ABSTRACT

Introduction

Immunosenescence is a normal biologic process involving deterioration of protective immune responses. Consequently, older adults experience increased risk of infectious diseases, particularly pneumonia, and its leading bacterial cause, Streptococcus pneumoniae. Pneumococcal vaccine recommendations are often limited to adults with specific medical conditions despite similar disease risks among older adults due to immunosenescence.

Areas covered

This article reviews epidemiologic, biologic, and clinical evidence supporting the consideration of older age due to immunosenescence as an immunocompromising condition for the purpose of pneumococcal vaccine policy and the role vaccination can play in healthy aging.

Expert opinion

Epidemiologic and biologic evidence suggest that pneumococcal disease risk increases with age and is comparable for healthy older adults and younger adults with immunocompromising conditions. Because immunocompromising conditions are already indicated for pneumococcal conjugate vaccines (PCVs), a comprehensive public health strategy would also recognize immunosenescence. Moreover, older persons should be vaccinated before reaching the highest risk ages, consistent with the approach for other immunocompromising conditions. To facilitate PCV use among older adults, vaccine technical committees (VTCs) could classify older age as an immunocompromising condition based on the process of immunosenescence. With global aging, VTCs will need to consider immunosenescence and vaccine use during healthy aging.

中文翻译：

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将老年归类为肺炎球菌疫苗政策的高风险、免疫受损状况的流行病学和生物学基础

摘要

介绍

免疫衰老是一个正常的生物学过程，涉及保护性免疫反应的恶化。因此，老年人患传染病的风险增加，尤其是肺炎及其主要细菌性肺炎链球菌。肺炎球菌疫苗建议通常仅限于患有特定疾病的成年人，尽管由于免疫衰老，老年人的疾病风险相似。

涵盖的领域

本文回顾了流行病学、生物学和临床证据，这些证据支持将免疫衰老导致的老年视为肺炎球菌疫苗政策的免疫损害条件，以及疫苗接种在健康老龄化中的作用。

专家意见

流行病学和生物学证据表明，肺炎球菌疾病的风险随着年龄的增长而增加，并且与健康的老年人和免疫功能低下的年轻人相当。由于肺炎球菌结合疫苗 (PCV) 已经适用于免疫功能受损的条件，因此全面的公共卫生战略也将识别免疫衰老。此外，老年人应在达到最高风险年龄之前接种疫苗，这与其他免疫功能低下疾病的方法一致。为了促进老年人使用 PCV，疫苗技术委员会 (VTC) 可以根据免疫衰老过程将老年人归类为免疫功能低下的疾病。随着全球老龄化，VTC 将需要在健康老龄化期间考虑免疫衰老和疫苗的使用。