Abstract
Older adults (≥65 years of age) are particularly vulnerable to influenza illness. This is due to a waning immune system that reduces their ability to respond to infection, which leads to more severe cases of disease. The majority (∼90%) of influenza-related deaths occur in older adults and, in addition, catastrophic disability resulting from influenza-related hospitalization represents a significant burden in this vulnerable population. Current influenza vaccines provide benefits for older adults against influenza; however, vaccine effectiveness is lower than in younger adults. In addition, antigenic drift is also a concern, as it can impact on vaccine effectiveness due to a mismatch between the vaccine virus strain and the circulating virus strain. As such, vaccines that offer higher and broader protection against both homologous and heterologous virus strains are desirable. Approaches currently available in some countries to meet this medical need in older adults may include the use of adjuvanted vaccines. Future strategies under evaluation include the use of high-dose vaccines; novel or enhanced adjuvantation of current vaccines; use of live attenuated vaccines in combination with current vaccines; DNA vaccines; recombinant vaccines; as well as the use of different modes of delivery and alternative antigens. However, to truly evaluate the benefits that these solutions offer, further efficacy and effectiveness studies, and better correlates of protection, including a precise measurement of the T cell responses that are markers for protection, are needed. While it is clear that vaccines with greater immunogenicity are required for older adults, and that adjuvanted vaccines may offer a short-term solution, further research is required to exploit the many other new technologies.
| Original language | English |
|---|---|
| Pages (from-to) | 5043-5053 |
| Number of pages | 11 |
| Journal | Vaccine |
| Volume | 27 |
| Issue number | 37 |
| Early online date | 24 Jun 2009 |
| DOIs | |
| Publication status | Published - 13 Aug 2009 |
| Externally published | Yes |
Funding
Ansaldi: has previously participated at speakers’ bureau and advisory board meetings sponsored by sanofi pasteur and Novartis Vaccines, and has received research funding from sanofi pasteur. Aspinall: has no conflicts to declare. McElhaney: CSL (honoraria), GSK (research funding, consultancy, and honaria), Merck (consultancy, honoraria, Site PI for a clinical research study, and a clinical trial), Novartis (honoraria), Novavax (consultancy), sanofi pasteur (consultancy and honoraria), and Solvay (consultancy and honoraria). Montaño: has no conflicts to declare. Monto: has received research funding from sanofi pasteur and has been a consultant or advisory board member for Novartis, GSK, and Solvay. Nichol: has received research funding from GSK and sanofi pasteur, and has served as a consultant on advisory boards to GSK, Novartis, CSL, MedImmune, sanofi pasteur. Puig-Barberá: has received honoraria or grants for participating in advisory boards, conferences, and attending scientific meetings from Novartis, GSK, sanofi pasteur, MSD, and ESTEVE. Schmitt: has been an employee of Novartis Vaccines and Diagnostics, Marburg, Germany from September 9, 2007. Stephenson: has received financial support for scientific research, speaker's fees, and attendance at international meetings from influenza vaccine manufacturers including GSK, Novartis, and sanofi pasteur. Development of this manuscript has been financed by an unrestricted grant from Novartis Vaccines. Editorial assistance was provided by Dr Rebecca Bradley at Alpharmaxim Healthcare Communications during the preparation of this paper, supported by Novartis Vaccines. Responsibility for opinions, conclusions, and interpretation of data lies with the authors.
Keywords
- Influenza
- Older adults
- Protection
ASJC Scopus subject areas
- Molecular Medicine
- General Immunology and Microbiology
- General Veterinary
- Public Health, Environmental and Occupational Health
- Infectious Diseases
