How to address decreased vaccine uptake in older adults
By Philip Dormitzer, head of global vaccine research and development, GSK
The vaccine landscape has changed a lot over the past few years in light of the COVID-19 pandemic. New technologies have been deployed at scale, innovative vaccine programs launched, and supply chains reorganized to help address global health challenges. However, while innovation has increased vaccine efficacy, global vaccine uptake may vary, and reduced vaccine coverage could harm populations.1
Reduced vaccination coverage has been especially seen in those at high risk, such as older adults, because it can interfere with ‘herd immunity’, a way of indirectly reducing transmission and death among the population. 2 .
As we age, our immune system function declines, putting us at higher risk of many vaccine-preventable diseases. With over 20% of the current EU population aged 65 and over3and this population is expected to represent one in four people living in Europe and North America by 20504we need to find effective and tailored approaches to help protect the elderly.
The rapid development, approval and global rollout of a COVID-19 vaccine are major achievements of a new ‘golden era’ for vaccine innovation. Scientific activity in vaccines is increasing, as evidenced by a 91% increase in vaccine-related clinical trials initiated between 2020-2021 compared to 2019-20205. Innovations and technologies that scientists like me have found promising and cutting edge as they enter the field, such as mRNA vaccines and structure-based antigen design, have become part of the everyday lives of vaccine researchers.
The need for vaccines and new technologies is more important than ever. With changing human demographics, the encroachment of human populations into natural ecosystems, climate change, and increased globalization, the likelihood of viruses from animal reservoirs threatening human populations has increased dramatically.6.
Multiple solutions are needed
More recently, the term “triplemic” was used to describe the intersection of illnesses caused by the influenza viruses, RSV and SARS-CoV-2. These viruses – alone and together – threaten not only at-risk populations, such as those over 65 years of age, but also health systems globally – highlighting the need for innovative solutions to protect against communicable respiratory diseases other than the flu.
Accelerated progress in immunization is not limited to developing new vaccines against viruses but also vaccines to combat long-developed problems such as antimicrobial resistance (AMR). AMR has been declared one of the top 10 global public health threats by WHO, and with antibiotics becoming less effective against a growing number of pathogens, new antibiotics and prevention tools are urgently needed.7.
New techniques are being used to improve our ability to update vaccines and keep up with rapidly changing pathogens, such as the influenza virus and SARS-CoV-2. For the influenza virus, for example, the system is reactive: we track the strains that may emerge and cause disease in humans in future seasons8. With machine learning and artificial intelligence, we may be able to improve the accuracy of selecting virus strains to target with a vaccine. With new technologies such as mRNA, we may be able to incorporate more antigens into vaccines to make them more robust against changes in circulating viruses.9.
Address vaccine challenges that prevent vaccines from being taken
Beyond innovation in vaccine technology, there is also an ongoing review of national immunization policies to help protect those at risk. Organizations like Vaccine Europe take this threat to older adults seriously. In its pipeline review, Vaccine Europe highlighted the impact of COVID-19 on adult immunization programs, and called on European and national authorities to include adults in their national immunization programs and ensure adequate funding.10.
Addressing the challenges and barriers that prevent vaccine uptake is just as important as developing new vaccines and vaccine programs targeted to changing populations. From laboratories to vaccine recipients, we must think about how we inspire confidence and trust in our work to ensure that the aging population continues to be vaccinated against viruses that can have devastating effects on their health and well-being.
Research conducted today is delivering innovation that was once impossible to achieve – laying the groundwork for the future of vaccines. As we move into this future, we must ensure that we bring with us the people who need vaccines most.
1 WHO. 2030 Immunization Agenda. https://www.immunisasiagenda2030.org/
2 WHO. Coronavirus Disease (COVID-19): Herd immunity, lockdowns and COVID-19. https://www.who.int/news-room/questions-and-answers/item/herd-immunity-lockdowns-and-covid-19
3 Population structure and aging – Statistical explanation (europa.eu): Population structure and aging – Statistical explanation (europa.eu).
4 United Nations. Aging. https://www.un.org/en/global-issues/ageing.
5 here. Comparison of Clinical Trials between 01/01/2018 – 31/12/2020 vs 01/01/2021 – 31/12/2021.
6 Gavi – The Vaccine Alliance. 5 reasons why a pandemic like COVID-19 is becoming more likely. https://www.gavi.org/vaccineswork/5-reasons-why-pandemics-like-covid-19-are-becoming-more-likely
7 WHO. Antimicrobial resistance. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance.
8 Kotey E, Lukosaityte D, Quaye O, Ampofo W, Awandare G, Iqbal M. Current and New Approaches in Influenza Management. Vaccines (Basel).
9 Wall AC, Fiala B, Schafer A, et al. Proposed Potent Neutralizing Antibody Response by Protein Nanoparticle Vaccines Designed for SARS-CoV-2. Cell 183.
10 European Vaccines. Vaccine Europe reveals its first channel review. Vaccines Europe reveals its first channel overview – Vaccines Europe
Disclaimer: This article was written by Philip Dormitzer, Global Head of Vaccines Research and Development, GSK, at the invitation of Labiotech, which retains editorial control.