Jilg Wolfgang
Institute for Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany,
Interdiscip Top Gerontol Geriatr. 2020;43:158-181. doi: 10.1159/000504492. Epub 2020 Apr 9.
People who travel to countries where they are at risk of contracting specific infections often need specific vaccines. To make correct recommendations in this respect several points have to be considered. The state of health of the traveler should be known as well as his or her destination and travel style. Very important, however, is the age of the traveler. As advancing age leads to changes in the immune system, in older individuals many infections are more severe. On the other hand, most vaccines are less immunogenic in the elderly. In this chapter, we will discuss which vaccines are necessary for older travelers visiting (mainly) tropical and subtropical countries, how these vaccines have to be used, and if perhaps their use has to be altered in older individuals. First, standard vaccinations will be addressed. When the immunization state of the individual is incomplete because certain vaccinations are expired or missing, it has to be updated. Vaccinations against tetanus, diphtheria, influenza, pneumococcal diseases, measles, and poliomyelitis have to be considered in this respect, because the risk of getting infected with these diseases in tropical and subtropical regions or in regions with poor hygienic conditions is often higher or at least the same as in industrialized countries. The second and main part of this chapter contains the typical travel vaccines. We will deal with vaccinations against cholera, hepatitis A and B, Japanese encephalitis, invasive meningococcal diseases, rabies, typhoid fever, and yellow fever. Clinical courses and epidemiology of the different infections are presented. The respective vaccines are discussed in detail, especially their efficiency in older individuals as far as data are available in this respect. Finally, recommendations for their use in older travelers will be given.
前往有感染特定传染病风险国家旅行的人通常需要接种特定疫苗。要在这方面给出正确建议，需要考虑几个要点。必须了解旅行者的健康状况、目的地以及旅行方式。然而，非常重要的是旅行者的年龄。随着年龄增长，免疫系统会发生变化，许多感染在老年人中会更严重。另一方面，大多数疫苗在老年人中的免疫原性较低。在本章中，我们将讨论前往（主要是）热带和亚热带国家的老年旅行者需要接种哪些疫苗、这些疫苗应如何使用，以及在老年人中使用这些疫苗是否可能需要调整。首先，将讨论标准疫苗接种。如果由于某些疫苗接种过期或缺失导致个人免疫状态不完整，则必须进行更新。在这方面，必须考虑接种破伤风、白喉、流感、肺炎球菌疾病、麻疹和脊髓灰质炎疫苗，因为在热带和亚热带地区或卫生条件差的地区感染这些疾病的风险通常更高，或者至少与工业化国家相同。本章的第二部分也是主要部分包含典型的旅行疫苗。我们将讨论霍乱、甲型和乙型肝炎、日本脑炎、侵袭性脑膜炎球菌疾病、狂犬病、伤寒和黄热病疫苗。介绍了不同感染的临床病程和流行病学。将详细讨论各自的疫苗，特别是就现有数据而言，它们在老年人中的有效性。最后，将给出在老年旅行者中使用这些疫苗的建议。
