Adult Vaccination

“Vaccination can provide cost-effective protection against a host of diseases throughout life, but remains an underused public-health strategy in adults for the promotion of healthy ageing. Without specific vaccination programmes for the adult population aged >50 years infectious diseases will continue to be a cause of substantial morbidity and mortality in late adulthood.”¹

Over the past 20 years we have seen the introduction of new vaccinations targeted explicitly at diseases which have a heavy burden on older adults including flu, pneumococcal disease and shingles,

Yet despite these developments, it remains that for too many adults, immunisation is seen as being ‘just for kids’; a few jabs for toddlers and school children and a begrudged necessity when travelling to certain parts of the world.

It is not viewed as the one aspect of a healthy lifestyle which doesn’t require us to abstain from a vice, work up a sweat or check a label for a food’s fat and calorie content.

Have we forgotten the lessons of the Spanish Flu?

Last year marked the 100th Anniversary of Spanish Flu. The deadly influenza (flu) pandemic infected some 500 million people² and resulted in deaths of between 50 and 100 million people. 17 million people may have died in India³ and half a million Americans lost their lives. Spanish Flu probably killed more people than the Black Death and more people in 24 weeks than AIDS did in 24 years⁴.

The Spanish Flu wasn’t a one off. Since 1918 the world has witnessed three other flu pandemics. Asian Flu in the late 1950s killed 1 million people⁵ and the 1968 Hong Kong Flu infected an estimated half a million people. The 2009 H1N1 Pandemic⁶ saw between 150,000 and half a million deaths across the world.

Yet despite the obvious risks of a future pandemic, academics and policymakers are concerned about growing complacency about the risks of infectious diseases⁷.

Such complacency is misplaced. In the US, the flu continues to kill between 3,000 and 49,000⁸ people per year. In 2014/2015 the flu was blamed for an increase in winter mortality among older people in the UK⁹.

There are fears that the world may be on the brink of another infectious disease pandemic. Late last year, the Daily Mail ran a story claiming “A global pandemic of a flu-like virus could kill 900 million people if it started to spread tomorrow”.¹⁰

Climate change, global conflict, and increasing levels of migration¹¹ and global travel increase the risk of diseases developing and spreading around the world very quickly. At the same time, humans are increasingly encroaching onto new environments, bringing together domestic and farmed animals closer to other wildlife.

In some those places most at risk of infectious diseases, there is an inadequate supply of healthcare workers¹² to limit the spread of disease. There are also fears that that antibiotic and antiviral resistance may reduce our ability to recover from disease. The potential for information about disease to travel around the world quickly could spread significant fear and have major economic repercussions.

How can adult vaccination help?

ILC-UK believes that vaccination has an instrumental role to play in reducing infection across the world.

In November 2013, SAATI (Supporting Active Ageing Through Immunisation)¹³ published ‘Adult vaccination: a key component of healthy ageing. Benefits of life-course immunisation in Europe’ (SAATI, 2013), which put forward evidence that adult immunisation programmes, especially for those aged above 50, can bring significant health and socio-economic benefits.

There is increasing interest and awareness in healthy ageing. As of August 2015 at least 5.5 million people in the UK had an active subscription to a gym¹⁴, with monthly prices ranging as widely as from £15 per month, or £180 a year, to up to £100 per month, or £1200 a year¹⁵.

As well as purchasing new gym wear and any additional paraphernalia, in 2012 UK consumers spent £385 million on vitamins, minerals and dietary supplements¹⁶, all money spent in the pursuit of good health and fitness.

Evidence from the UK showed that during the 2014-2015 seasonal influenza season in the UK, only 50%¹⁷ of those aged six months to under 65 years in an at risk category received their free flu jab, a tried and tested method of keeping us healthy which requires no more exertion then popping to our GPs or booking a visit to a community pharmacy. For frontline health care workers, this figure was only 54.9%¹⁸.

Recent research by ILC-UK has highlighted how flu vaccination uptake has been falling across Europe.

So what next?

It is clear to us that adult vaccination is a key component of healthy ageing. Yet we are not maximising the potential of this intervention. In our ageing world it is vital that policymakers, consumer groups and industry work together to raise awareness and increase uptake of adult vaccinations.

ILC-UK intend to build on our work in this area an engage policymakers and practitioners in identifying solutions to the concerns we have highlighted.

For more info, visit ilcuk.org.uk

References

• 1 Michel, J. -P., Gusmano, M., Blank, P.R. and Philp, Ian (2010) Vaccination and healthy ageing : how to make life-course vaccination a successful public health strategy. European Geriatric Medicine, Vol.1 (No.3). pp. 155-165.doi:10.1016/j.eurger.2010.03.013
• 2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291398/
• 3 https://www.geni.com/projects/1918-lnfluenza-Pandemic-India-Fatalities/24256
• 4 https://www.nytimes.com/2004/03/14/books/virus-alert.html
• 5 https://en.wikipedia.org/wiki/1968_flu_pandemic
• 6 https://www.cdc.gov/flu/pandemic-resources/basics/past-pandemics.html
• 7 https://www.gatesnotes.com/Health/Shattuck-Lecture
• 8 https://www.scientificamerican.com/article/how-does-the-flu-actually-kill-people/
• 9 https://www.theguardian.com/society/2015/nov/25/excess-winter-deaths-rose-more-than-150-43900-2014
• 10 https://www.dailymail.co.uk/health/article-6006655/A-deadly-virus-pandemic-kill-900-million-people-happened-today.html
• 11 https://edition.cnn.com/2017/04/03/health/pandemic-risk-virus-bacteria/index.html
• 12 https://ysjournal.com/the-critical-shortage-of-healthcare-workers-in-sub-saharan-africa-a-comprehensive-review/
• 13 SAATI Partnership (2013). Adult vaccination: a key component of healthy ageing. Benefits of life-course immunisation in Europe. [pdf] SAATI Partnership. Available at: http://www.ilcuk.org.uk/index.php/publications/publication_details/adult_vaccination_a_key_component_of_healthy_ageing [Accessed on 22 January 2014].
• 14 https://www.theguardian.com/lifeandstyle/2015/aug/18/uk-gym-membership-spending-up-by-44-per-cent
• 15 https://www.theguardian.com/money/2014/jan/04/buyers-guide-gym-membership
• 16 https://store.mintel.com/vitamins-and-supplements-uk-september-2012?cookie_test=true
• 17 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/429612/Seasonal_Flu_GP_Patient_Groups_Annual_Report_2014_15.pdf
• 18 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/429612/Seasonal_Flu_GP_Patient_Groups_Annual_Report_2014_15.pdf