Vaccines against viral infections

Abstract

Abstract A decline in immune function and increased susceptibility to infection is a hallmark of ageing. Influenza is foremost among these infections with 90% of deaths occurring in older adults despite widespread vaccination programmes. Common medical conditions and mental and psychosocial health issues, as well as degree of frailty and functional dependence may all contribute to the loss of immune responsiveness to infections and vaccination. The interactions of immune senescence, persistent cytomegalovirus infection, inflammaging (chronic elevation of inflammatory cytokines), and dysregulated cytokine production pose major challenges to the development of new or more effective vaccines. This chapter describes viral infections that have the greatest impact in older adults, age-related changes in the immune system that contribute to loss of vaccine responsiveness, available vaccines against influenza and herpes zoster and the need for vaccines against other viruses, and strategies for improving vaccine effectiveness to address the public health need for ‘vaccine preventable disability’.