The world’s population is getting bigger, and older. With the elderly increasingly close to outnumbering their younger counterparts by 2050, there will be nearly three times more people aged 65 and above than people under four years old — many fear that the burden on government budgets, health-care systems, and economies will become untenable. But there is something we can do to ease that burden: Improve the health of the elderly.
As we age, our bodies undergo complex changes that, among other things, progressively weaken our ability to respond to infections and develop immunity. That is why diseases in older adults tend to be more severe, with a greater impact on quality of life, disability and mortality than the same diseases in younger patients. Put simply, aging adults’ immune systems need backup. That is where vaccines come in. Vaccines are most often discussed with regard to young children, who should receive a series of inoculations against childhood illnesses like measles and polio. Childhood vaccinations are one of the greatest medical success stories of the 20th century, not least because of so-called herd immunity (the indirect protection of entire communities, including those who cannot be immunized for reasons like illness or age, by vaccinating most of their members).
Nothing prohibits adults from taking advantage of the same science. In fact, they would reap far-reaching benefits, including the protection of their family and neighbors, from doing so. Yet few actually do.
Adults need to understand that some of the more common infections to which they are vulnerable are vaccine-preventable. Consider shingles, an infection that can affect anyone who has had chicken pox in their lifetime (that is, 95% of adults worldwide). In the US, roughly one-third of the population will get shingles at some point in their lives.
A case of shingles may be benign and relatively bearable for someone in his or her thirties. But the disease is far more common among people aged 50 and above — for whom it can be extremely painful. Older adults with shingles may experience chronic discomfort and serious complications that make it difficult to sleep, leave the house, or carry out daily activities. If they have been vaccinated — the Centers for Disease Control and Prevention recommends getting vaccinated at age 60 — they can avoid this painful, sometimes debilitating condition.
Influenza is another vaccine-preventable disease. While the influenza virus can cause disease in people of all ages, the elderly — those aged 65 and above — are disproportionately affected, in terms of both death and hospitalization, with the oldest being at the greatest risk.
The list does not end there. Diphtheria, caused by the aerobic gram-positive bacterium Corynebacterium diphtheria is an acute, toxin-mediated disease that can manifest as an upper respiratory tract infection or a skin infection. The overall fatality rate is 5-10 percent, with higher death rates among people younger than five and older than 40.
Tetanus, commonly known as “lockjaw,” is a bacterial disease that affects the nervous system, causing painful tightening of muscles throughout the body. It does not lead to a very high number of deaths among the elderly; but, given that it is preventable, any number higher than zero is unacceptable.
Then there is pertussis. We do not know precisely the extent to which it affects the elderly, because the disease is badly underdiagnosed and underreported in all age groups. But the Advisory Committee on Immunization Practices thinks that the burden of disease is at least 100 times greater than currently reported.
The Tdap vaccine, which protects adults from diphtheria, tetanus and pertussis, could reduce this burden considerably. Another vaccine, called Td, protects against tetanus and diphtheria, but not pertussis. A Td booster should be given every ten years. Finally, there is pneumococcal disease, a bacterial infection caused by Streptococcus pneumoniae, which can cause pneumonia, meningitis or bloodstream infection (sepsis), Depending on which complications occur, symptoms may include cough, abrupt onset of fever, chest pain, chills, shortness of breath, stiff neck, disorientation and sensitivity to light.
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Melvin Sanicas is Program Officer and Global Health Fellow at the Bill & Melinda Gates Foundation. ©Project Syndicate
As we age, our bodies undergo complex changes that, among other things, progressively weaken our ability to respond to infections and develop immunity. That is why diseases in older adults tend to be more severe, with a greater impact on quality of life, disability and mortality than the same diseases in younger patients. Put simply, aging adults’ immune systems need backup. That is where vaccines come in. Vaccines are most often discussed with regard to young children, who should receive a series of inoculations against childhood illnesses like measles and polio. Childhood vaccinations are one of the greatest medical success stories of the 20th century, not least because of so-called herd immunity (the indirect protection of entire communities, including those who cannot be immunized for reasons like illness or age, by vaccinating most of their members).
Nothing prohibits adults from taking advantage of the same science. In fact, they would reap far-reaching benefits, including the protection of their family and neighbors, from doing so. Yet few actually do.
Adults need to understand that some of the more common infections to which they are vulnerable are vaccine-preventable. Consider shingles, an infection that can affect anyone who has had chicken pox in their lifetime (that is, 95% of adults worldwide). In the US, roughly one-third of the population will get shingles at some point in their lives.
A case of shingles may be benign and relatively bearable for someone in his or her thirties. But the disease is far more common among people aged 50 and above — for whom it can be extremely painful. Older adults with shingles may experience chronic discomfort and serious complications that make it difficult to sleep, leave the house, or carry out daily activities. If they have been vaccinated — the Centers for Disease Control and Prevention recommends getting vaccinated at age 60 — they can avoid this painful, sometimes debilitating condition.
Influenza is another vaccine-preventable disease. While the influenza virus can cause disease in people of all ages, the elderly — those aged 65 and above — are disproportionately affected, in terms of both death and hospitalization, with the oldest being at the greatest risk.
The list does not end there. Diphtheria, caused by the aerobic gram-positive bacterium Corynebacterium diphtheria is an acute, toxin-mediated disease that can manifest as an upper respiratory tract infection or a skin infection. The overall fatality rate is 5-10 percent, with higher death rates among people younger than five and older than 40.
Tetanus, commonly known as “lockjaw,” is a bacterial disease that affects the nervous system, causing painful tightening of muscles throughout the body. It does not lead to a very high number of deaths among the elderly; but, given that it is preventable, any number higher than zero is unacceptable.
Then there is pertussis. We do not know precisely the extent to which it affects the elderly, because the disease is badly underdiagnosed and underreported in all age groups. But the Advisory Committee on Immunization Practices thinks that the burden of disease is at least 100 times greater than currently reported.
The Tdap vaccine, which protects adults from diphtheria, tetanus and pertussis, could reduce this burden considerably. Another vaccine, called Td, protects against tetanus and diphtheria, but not pertussis. A Td booster should be given every ten years. Finally, there is pneumococcal disease, a bacterial infection caused by Streptococcus pneumoniae, which can cause pneumonia, meningitis or bloodstream infection (sepsis), Depending on which complications occur, symptoms may include cough, abrupt onset of fever, chest pain, chills, shortness of breath, stiff neck, disorientation and sensitivity to light.
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Melvin Sanicas is Program Officer and Global Health Fellow at the Bill & Melinda Gates Foundation. ©Project Syndicate
