Maggi Stefania, Launay Odile, Dawson Rachel
National Research Council, Neuroscience Institute-Aging Branch, Padua, Italy.
Université Paris Cité; Inserm, CIC 1417; Assistance Publique Hôpitaux de Paris, Hôpital Cochin, CIC Cochin Pasteur, Paris, France.
Infect Dis Ther. 2025 Jan;14(Suppl 1):99-114. doi: 10.1007/s40121-024-01082-2. Epub 2024 Dec 30.
While marked differences exist between influenza virus, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there is substantial overlap in the vulnerability of populations most at risk for severe disease following infection, chief among them being advanced age, multiple comorbidities, and immunocompromise. Vaccination is an established and effective preventative strategy to protect against respiratory viral infections (RVIs), reducing morbidity and mortality, minimizing the potential for long-term complications, and mitigating exacerbation of existing health conditions. Despite the demonstrated benefits of immunization throughout the life course and recommendations by health authorities, coverage rates of at-risk populations against vaccine-preventable diseases remain suboptimal and vary considerably by country and demographic strata. The objective of this supplement's concluding article is to discuss the current barriers to vaccination and strategies to enhance coverage against RVIs among adult at-risk populations. Identified barriers include low awareness of the risks of vaccine-preventable diseases, low perceived benefits of vaccination, and doubts regarding vaccine safety, which together contribute to vaccine hesitancy. Additionally, logistical issues related to vaccine supply, access, and costs present further challenges in achieving optimal coverage. Potential strategies to overcome these barriers and improve uptake include strengthening and harmonizing immunization guidelines and improving respiratory disease surveillance systems to appropriately identify needs and direct resources. Co-administration or use of combination vaccines against multiple viruses may be a viable strategy to enhance coverage by simplifying schedules and improving access, together with future utilization of enhanced vaccine platforms to develop novel vaccines. In addition, vaccination-focused healthcare provider training and consumer education are recommended to address vaccine hesitancy. Reaching vaccination targets and expanding coverage in adult at-risk populations are increasingly achievable with the availability of new and updated vaccination strategies for respiratory viruses, but will require collective efforts across providers, policymakers, scientists, health officials, and the general population.
虽然流感病毒、呼吸道合胞病毒（RSV）和严重急性呼吸综合征冠状病毒2（SARS-CoV-2）之间存在显著差异，但感染后最易患重症的人群存在很大重叠，其中主要包括老年人、多种合并症患者和免疫功能低下者。接种疫苗是预防呼吸道病毒感染（RVI）的既定且有效的预防策略，可降低发病率和死亡率，将长期并发症的可能性降至最低，并减轻现有健康状况的恶化。尽管免疫接种在整个生命过程中已证明有益，且有卫生当局的建议，但高危人群针对疫苗可预防疾病的接种率仍不理想，且因国家和人口阶层的不同而有很大差异。本增刊的结语文章旨在讨论当前的疫苗接种障碍以及提高成年高危人群RVI疫苗接种覆盖率的策略。已确定的障碍包括对疫苗可预防疾病风险的认识不足、对疫苗接种益处的认知度低以及对疫苗安全性的疑虑，这些共同导致了疫苗犹豫。此外，与疫苗供应、获取和成本相关的后勤问题在实现最佳覆盖率方面带来了进一步挑战。克服这些障碍并提高接种率的潜在策略包括加强和统一免疫接种指南，以及改善呼吸道疾病监测系统，以适当确定需求并指导资源分配。联合接种或使用针对多种病毒的联合疫苗可能是一种可行的策略，通过简化接种程序和改善获取途径来提高覆盖率，同时未来利用改进的疫苗平台开发新型疫苗。此外，建议针对医疗保健提供者开展以疫苗接种为重点的培训和对消费者进行教育，以解决疫苗犹豫问题。随着针对呼吸道病毒的新的和更新的疫苗接种策略的出现，在成年高危人群中实现疫苗接种目标并扩大覆盖率越来越可行，但这需要提供者、政策制定者、科学家、卫生官员和普通民众的共同努力。
