The Importance of Vaccination in Older Adults

This year has seen a significant increase in respiratory infections compared to the previous year. For older adults, being vaccinated against influenza and COVID-19 is crucial.

According to the Robert Koch Institute, uptake of recommended vaccinations for adults aged 60 and above remains low, leaving many without adequate protection. In the 2023/24 season, only 16% of this age group received the COVID-19 vaccine, while influenza vaccination rates dropped from 51% to 38%, with a temporary peak of 48% during the 2020/21 season.

Experts emphasize the need for greater awareness regarding the complications that can arise from respiratory infections. Vaccinations are shown to significantly reduce the risk of serious complications, including cardiovascular issues such as heart attacks and strokes, particularly among older individuals. Influenza and COVID-19 infections pose a heightened risk for these complications due to their vascular impact.

Older adults often experience diminished immune competence, making them more susceptible to infections from respiratory syncytial virus (RSV) and varicella-zoster virus (VZV). The Standing Committee on Vaccination (STIKO) recommends RSV vaccination starting at age 75, provided that underlying health conditions are well managed.

For shingles prevention, STIKO advises individuals aged 60 and older to receive two doses of the adjuvanted inactivated vaccine Shingrix®, spaced two to six months apart. Those with chronic conditions such as asthma or diabetes should start vaccination at 50. This vaccine has been shown to provide over 90% protection against shingles, with a sustained effect lasting at least 11 years.

In Germany, approximately 400,000 cases of shingles occur annually, with half of unvaccinated individuals over 50 experiencing an episode. The importance of vaccination lies in preventing complications, such as ocular issues or post-herpetic neuralgia, which can lead to prolonged pain and affect daily activities and quality of life.

Vaccination rates for shingles remain disappointing, with the RKI reporting a first-dose rate of only 11.5% and a second-dose rate of 7.7% between 2019 and 2022.

Pneumococcal infections are often underestimated in older adults. The STIKO has revised its recommendations, now suggesting the 20-valent conjugate vaccine (PCV20) as a standard vaccination for those aged 60 and above, especially for individuals with certain comorbidities or immunosuppression.

To improve vaccination rates, it is proposed that pneumococcal immunization be promoted within travel medicine, as pneumococci are a leading cause of severe illness in travelers.

Regarding human papillomavirus (HPV) vaccination, the STIKO currently recommends it only for individuals aged 9 to 17. However, infections with high-risk HPV types can occur throughout life, and the potential for cancer development remains significant in older populations.

Recent data indicate that HPV is a relevant cancer risk for men as well, with around 1,900 men diagnosed with oropharyngeal cancer linked to HPV infections annually. Despite the clear benefits of vaccination, only 34% of 15-year-old boys and 55% of girls were fully vaccinated in 2023, lagging behind countries like Australia and the UK, where rates are nearly 90%.

In conclusion, increasing vaccination rates among older adults is essential to reduce the burden of preventable diseases and their associated complications.