The avalanche is coming... and just now it's starting to snow

Previous vaccine development has been driven mainly by policies and concerns around childhood, with the aim of preventing premature death amongst young children from infectious disease and stopping them from acting as carriers. Whilst this is important, the face of the world has changed recently and the problem has now to be extended to include the protection of a vulnerable aging population. Here we present the case for a need to develop a prophylactic regimen for older individuals which features vaccination at the center of a portfolio of treatments. Advances in medical, social, and economic conditions have resulted in human population growth and an ever-extending life expectancy such that for the first time in our history the world population will soon have more people over the age of 65 than under the age of 5. The development of antibiotic therapy, progresses in vaccine technology combined with mass vaccination programs and government schemes to improve economic and social well-being mean that the majority of individuals over the age of 65 are currently physically more active than their counterparts a few decades ago (Michel et al., 2008). Moreover these individuals now travel more than either their parents or grandparents. The world is now so closely networked that any pathogen may spread across the globe within hours, as was observed with the recent H5N1 and H1N1 pandemics (Lang and Aspinall, 2012). In addition to the continuing trend toward increased life expectancy and the shifting demographics, the incidence and prevalence of chronic diseases are also expected to reach unprecedented levels as evidenced from a recent study on individuals over 80 years of age, which showed that many are living with an increasing number of comorbidities (Collerton et al., 2009).