Differential Approaches for Vaccination from Childhood to Old AgePrelog M.
Department of Pediatrics, University of Würzburg, Würzburg, Germany; Department of Pediatrics, Medical University Innsbruck, Innsbruck, Austria
Primary prevention strategies, such as vaccinations at the age extremes, in neonates and elderly individuals, demonstrate a challenge to health professionals and public health specialists. The aspects of the differentiation and maturation of the adaptive immune system, the functional implications of immunological immaturity or immunosenescence and its impact on vaccine immunogenicity and efficacy will be highlighted in this review. Several approaches have been undertaken to promote Th1 responses in neonates and to enhance immune functions in elderly, such as conjugation to carrier proteins, addition of adjuvants, concomitant vaccination with other vaccines, change in antigen concentrations or dose intervals or use of different administration routes. Also, early protection by maternal vaccination seems to be beneficial in neonates. However, it also appears necessary to think of other end points than antibody concentrations to assess vaccine efficacy in neonates or elderly, as also the cellular immune response may be impaired by the mechanisms of immaturity, underlying health conditions, immunosuppressive treatments or immunosenescence. Thus, lifespan vaccine programs should be implemented to all individuals on a population level not only to improve herd protection and to maintain protective antibody levels and immune memory, but also to cover all age groups, to protect unvaccinated elderly persons and to provide indirect protection for neonates and small infants.
Prof. Martina Prelog, MD, MSc
Department of Pediatrics, University of Würzburg
DE-97080 Würzburg (Germany)
Received: January 4, 2012
Accepted: September 17, 2012
Published online: November 24, 2012
Number of Print Pages : 10
Number of Figures : 0, Number of Tables : 2, Number of References : 47
Gerontology (International Journal of Experimental, Clinical, Behavioural and Technological Gerontology)
Vol. 59, No. 3, Year 2013 (Cover Date: April 2013)
Journal Editor: Wick G. (Innsbruck)
ISSN: 0304-324X (Print), eISSN: 1423-0003 (Online)
For additional information: http://www.karger.com/GER