Promoting Healthy Ageing in South Africa Through Vaccination of the Elderly.

Mncengeli Sibanda,Rosemary J. Burnett,Johanna C. Meyer,Kesentseng J. Mahlaba

doi:10.3389/fpubh.2021.635266

Mncengeli Sibanda, Rosemary J. Burnett + Show 2 more

Open Access

https://doi.org/10.3389/fpubh.2021.635266

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Abstract

The World Health Organization estimates that globally, the proportion of people aged ≥60 years will more than double by the year 2050, with the majority of elderly people living in low- and middle-income countries such as South Africa. Population ageing is an impending public health concern, potentially negatively impacting on South Africa's economy and health system if the government does not adequately prepare for this change. Globally, many potential solutions to ensure healthy ageing are being discussed and implemented, including adopting a “life-course” approach to vaccination which includes vaccination of the elderly, since they are at considerable risk of severe morbidity and mortality from vaccine-preventable diseases. While vaccines are considered as one of the greatest tools for preventing childhood infectious disease morbidity and mortality, they are under-utilised in strategies for promoting healthy ageing in South Africa, where only influenza vaccination is available free of charge to the elderly accessing public sector healthcare. Population ageing coupled with the high incidence of vaccine-preventable diseases amongst elderly South Africans, necessitates establishing a comprehensive national policy and guidelines for vaccination of the elderly.

Highlights

Healthy ageing is defined by the World Health Organization (WHO) as “the process of developing and maintaining the functional ability that enables well-being in older age” [1]
antimicrobial resistance (AMR) is increasingly becoming a public health concern and again the elderly are more at risk of acquiring multidrug-resistant infections and contribute to AMR for a number of reasons [21,22,23]. These include immunosenescence, impaired immune function due to chronic diseases, and other factors such as increased and longer contact with healthcare facilities, staying in old-age homes, and the use of medical devices e.g., catheters which are predisposed to bacterial colonisation [21,22,23]
Since the successful introduction of antiretroviral treatment for HIV/AIDS, South Africa (SA) entered into a demographic transition which is expected to see the elderly comprise almost 16% of the population by 2050

Summary

INTRODUCTION

Healthy ageing is defined by the World Health Organization (WHO) as “the process of developing and maintaining the functional ability that enables well-being in older age” [1]. AMR is increasingly becoming a public health concern and again the elderly are more at risk of acquiring multidrug-resistant infections and contribute to AMR for a number of reasons [21,22,23] These include immunosenescence, impaired immune function due to chronic diseases, and other factors such as increased and longer contact with healthcare facilities (due to higher morbidities in old age), staying in old-age homes (which increases the chance of transmission of infectious diseases such as influenza and pneumococcal pneumonia), and the use of medical devices e.g., catheters which are predisposed to bacterial colonisation [21,22,23]. While SA private sector recommendations are more comprehensive than the STGs/EML, when compared to HICs (Table 1) there are still several deficiencies [22, 28,29,30,31, 52]

CONCLUSIONS

Findings

31. Germany