Application of prophylactic vaccines in the elderly

Extended lifespan and increasing number of the elderly (>65 years) worldwide carries the challenges for the public health system, as this is the population particularly susceptible to infectious diseases. One way to prevent these diseases is vaccination. In order to improve the quality of life of the elderly, to reduce complications, hospitalizations and mortality, many European countries and the United States recommend the vaccination of the elderly with the influenza vaccine, vaccines against Streptococcus pneumoniae and Varicella-zoster virus (VZV), and booster vaccination against tetanus, pertussis and diphtheria. The reason for the greater susceptibility to infectious diseases, and lower efficacy of vaccines in the elderly, are age-associated changes of the immune system. In most European countries seasonal influenza vaccine is recommended for the individuals over 65 years of age. Its efficacy is lower in the elderly than in adults, so strategies are being developed to overcome these problems (including adjuvants in the formulation, increasing the antigen dose, changing the route of immunization, development of vector-based vaccines). Polysaccharide and conjugated vaccines are available against S. pneumoniae, but data regarding their efficacy are inconsistent. The VZV vaccine is an attenuated, live vaccine and has been shown to be effective in reducing the incidence of herpes zoster and post-herpetic neuralgia. Raising awareness of the importance of vaccination in the elderly and the development of vaccines tailored for this population is of great importance for the preservation of their health.