The role of vaccination in successful independent ageing

Ageing increases the risk and severity of infectious diseases, especially when chronic diseases are present. Healthcare providers generally view vaccination as a childhood intervention and consider vaccination of the elderly not to be sufficiently effective due to immunosenescence. However, the burden of frequent vaccine-preventable diseases, such as influenza, pneumococcal disease and herpes zoster, increases with age, so that the perceived lower vaccine effectiveness should be considered in the context of this higher burden. Vaccination can prevent infection and mortality hospitalization and functional decline, and their consequences thereby having a positive impact. The use of medications will be reduced (e.g. antibiotics, analgesics) and therefore the iatrogenic risk would be lower. This contributes to an improved quality of life and to successful ageing. Many countries recommend influenza and pneumococcal vaccination in the elderly and, more recently, some recommend the live-attenuated herpes zoster vaccine. However, better guidelines and recommendations, especially for frail individuals are needed. Protection may be improved by offering vaccination to younger, fitter individuals, before they become frail. In addition, offering vaccination to caregivers and others who are in contact with the elderly could also improve protection. Many studies have demonstrated that influenza, pneumococcal and herpes zoster vaccinations in the elderly are cost-effective and can even be cost-saving. Healthcare providers and public health decision-makers need to understand more fully the value of vaccination and to consider it as an important preventive tool in the promotion of successful ageing.