Ciarambino Tiziana, Crispino Pietro, Buono Pietro, Giordano Vincenzo, Trama Ugo, Iodice Vincenzo, Leoncini Laura, Giordano Mauro
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.
Vaccines (Basel). 2023 Aug 24;11(9):1412. doi: 10.3390/vaccines11091412.
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.
随着人口平均年龄的逐步延长，尤其是在意大利等一些国家，老年人的疫苗接种成为公共卫生工作的重点，因为流行性传染病，特别是冬季传染病，对严重疾病的进展、住院治疗和死亡有重大影响。保护老年人免受急性传染病侵害，不仅应降低死亡率，还应对这些人的脆弱性产生积极影响，即减少残疾和护理需求。然而，与其他人群相比，老年人群体的疫苗接种在效力和安全性方面存在差异，因为衰老以及随之而来的免疫系统效率下降会导致疫苗免疫原性降低，无法实现持久的抗体覆盖。有多种策略可避免疫苗免疫失败，例如采用含佐剂疫苗的补充剂量、增加所用抗原的剂量，或选择通过疫苗的各种给药途径接种血清。鉴于抗生素耐药性不断增加，老年人的疫苗接种也是一个重要因素，因为它可以间接有助于对抗抗生素耐药性，从理论上减少这些药物的使用。此外，老年人接种疫苗可降低可通过疫苗预防的传染病死亡率，并降低对抗生素的耐药率。鉴于该主题的重要性和复杂性，在本综述中，我们将探讨老年人疫苗接种的主要方面及其如何影响死亡率和医疗成本，特别是在人口老龄化更为明显的国家。因此，我们在PubMed上进行了系统的文献检索，以确定截至2023年5月31日发表的所有研究类型，这些研究探讨了疫苗接种与老年人之间的关联。数据提取和质量评估由两位审稿人（PC和TC）进行，他们独立提取以下数据并评估每项研究的质量。
