on the average age (84) of the elderly in the research group, it was seen that they were able to exceed the average life expectancy of their fathers (72) and mothers (73). It has been found that the participants live 11-12 years longer than their parents. It was also found that more than half (51.9%) of the elderly have the habit of walking regularly every day. It was determined that the elderly mostly consumed vegetables and fruits (88.5%), milk and dairy products and meat, respectively. Conclusion The elderly stated that natural and healthy nutrition, working and staying away from stress in the top three places as the reason of their long and healthy life.
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Affiliation(s)
- Turgut Sahinoz
- Dr. Turgut Sahinoz, M.D., Public Health Specialist, Assist. Professor, Department of Health Management, Ordu University, Faculty of Health Sciences, Altinordu, Ordu, Turkey
| | - Saime Sahinoz
- Prof. Dr. Saime Sahinoz, M.D., Public Health Specialist, Department of Emergency and Disaster Management, Gumushane University, Faculty of Health Sciences, Merkez, Gumushane, Turkey
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Vaccination Programs for Adults in Europe, 2019. Vaccines (Basel) 2020; 8:vaccines8010034. [PMID: 31968652 PMCID: PMC7157239 DOI: 10.3390/vaccines8010034] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 11/17/2022] Open
Abstract
Background: While all European countries implement vaccination programs for children, there are gaps in terms of vaccination programs for adults. Methods: We studied the 2019 vaccination policies for adults in 42 European countries. Results: Vaccination programs for adults were in place in all countries. However, there were considerable differences between countries in terms of number of vaccinations, target populations and frame of implementation (recommended or mandatory vaccinations). In particular the following vaccination policies were in place: influenza (42 countries), tetanus (31), diphtheria (30), pneumococcus (29), hepatitis B (20), pertussis (18), measles (14), human papilloma virus (14), meningococcus tetravalent A,C,W,Y (14), rubella (13), hepatitis A (11), mumps (11), poliomyelitis (10), herpes zoster (9), varicella (8), tick-born encephalitis (8), meningococcus B (6), rabies (6), Haemophilus influenzae type b (5), tuberculosis (3), typhoid fever (3), meningococcus C (2), and yellow fever (1). Seventeen countries implement mandatory vaccinations, mainly against diphtheria, tetanus and hepatitis B. Conclusions: There are significant differences in vaccination programs for adults in Europe. Routine vaccination programs for adults need to be strengthened. A consensus-based vaccination program is needed.
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Tak CR, Marciniak MW, Savage A, Ozawa S. The essential role of pharmacists facilitating vaccination in older adults: the case of Herpes Zoster. Hum Vaccin Immunother 2019; 16:70-75. [PMID: 31369322 DOI: 10.1080/21645515.2019.1637218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Older adults share a disproportionately high burden of vaccine-preventable diseases. Despite recommendations from national and international health organizations, vaccination rates among older patients remain suboptimal, suggesting poor access and barriers to vaccination. Pharmacists are uniquely positioned to assist patients in overcoming many of these barriers. In this commentary, we describe some of the common barriers to vaccination that older adults encounter and the role pharmacists have in overcoming these barriers, in the US and abroad. We provide a case study of pharmacists' impact in supporting herpes zoster vaccination. We also identify areas of opportunities to promote further pharmacist involvement in vaccination efforts.
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Affiliation(s)
- Casey R Tak
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,UNC Health Sciences at MAHEC, Asheville, NC, USA
| | - Macary Weck Marciniak
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amanda Savage
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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