Differential Approaches for Vaccination from Childhood to Old Age

Department of Pediatrics, University of Würzburg, Würzburg, Germany
Gerontology (Impact Factor: 3.06). 11/2012; 59(3). DOI: 10.1159/000343475
Source: PubMed


Primary prevention strategies, such as vaccinations at the age extremes, in neonates and elderly individuals, demonstrate a challenge to health professionals and public health specialists. The aspects of the differentiation and maturation of the adaptive immune system, the functional implications of immunological immaturity or immunosenescence and its impact on vaccine immunogenicity and efficacy will be highlighted in this review. Several approaches have been undertaken to promote Th1 responses in neonates and to enhance immune functions in elderly, such as conjugation to carrier proteins, addition of adjuvants, concomitant vaccination with other vaccines, change in antigen concentrations or dose intervals or use of different administration routes. Also, early protection by maternal vaccination seems to be beneficial in neonates. However, it also appears necessary to think of other end points than antibody concentrations to assess vaccine efficacy in neonates or elderly, as also the cellular immune response may be impaired by the mechanisms of immaturity, underlying health conditions, immunosuppressive treatments or immunosenescence. Thus, lifespan vaccine programs should be implemented to all individuals on a population level not only to improve herd protection and to maintain protective antibody levels and immune memory, but also to cover all age groups, to protect unvaccinated elderly persons and to provide indirect protection for neonates and small infants.

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    • "In most infectious disease models, it has been assumed that all vaccinated individuals have equal immunity provided by the vaccine during their vaccination period. However, the duration of protection provided by vaccination varies and is influenced by many factors, particularly the individual characteristics and the vaccine-age [6] [7]. Therefore, there are enough reasons to study the possible effects of loss of vaccineinduced immunity on the dynamics of infectious diseases. "
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    ABSTRACT: In this paper, we formulate a susceptible-vaccinated-infected-recovered (SVIR) model by incorporating the vaccination of newborns, vaccine-age and mortality induced by the disease into the SIR epidemic model. It is assumed that the period of immunity induced by vaccines varies depending on the vaccine-age. Using the direct Lyapunov method with Volterra-type Lyapunov function, we show the global asymptotic stability of the infection-free and endemic steady states. Keyword: Age-dependent epidemic model; Vaccine-age; Waning vaccine-induced immunity; Volterra-type Lyapunov function; Global stability
    Abstract and Applied Analysis 01/2015; DOI:10.1155/2015/341854 · 1.27 Impact Factor
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    • "As such, it is generally recommended that everyone over the age of 65 receive the seasonal trivalent inactivated influenza vaccine (TIV) as well as pandemic influenza vaccines, if applicable, in order to maintain serum antibody levels. The effectiveness of this strategy is debatable, with multiple studies of the efficacy of the vaccine in the elderly being performed with little consensus between studies (Prelog, 2012). This lack of consensus is due to a lack of study protocol standardization and outcome parameters, as well as insufficient consideration of patient frailty and study bias. "
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    ABSTRACT: Vaccination remains the most effective prophylactic intervention for infectious disease in the healthcare professional's toolkit. However, the efficacy and effectiveness of vaccines decrease with age. This becomes most apparent after an individual reaches 65-70 years old, and results from complex changes in the immune system that occur during aging. As such, new vaccine formulations and strategies that can accommodate age-related changes in immunity are required to protect this expanding population. Here, we summarize the consequences of immunosenescence on vaccination and how novel vaccination strategies can be designed to accommodate the aging immune system. We conclude that current vaccination protocols are not sufficient to protect our aging population and, in some cases, are an inefficient use of healthcare resources. However, researchers and clinicians are developing novel vaccination strategies that include modifying who and when we vaccinate and capitalize on existing vaccines, in addition to formulating new vaccines specifically tailored to the elderly in order to remedy this deficiency.
    Frontiers in Immunology 06/2013; 4:171. DOI:10.3389/fimmu.2013.00171