World Immunization Day: The elderly are threatened by chronic diseases and infectious diseases, and it is urgent to raise awareness of vaccination prevention

At this stage, China is rapidly entering an aging society. According to the National Health Commission, it is estimated that by around 2035, the number of people aged 60 and above in my country will exceed 400 million, accounting for more than 30% of the total population, entering a severe aging stage. As my country's aging process continues to intensify, disease prevention and health management for the elderly have also attracted attention from all parties. December 15 is World Immunization Day. Liang Yaqiong, chairman of the Immunization Program Committee of the Nanjing Society of Preventive Medicine and deputy chief of the Immunization Program Section of the Nanjing Center for Disease Control and Prevention, said that the elderly often suffer from one or more chronic diseases and are susceptible to infectious diseases such as influenza, pneumonia, and herpes zoster, and need to be prevented through vaccination.

The elderly are threatened by both chronic diseases and infectious diseases and are the focus of vaccination.

According to statistics, in 2021, about 190 million elderly people in my country will suffer from chronic diseases[1], such as cardiovascular and cerebrovascular diseases, diabetes, chronic respiratory diseases, etc. About 75% of the elderly aged 60 and above suffer from one or more chronic diseases[2]. Liang Yaqiong said: "Old people with underlying diseases or chronic diseases are already a vulnerable group in terms of health. Their risk of contracting infectious diseases will increase significantly. For example, chronic disease patients have an increased risk of developing shingles and postherpetic neuralgia, and shingles will increase the management burden of chronic diseases such as diabetes and chronic respiratory diseases. Therefore, elderly people with underlying diseases need to be vaccinated to prevent infectious diseases. The vaccines recommended for the elderly include the new coronavirus vaccine, influenza vaccine, pneumococcal vaccine, shingles vaccine, etc."

Elderly people with chronic diseases such as diabetes and hypertension may worry about whether they can get vaccinated. Liang Yaqiong explained that chronic diseases are not an absolute contraindication to vaccination. If the underlying disease is in a stable period, or the condition is in a stable stage after taking medication, it is completely possible to get vaccinated.

Vaccination is a cost-effective disease prevention measure

Vaccination is one of the most economical and effective public health intervention measures to prevent and control infectious diseases. It is also an effective means for families to reduce the occurrence of diseases and reduce medical expenses.

Liang Yaqiong introduced that the body's prevention includes active immunity and passive immunity. Vaccination belongs to active immunity, which is generally achieved by inactivating or attenuating the antigen and then injecting it into the human body. Antibodies are produced through the body's own immunity, so that when the body encounters the same pathogen again, it can quickly identify it and produce antibodies to eliminate the antigen. Therefore, vaccination is a safe and effective way to produce antibodies and disease resistance without causing illness in the human body, and it is an effective strategy to protect susceptible populations.

Vaccination helps reduce the disease burden of vaccine-preventable diseases. For the elderly, infectious diseases often cause a heavy economic burden and increase the consumption of medical resources. Liang Yaqiong introduced that taking herpes zoster as an example, some survey data show that the direct economic burden of herpes zoster is about 1,600 yuan per person. With the increase of age, the economic burden increases accordingly. For people over 65 years old, the economic burden reaches nearly 3,000 yuan; in addition, herpes zoster may also cause postherpetic neuralgia, which costs nearly 16,000 yuan, which is still a heavy economic burden for ordinary people. In addition to these direct economic burdens, more indirect economic burdens may be incurred due to work, care and other reasons.

Raise vaccination awareness among the elderly and promote their health

Compared with children, the overall vaccination rate of the elderly in my country is still relatively low. Taking influenza vaccination as an example, according to the national influenza vaccination rate statistics for 2018-2019, among the elderly aged ≥60 years, the vaccination rate of the voluntary self-funded population was 1.1%, and the vaccination rate of the population in areas with medical insurance reimbursement policies was 1.51% [3]. In this regard, Liang Yaqiong gave suggestions from three aspects to improve the vaccination awareness of the elderly. First, strengthen health education and publicity to enhance the awareness of being the first person responsible for their own health. Second, strengthen the promotion of vaccination by clinical doctors. The elderly often have a stronger sense of identity with doctors, so it is recommended that clinical and prevention work together to improve the elderly's awareness of vaccination to prevent diseases. Third, the national and local governments should introduce an overall strategy for vaccination of the elderly and form a coherent vaccination recommendation for the elderly. The "Core Information on Prevention of Disability in the Elderly" recommends that the elderly be vaccinated with pneumococcal vaccines and herpes zoster vaccines, and that they be vaccinated with influenza vaccines under the guidance of doctors before the influenza epidemic season. The "Healthy China 2030" Planning Outline also clearly points out that we should adhere to the work strategy of focusing on prevention and combining prevention and treatment, promote a healthy lifestyle, and reduce the occurrence of diseases [4].

[1] Zhang Wei. "Three reductions and three healths" to prevent chronic diseases and enjoy a healthy and long life[J]. China Torch, 2022(2):1.

[2] Wang Limin, Chen Zhihua, Zhang Mei, et al. Study on the prevalence and disease burden of chronic diseases in the elderly population in China[J]. Chinese Journal of Epidemiology, 2019, 40(3):7.

[3] Hunan Provincial Association of Preventive Medicine. Expert consensus on the public influenza vaccination program[J]. Chinese Journal of Preventive Medicine, 2020, 54(12):1364-1377.

[4] The CPC Central Committee and the State Council issued the “Outline of the Healthy China 2030 Plan”. Central relevant documents_Chinese Government Website (www.gov.cn).