Vaccines are one of the best life-saving interventions developed with the intent to prevent the spread of infectious diseases. Vaccines are also the principal tool for primary prevention of communicable diseases, being highly efficacious and cost-effective. Thus, promoting life-course vaccination programmes is essential for the wellbeing of the whole population, particularly in the elderly.
The aging immune system or immunosenescence is thought to be a major risk factor for the higher incidence and prevalence of chronic conditions, like cardiovascular diseases, metabolic diseases, and neurodegenerative diseases. With the advance of immunosenescence, older adults also become more susceptible to infectious diseases and cancer. In practice this means that vaccination schedules for old adults should be adapted accordingly, and tailored vaccines should be considered in old age. The impressive and unexpected efficacy of new mRNA-based vaccines opens the way to encourage a more global advance in vaccine research to help achieve an overall better immunological protection.
Those considerations are only some of the concerns highlighted on the ‘Immunisation for old adults in Europe: scientific and social strategies‘ report published today (9 March), prepared by the Federation of European Academies of Medicine (FEAM), who convened an expert committee with the aim of examining some basic parameters of immunosenescence and of identifying challenges on the current situation of adult vaccination in Europe.
A survey distributed by FEAM in Spring 2021, assembled data from European Academies on current national adult vaccination schedules. The collected data clearly confirmed the heterogeneity existing amongst EU countries on vaccination policies, particularly in terms of age qualification, vaccine components, frame of implementation and reimbursement procedures. While Member States have their own mechanisms to recommend and facilitate vaccination, a greater harmonization of such programmes would be beneficial, while also crucial is the development of a culture of vaccine promotion among the general population and between healthcare workers. As a matter of fact, the lack of consensus for some immunization schedules was also noted as an important issue, as such behavior may contribute to a reduction in confidence in the entire adult vaccination program. Despite the highly significant role that vaccines play in global health, concerns over their safety and the heterogeneity of distribution worldwide have increased tremendously over the years.
The FEAM report also examines this growing issue of vaccine hesitancy leading to refusal, with an emphasis on education for old people and healthcare workers. Due to a lack of appropriate vaccine education, healthcare professionals may lack confidence in the efficacy of vaccines, or not fully appreciate the positive effects they bring, or the risk of the disease, and the importance of their role in possible transmission. A considerable higher level of education may contribute to higher acceptance and recognition of vaccine’s benefits, and this is key to promote the establishment of more inclusive societies that allay fears and address concerns around vaccination efficacy.
FEAM strongly believes that in the current COVID-19 era, the time is right to increase vaccine diplomacy. Our goal is thus to contribute to the establishment of common immunisation programmes across Europe, and recommendations for promoting “health ageing” are reported in this paper. George Griffin, FEAM Immediate Past-President and Chair of the Expert Committee, stressed the importance of addressing the challenge of adult vaccination: “At European level, there are already very clear paediatric vaccination programmes, but this is not the case for older adult programmes. This report comes to reveal this major gap.”
In view of healthy ageing, experts call on Europe and all Member States to prioritise vaccination in the older population and harmonise schedules and recommendations. This will enable the existing gap in vaccines for adults to be closed and protect the older population at risk.
About the report:
The FEAM Working Group met in May, July, October, and November 2021 by videoconference. In addition to the Working Group meetings, evidence was gathered in a workshop organised by the FEAM European Biomedical Policy Forum in October 2021. The draft report was reviewed and endorsed by the 23 FEAM academies in January 2022. FEAM thanks all who contributed to preparing and reviewing the text. FEAM wishes to express its gratitude to the GlaxoSmithKline (GSK) Biologicals SA for sponsoring this project in the form of an unrestricted grant and in accordance with FEAM policy on cooperation with private sector.