Department of Internal Medicine, Rehabilitation & Geriatrics, Medical School & University Hospitals of Geneva, Hospital of Trois-Chêne, Chemin du Pont-Bochet 3, CH-1226 Thônex-Geneva, Geneva, Switzerland.
Expert Rev Vaccines. 2012 Feb;11(2):167-76. doi: 10.1586/erv.11.187.
Vaccination is a powerful public health tool that has been of tremendous benefit in protecting vulnerable populations from specific infections. Moreover, in addition to the direct benefits to vaccinated individuals, the indirect effects of protection at the community level have also been demonstrated and termed 'herd immunity'. The predicted demographic shift in the population landscape towards an ever-increasing aging population and the evidence suggesting that older individuals produce less-than-optimal vaccine responses have raised the question of rethinking vaccine schedules. This article provides evidence that even if herd immunity might be an option to indirectly protect the aging and aged adult population, the highest priorities for the near future must be to understand how vaccine responses in older individuals can be improved, to break down the public, cultural, societal and political barriers to vaccination and to counter the antivaccination movement that inhibits the worldwide spread of lifelong immunization programs.
疫苗接种是一项强有力的公共卫生工具，在保护弱势群体免受特定感染方面具有巨大的益处。此外，除了对接种个体的直接益处外，在社区层面上的保护的间接影响也已经得到证实，并被称为“群体免疫”。人口结构中预计会出现的人口老龄化趋势以及证据表明，老年人产生的疫苗反应不如最佳状态，这引发了重新思考疫苗接种计划的问题。本文提供的证据表明，即使群体免疫可能是间接保护老龄化和老年人群体的一种选择，但近期的首要任务必须是了解如何改善老年人的疫苗反应，打破疫苗接种方面的公众、文化、社会和政治障碍，并对抗阻碍全球范围内终身免疫计划传播的反疫苗运动。
