From ID Week: Adult Immunization Barriers and Promoters

How is the immune system similar to your marathon time? As we age, our immune response decreases at the same slope that our marathon race times increase. Presenters described this and some of the other problems of immunizing adults in the Symposium on Adult Immunizations, an early session at the Infectious Diseases Society 2014 conference at the Philadelphia Convention Center.

Kenneth Schmader, MD, noted that though adults age differently – some adults at age 75 may be running marathons while others may be frail – all are subject to immune system senescence, and all are vulnerable to rapid functional declines that may result from an acute stressor, whether it’s a fall or a debilitating case pneumococcal pneumonia.

Immunization, therefore, is important for older adults, and also for their community members and caregivers. Several studies have demonstrated the benefits to older adults when schoolchildren in the community receive influenza immunization and pneumococcal immunization. Caregivers can protect themselves from vaccine-preventable diseases while also providing a transmission barrier to the older adults for whom they are responsible.

Questions after Dr. Schmader’s presentation regarding the intricacies of vaccinating older adults with pneumococcal and herpes zoster vaccines illustrated a theme of the next talk. William Schaffner, MD, discussed the factors that create a challenging environment for adult immunization. Whereas the childhood immunization schedule is mostly universal and straightforward, the adult schedule is full of special cases and special populations. Childhood vaccines are “great” vaccines: they’ve eliminated or nearly eliminated polio, measles, rubella, and diphtheria, whereas adult vaccines are “good” vaccines that don’t eliminate diseases but rather reduce an individual’s risk for illness or severe illness.

Another difference between the childhood and adult immunization programs is that many professional organizations communicate to the public about childhood immunization. There’s no set of similar strong champions for adult immunization.

Dr. Schaffner noted that the National Adult and Influenza Immunization Summit might be able to become such an advocate in the future.