Communiqué
Published 22 January 2025

Vaccinating seniors: a neglected prevention duty

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Vaccinating seniors: a neglected prevention duty1

Press release from the National Academy of Medicine

January 22, 2025

Some infections are an increasingly heavy national medical and economic burden among seniors (people aged 65 and over), due to immunosenescence (decline in immune function). These include seasonal influenza, Covid-19, pneumococcal and respiratory syncytial virus (RSV) infections, and shingles. More than 90% of deaths attributable to influenza or Covid-19 occur after the age of 65. Pneumococcal and RSV infections cause high morbidity and mortality in this age group. In the elderly, the risk of cardiovascular events is significantly increased in the weeks following a respiratory infection [1]. The functional decline observed after influenza, Covid-19 or pneumococcal infection, with progressive loss of autonomy, represents the sixth leading cause of disability in the elderly. After age 70, the prevalence of shingles exceeds 10 p.1000, with frequent painful complications that impair quality of life for several months.

Despite the annual coverage by French Health insurance for vaccination against seasonal flu and Covid-19 (vaccinations on an annual basis), and despite the regular updating of the vaccination calendar by the Ministry of Health, these recommendations are poorly followed, and the vaccination coverage among seniors is stagnating at low levels for vaccines against influenza (54%), Covid-19 (30%), pneumococcus (5%) and shingles (4%), according to Santé Publique France. During the current severe flu epidemic, 79% of people hospitalized in intensive care during the first week of January 2025 were not vaccinated.

Vaccination coverage for senior citizens depends primarily   on the attending physicians who play a pivotal role. This requires, on their part, a good knowledge of new vaccines, their safe use, and the evolution of vaccine recommendations. The limited time of the medical consultation of an elderly person, already largely devoted to monitoring chronic illnesses, works also against the attention given to vaccination. In addition, the isolation of some seniors and the lack of coordination between the various healthcare actors can add a confusing factor to the implementation of vaccination.

The National Academy of Medicine recommends that vaccination of senior becomes a priority public health objective, as it increases active and autonomous life expectancy, avoids severe forms and complications of target diseases as well as post-infectious functional decline, reduces the associated economic burden, maintains group immunity (in the family or institutional environment) and helps to fight antibiotic resistance [2].

To improve vaccination coverage among seniors, the Academy recommends to:

– Implement a national prevention policy and prioritize five target diseases in the vaccination program for seniors: influenza, Covid-19, pneumococcal and RSV infections, shingles;

– Encourage healthcare professionals (doctors, but also pharmacists and nurses since the extension of vaccination competencies) to ensure that the vaccination status of elderly patients is updated, based on the new HAS (“Haute Autorité de santé”; High Health Authority) recommendations [3, 4, 5];

– Never assume that it is too late to vaccinate the elderly, as the effects of immunosenescence can be overcome by the use of new vaccines or new vaccine schedules [6];

– Make vaccinations accessible to elderly people living in EHPAD (nursing homes for the elderly), those living at home beneficiary of the personalized autonomy allowance (“Allocation personnalisée d’autonomie”) and those living far from health care centers, by developing mobile vaccination teams based on the “go towards” principle;

– Extend the use of digital vaccination records to the entire population, and seize every opportunity to update senior citizens’ vaccinations: outpatient consultations, hospitalizations, trips abroad, vaccination campaigns, etc;

– Accompany these measures with efforts to significantly increase vaccination coverage rates among healthcare professionals and entourage working in contact with the elderly, particularly against influenza and Covid-19, and especially during epidemic periods.

 

References

– Muñoz-Quiles C., López-Lacort M., Urchueguía A. et al., Risk of cardiovascular events after influenza : a population-based self-controlled case series study, Spain, 2011-2018, J Infect Dis., 2024; 230(3) : e722-e731

– Académie nationale de médecine, Vaccination des seniors, Rapport 23-25, 7 novembre 2023

https://www.academie-medecine.fr/wpcontent/uploads/2023/11/Rapport-23-25-Vaccination-des-se_2024_Bulletin-de-l-Acad-mie-Nationale-de-M.pdf

– HAS, Recommandation sur la Stratégie de vaccination contre les infections par le VRS chez l’adulte âgé de 60 ans et plus : place du vaccin mRESVIA (Moderna), 21 oct 2024. https://www.has-sante.fr/jcms/p_3550892/fr/

– HAS, Élargissement des critères d’éligibilité à la vaccination antipneumococcique chez les adultes, note de cadrage mise en ligne le 28 oct 2024, https://www.has-sante.fr/jcms/p_3552943/fr/

– HAS, Recommandations vaccinales contre le Zona. Place du vaccin Shingrix, Mis en ligne le 7 mars 2024. https://www.has-sante.fr/jcms/p_3498915/fr/

– “High dose” influenza vaccination: a step forward in the protection of seniors to be preserved. Press release from the French National Academy of Medicine May 15, 2024 https://www.academie-medecine.fr/

 

CONTACT PRESSE : Virginie Gustin +33 (0)6 62 52 43 42 virginie.gustin@academie-medecine.fr ACADÉMIENATIONALE DE MÉDECINE, 16 rue Bonaparte – 75272 Paris cedex 06 Site : www.academie-medecine.fr /

Twitter : @Acadmed

[1] Press release from the Rapid Communication Platform of the Academy.