Effectiveness of influenza vaccine in aging and older adults: comprehensive analysis of the evidence
Pierre-Olivier Lang1,2, Aline Mendes1, Jennifer Socquet1, Noémie Assir1, Sheila Govind2, Richard Aspinall2
1Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals and Medical School of Geneva, Geneva, Switzerland; 2Translational Medicine Research Group, Cranfield Health, Cranfield University, Cranfield, England
Abstract: Foremost amongst the diseases preventable by vaccination is influenza. Worldwide, influenza virus infection is associated with serious adverse events leading to hospitalization, debilitating complications, and death in elderly individuals. Immunization is considered to be the cornerstone for preventing these adverse health outcomes, and vaccination programs are timed to optimize protection during the annual influenza season. Trivalent inactivated influenza virus vaccines are believed to be both effective and cost-saving; however, in spite of widespread influenza vaccination programs, rates of hospitalization for acute respiratory illness and cardiovascular diseases have been increasing in this population during recent annual influenza seasons. From meta-analyses summarizing estimates of influenza vaccine effectiveness from available observational clinical studies, this review aims to examine how effective current influenza vaccine strategies are in the aging and older adult population and to analyze which are the most important biases that interfere with measurements of influenza vaccine effectiveness. Furthermore, consideration is given to strategies that should be adopted in order to optimize influenza vaccine effectiveness in the face of immune exhaustion.
Keywords: influenza vaccine effectiveness, influenza virus infection, immunosenescence, hemagglutinin activity inhibition, innate immunity, hemagglutinin inhibition, older adults
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