The document highlights the importance of adult vaccination in promoting healthy aging, particularly as the elderly population and related health issues increase globally. It discusses barriers to vaccination, including lack of awareness and myths, and provides recommendations for promoting vaccination awareness among seniors through mobile camps, education, and community involvement. Vaccination is presented as a crucial intervention to reduce disease burden, hospitalization, and improve health outcomes for older adults.

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Healthy Aging through AdultVaccination
Prof. Sreerama Krupanidhi
Former Professor and Dean
Dept of Biosciences, SSSIHL, AP &
Dept of Biotechnology,VFSTRU, AP
sknbirac@gmail.com; Mobile: 9440984668
20-09-2024

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Purpose
1. To disseminate the information on the importance and
necessity of adult vaccination.
2. To provide a few recommendations to create awareness
particularly among the senior adults.

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Source: Our World in Data Historical Pandemics Database 2023
Pre-vaccination period: Humanity suffered through series of disease pandemics
Disease Pandemic before 19th
century:
1347-1353 Black Death: 50 million deaths (60% Europeans)
1492-1600 Columbian Exchange: 48 million deaths (90% Native Americans)

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Contents
1. UN Decade of Healthy aging concept-Increase
in elderly population, related illness and
remedial measures.
2. Decline in immune response upon aging.
3. Barriers in adult vaccination.
4. Programmed adult vaccination-upkeep the
health even in the late ages.

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“Aging”World Population
By 2050 it is anticipated globally that there would be 2
individuals above >65 for every child aged <5 years.
A similar trend is expected in India, where the
proportion of elderly population is anticipated to
increase from 8% in 2015 to 19% by 2050. (if Indian
population is 150 crores by 2050, 19% comes to
approximately 28 crores of senior adults)

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Possible reasons for the onset of The Concept of Healthy
Aging
The elderly population is more susceptible to infections due to age-
related decline in their immunity—termed as immuno-senescence.
Moreover, the presence of one or more co-morbid conditions in the
elderly, such as 1) cardiovascular diseases, 2) pulmonary
disorders, 3) diabetes mellitus, 4) neuro-degenerative disorders
and 5) chronic kidney disease, render them more vulnerable to
infectious diseases.
Thus, the anticipated increase in the proportion of global aged
individuals with their possible illness must have been prompted to
introduce the concept of “a decade of healthy aging” by UN.
The World Health Organization (WHO) recognized that vaccination at
various stages in an individual’s life is a significant component to up-
keep his/her health.

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Action areas of UN Decade of Healthy Aging
1. Combating Ageism: Contemplate on how we think, feel and act towards ageing
2. Integrated Care: Primary health services to older people
3. Long-Term Care: Access to long-term care for older people
4. Age-Friendly Environments: Communities to foster the skills of older people

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Contents
1. UN Decade of Healthy aging concept-Increase
in elderly population, related illness and
remedial measures.
2. Decline in immune response upon aging.
3. Barriers in adult vaccination.
4. Programmed adult vaccination-upkeep the
health even in the late ages.

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1. A vaccine is a biological
preparation that improves
immunity against a specific
infectious disease.
2. A vaccine leads to the
development of a clone of memory
cells which makes vaccinated
individual to protect from recurrent
infection.
3. The terms vaccine and vaccination
are derived from Variolae
vaccinae (smallpox of the cow),
the term coined by Edward Jenner,
1798.
4. Life story of Edward Jenner:
https://www.ncbi.nlm.nih.gov/pmc/a
rticles/PMC1200696/

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The Master Immune cell is disrupted with aging

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Senescence-associated secretory phenotype

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Decline in Immune competence and Immune response
among elders & Revitalization due to AV
Source: GSK Pharmaceutical
conducted a Debate.

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Illness index (II) with progressive age (PA) due to vaccination
(Hypothetical representation)

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A few examples citing that Adult Vaccination reduces disease burden
Country Duration of the
data
Type of adult
vaccination
Preventing illness and hospitalization in the respective
community
China 1992-2014 HBsAg
vaccine
28 million prevented from
Hepatitis infection
5 million Prevented
from death
UK 2013-2018 Adult
Vaccination
37% decline in
Hospitalization
7.5% decline in
PHN consultations
USA 2019-2020 Influenza ~1,00,000 prevented from
hospitalization (21% of all
hospitalizations)
~7100 reduced
influenza related
deaths

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Contents
1. UN Decade of Healthy aging concept-Increase
in elderly population, related illness and
remedial measures.
2. Decline in immune response upon aging.
3. Barriers in adult vaccination.
4. Programmed adult vaccination-upkeep the
health even in the late ages.

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“I suffer
from
illness, if I
get
vaccinated”
“I always
get the flu
when I get
the flu
shot.”
“I’m
healthy, I
don’t need
it”
“I don’t
want
chemicals
injected
into my
body.”
Adult Vaccine hesitancy
Who influence adults to
overcome vaccine hesitancy
Personal physician 69%
Members of the family 17%
Celebrity,
public figure, other 7%
“What, if I
am not
vaccinated?”
“My
ancestors
have not
taken the
vaccine.Why
should I?”
“Let my
Neighbors be
vaccinated.
I think later
for myself.”
A few adamant responses

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Barriers in AdultVaccination:
Lack of awareness.
The awareness about adult vaccination is poor in India
despite the heavy disease burden.
A survey revealed that globally >80% adults are un-
aware of adult vaccination schedule.
Over 2/3 of Indian adults (97crores : above 15 years; of
which 2/3 means= 64.74 crores) are not aware of adult
vaccination, many still think that vaccines are only for
children.
Lack of dedicated adult vaccination centres in hospitals.

