Age-related changes of the immune system contribute to increased incidence and severity of infections in the elderly. Vaccination is the most effective measure to prevent infections and vaccination recommendations in most countries include specific guidelines for the elderly. Vaccination against influenza and Streptococcus pneumoniae is usually recommended for persons with underlying diseases and for the elderly with heterogeneous age limits between ≥ 50 years and ≥ 65 years. Some countries also recommend vaccination against herpes zoster. Several vaccines are recommended for all adults, such as regular booster shots against tetanus/diphtheria/pertussis/polio, or for specific groups, e.g. vaccination against tick-borne encephalitis in endemic areas or travel vaccines. These are also relevant for the elderly. Most currently used vaccines are less immunogenic and effective in the elderly compared to younger adults. Potential strategies to improve their immunogenicity include higher antigen dose, alternative routes of administration, and the use of adjuvants, which were all implemented for influenza vaccines, and induce moderately higher antibody concentrations. Research on universal vaccines against influenza and S. pneumoniae is ongoing in order to overcome the limitations of the current strain-specific vaccines. Respiratory syncytial virus causes significant morbidity in the elderly. Novel vaccines against this and other pathogens, for instance bacterial nosocomial infections, have tremendous potential impact on health in old age and are intensively studied by many academic and commercial organizations. In addition to novel vaccine developments, it is crucial to increase awareness for the importance of vaccination beyond the pediatric setting, as vaccination coverage is still far from optimal for the older population.

中文翻译：

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老年人疫苗：当前的使用和未来的挑战。

与年龄有关的免疫系统变化导致老年人感染的发生率和严重性增加。疫苗接种是预防感染的最有效措施，大多数国家的疫苗接种建议包括针对老年人的特定指南。通常建议患有基础疾病的人以及年龄在≥50岁和≥65岁之间的老年人接种针对流感和肺炎链球菌的疫苗。一些国家还建议对带状疱疹进行疫苗接种。建议为所有成年人提供几种疫苗，例如针对破伤风/白喉/百日咳/脊髓灰质炎的常规加强注射，或针对特定人群，例如针对流行地区的tick传播性脑炎进行疫苗接种或旅行疫苗。这些也与老年人有关。与年轻人相比，大多数当前使用的疫苗对老年人的免疫原性较低，效果更好。改善其免疫原性的潜在策略包括更高的抗原剂量，替代的给药途径以及使用佐剂，所有这些均已用于流感疫苗，并诱导适度更高的抗体浓度。为了克服当前菌株特异性疫苗的局限性，正在进行针对流感和肺炎链球菌的通用疫苗的研究。呼吸道合胞病毒在老年人中引起很大的发病率。针对这种病原和其他病原体的新型疫苗，例如细菌性医院感染，对老年健康具有巨大的潜在影响，许多学术和商业组织都对其进行了深入研究。除了新颖的疫苗开发，