Ageing and immunization Roman Prymula University Hospital Hradec
- Slides: 7
Ageing and immunization Roman Prymula University Hospital Hradec Kralove Prague 31 May 2012
Why immunization of adults? n Ratio of age cohorts 0 -14 and 65+ in the Czech population in time Adult population is exposed to: Vaccine preventable diseases ¨ Chronic diseases and comorbidities ¨ n n n Ageing Waning immunity and immunosenescence New vaccines for adults and older people ¨ n n ČSÚ: Projekce obyvatelstva České republiky, available at: http: //www. czso. cz/csu/2004 edicniplan. nsf/t/B 0001 D 6145/$File/4025 rra. pdf VZV, HSV, CMV, Alzheimer disease, Parkinson disease, various carcinomas Vaccination coverage in adults is low Perception on vaccines is low In US 350 x more adults die on vaccine preventable diseases than children! Prague 31 May 2012
Ratio of older people in population, 2008 -2040 (Europe) Western Europe Eastern Europe 30 30 28. 1 2008 24. 4 25 2020 15 17. 3 14. 5 12. 6 10 6 7. 8 6. 9 4. 3 5 3 0 2040 20. 9 Population (%) 2040 20 2020 25 20 17. 8 15 15 10. 1 8. 5 10 9. 3 4. 9 5 6. 2 0 >65 >75 Age (Years) >80 >65 >75 >80 Age (Years) Kinsella K, He W. US Census Bureau, International Population Reports, P 95/09 -1, 3 An Aging World: 2008, US Government Printing Office: Washington, DC; 2009.
Risk of pneumococcal diseases development is multiplied in chronic ill adults 57 x 60 48 x 50 34 x 40 30 20 10 0 6 x Diabetes mellitus 7 x 10 x 11 x Chronic Cardiovascula Alcoholism respiratory d. r d. Solid tumor HIV Haematologica l malig. Kyaw MH et al. JID 2005; 192: 377 -86
Children Adoles cents Vaccination in adults Adults Older people 1. Boosting after primary schedule in childhood 2. Primary immunization in adults and older people 3. Boosting in adults and older people 4. Vaccination of travellers Prague 31 May 2012
Higher mortality on pneumonia (community acquiered included) starts since 45 th year of age 9 9 9, 70, 0 6 5 United Kingdom, Mortality according to age, 2005 61. 2 Female 60 Male 40. 6 50 40 2 1. 4. 5 9 57 0. 60 9. 6. 7 2. 7 0. 4 0. 3 0. 2 1 0. 5 0. 1 1. 1 2 9 5. 10 6 12 20 9 18. 6 30 3. Mortality/100, 000 inhabitants 70 0 <1 1 -4 5 -14 15 -24 25 -34 35 -44 45 -54 55 -64 Age (years) Prague 31 May 2012 (WHO Statistics. Mortality Database. http: //apps. who. int/whosis/database/mort/table 1_process. cfm. Accessed June 10, 2009. ) 65 -74 75+
Conclusion n n n Rising importance of adult and older people vaccination Persistent low coverage of older people Implementation of adult immunization calendar Development of national guidelines Accessibility to adult vaccines Role of GPs Vaccination is very important for prevention of diseases and generaly for life protection. Prague 31 May 2012