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Convincing data for the Past 70Years
Disease
Reported Cases
(year)
Reported Cases
(2012)
% Decrease in
Reported Cases
Diphtheria 5796 (1950) 0 100%
Tetanus 486(1950) 36 93%
Pertussis 120,718(1950) 41880 65%
Measles 319,124 (1950) 55 >99%
Mumps 152,209 (1968) 199 >99%
Rubella 46,975 (1966) 8 >99%
Hepatitis A 32,859 (1966) 1402 96%
Hepatitis B 26,611 (1985) 2950 89%
Polio 33,300(1950) 0 100%
Source: https://www.nyacp.org/files/iRAISE%20Rates%20deck.pdf

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Adult
Vaccination Rates =
POOR!
Vaccine 2011 Vaccine Coverage
Influenza
[All] 50-64 years 42.2%
> 65 years 68.8%
HCW [19-64 years] 66.9 %
Pneumococcal
High risk 19-49 years 20.1 %
> 65 years 62.3%
Pertussis 12.5%
Tetanus 64.5 %
Zoster 15.8%
Hepatitis B Vaccine [High risk 19-49
years]
35.9 %
HPV Vaccine [women 19-26 years] 29.5 %
Source: Adult Immunizations:
Crucial Conversations, Marie
Brown and Rupel Dedhia,
October 22, 2015, Adult
Immunization Learning Series
Webinar, i-RAISE (Prioritize,
Immunize, Protect)

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Need for adult vaccination
Infectious diseases affect more of those individuals with weakened immune
response for example diabetics.
Currently, 6.6% of the Indian population is above 65 years of age (9 crores) ;
with the size of this population continuously increasing.
Vaccination has been used successfully in prevention of disease and
promoting health among children.
Besides protecting a senior individual from health hazard, vaccination also
decreases healthcare utilization such as hospitalization and nursing and
preserves economic productivity.
Hence, it is of utmost importance to promote adequate adult vaccination in
developing economies like India.

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Vaccine Platforms
1. Live, attenuated vaccines
2. Inactivated vaccines
3. Subunit vaccines
4. Toxoid vaccines
5. Conjugate vaccines
6.Recombinant vector vaccines
7. DNA vaccines
8. mRNA vaccine (Katalin Karikó, Drew
Weissman)

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Vaccine formulations:
Next generation vaccines for the elderly
https://doi.org/10.1016/j.smim.2018.10.010

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Focus
1. UN Decade of Healthy aging concept-Increase
in elderly population, related illness and
remedial measures.
2. Decline in immune response upon aging.
3. Barriers for adult vaccination.
4. Programmed adult vaccination-upkeep the
health even in the late ages.

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Benefits due to adult vaccination
Vaccination is the basic health intervention to prevent
communicable diseases namely pneumococcal pneumonia and
invasive pneumococcal disease in adults. (Sepsis, Meningitis)
Vaccination in the elderly attenuates the disease severity and
ameliorates the complications due to co-morbidities.
A study demonstrated that both influenza and pneumococcal
vaccines resulted a 50% reduction in myocardial infarction.
The incidence of pneumonia is 3- to 9-fold in patients with
cardiovascular disease alone which can be avoided by vaccination.
Similarly, Herpes zoster is associated with an increased risk of stroke,
which can be evaded through effective vaccination.

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Adult immunization schedule, CDC

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Adult Immunization Guidelines in India
Universal Immunization Program
National Health Mission
Influenza >50 years
Pneumococcal >65 years
Human papilloma virus 9-26 years
Zoster >60 years
DPT: Diphtheria, Pertussis and Tetanus
MMR: Measles, Mumps and Rabies
RSSDI (2020) recommended that diabetic individuals in the age
range of 2 to 64 years should be administered pneumococcal
vaccine.
RSSDI: Research Society for the study of Diabetes in India.

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Pro-active steps advised for the promotion of AV
1. Set up mobile vaccination camps and vans
2. Family doctors to initiate with their respective patients
3. Short message service (SMS) from medical professionals/healthcare workers.
4. App-based reminders-a great way to remind elders on the value of vaccination.
5. Introduce a course on healthy aging in the general science subjects in the school.
6. Promotion through social media.
7. Start Dedicated adult vaccination centers in all hospitals.
8. Recruit adult healthcare volunteers with pamphlets in the regional languages.
9. Weekly report in national/regional newspapers on the progress of adult vaccination.

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Indian mythology reminds that the cattle
farming keeps us away from smallpox
Cowherd boy Lord Krishna saved His devotees
Through passive immunization as they were
allowed to dwell with cattle. Edward Jenner invented vaccine from mild Cowpox
Pustule to cure wild smallpox. Saved humanity

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Summary
1. A decade of Healthy Ageing is directed by UN due to the increase in
the number of older people in the population, their ill-health and
consequent measures to be taken are highlighted.
2. The onset of immuno-senescence as the age progresses is shown.
3. The benefits of adult vaccination are :: reduction in myocardial
infarction, reduction hospitalization, reduction in nursing and
reduction in infection due to vaccine preventable diseases;
Availability of elders to assist/guide the family and community.
4. Recommendations for Promotional Aspects: Mobile vaccination vans
and camps, educating adults through WhatsApp messages and app-
based reminders and social media possibly to elicit an awareness
among the adults to upkeep their health and reduce the disease
burden on the family and nation.

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Acknowledgements
Acknowledge online resources/public
domains for the use of the content to develop
this presentation for the dissemination of the
knowledge.

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Harappan Civilization showing the
urban living
1. Sanitation
2. Use of herbs for treatment
3.Town Planning, housing
4. Farming
THANK YOU ALL
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