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Public Health Impact of Adult Vaccine-Preventable Diseases on Performance, Disability, Mortality and Healthcare Costs in Europe

  • Giovanni RezzaEmail author
Chapter
Part of the Practical Issues in Geriatrics book series (PIG)

Abstract

Prevention and control of vaccine-preventable diseases (VPDs) in the elderly are becoming an important issue due to population ageing. VPDs affecting older people comprise the “cursed triad” of influenza (flu), pneumococcal pneumonia, and herpes zoster. The flu vaccine is the most widely used vaccine in Europe, and most countries have programmes to protect older individuals against flu. Interestingly, influenza is the only case where a specific Council Recommendation for the vaccination of older age groups exists at EU level and with a specific target for coverage (75% vaccine coverage rate, VCR). Unfortunately, accurate figures about the true magnitude of flu infection rates are lacking, although influenza is estimated to affect 5–15% of the population, corresponding to 35–110 million (average 70 million) persons, with around 94,000 excess deaths directly or indirectly attributable to influenza and 50,000 excess hospitalisations. Pneumococcal disease is also one of the main public health threats in the elderly, accounting for the majority of community-acquired pneumonia (CAP) cases in Europe, whose incidence rate is estimated to range from 1.07 to 1.2 per 1000 person-years. Finally, herpes zoster, whose annual HZ incidence is around 7 to 8/1000 person-years over 50 years of age, increasing to 10/1000 person-years after 80 years of age, may cause post-herpetic neuralgia in up to 20% of those affected, being an important cause of hospitalisation. Thus, the burden of VPDs among the elderly is high in Europe and urges for more aggressive vaccination policies at regional and country level.

Keywords

Vaccines Immunisation Vaccine-preventable diseases Elderly 

References

  1. 1.
    Preaud E, Durand L, Macabeo B, Farkas N, Sloesen B, Palache A, et al. Annual public health and economic benefits of seasonal influenza vaccination: a European estimate. BMC Public Health. 2014;14:813.CrossRefGoogle Scholar
  2. 2.
    GBD Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–71.CrossRefGoogle Scholar
  3. 3.
    Torres A, Peetermans WE, Viegi G, Blasi F. Risk factors for community-acquired pneumonia in adults in Europe: a literature review. Thorax. 2013;68(11):1057–65.CrossRefGoogle Scholar
  4. 4.
    Vila-Corcoles A, Ochoa-Gondar O, Rodriguez-Blanco T, Raga-Luria X, Gomez-Bertomeu F, Group ES. Epidemiology of community-acquired pneumonia in older adults: a population-based study. Respir Med. 2009;103(2):309–16.CrossRefGoogle Scholar
  5. 5.
    Benard A, Mercie P, Alioum A, Bonnet F, Lazaro E, Dupon M, et al. Bacterial pneumonia among HIV-infected patients: decreased risk after tobacco smoking cessation. ANRS CO3 Aquitaine Cohort, 2000–2007. PLoS One. 2010;5(1):e8896.CrossRefGoogle Scholar
  6. 6.
    Mullerova H, Chigbo C, Hagan GW, Woodhead MA, Miravitlles M, Davis KJ, et al. The natural history of community-acquired pneumonia in COPD patients: a population database analysis. Respir Med. 2012;106(8):1124–33.CrossRefGoogle Scholar
  7. 7.
    Ochoa-Gondar O, Vila-Corcoles A, de Diego C, Arija V, Maxenchs M, Grive M, et al. The burden of community-acquired pneumonia in the elderly: the Spanish EVAN-65 study. BMC Public Health. 2008;8:222.CrossRefGoogle Scholar
  8. 8.
    Bewick T, Sheppard C, Greenwood S, Slack M, Trotter C, George R, et al. Serotype prevalence in adults hospitalised with pneumococcal non-invasive community-acquired pneumonia. Thorax. 2012;67(6):540–5.CrossRefGoogle Scholar
  9. 9.
    Welte T, Torres A, Nathwani D. Clinical and economic burden of community-acquired pneumonia among adults in Europe. Thorax. 2012;67(1):71–9.CrossRefGoogle Scholar
  10. 10.
    Lode HM. Managing community-acquired pneumonia: a European perspective. Respir Med. 2007;101(9):1864–73.CrossRefGoogle Scholar
  11. 11.
    European Centre for Disease Prevention and Control. Annual Epidemiological Report 2016—invasive pneumococcal disease. Stockholm. 2016. http://ecdc.europa.eu/en/healthtopics/invasivepneumococcaldisease/Pages/Annualepidemiologicalreport2016.aspx. Accessed 9 Jan 2018.
  12. 12.
    Shea KM, Edelsberg J, Weycker D, Farkouh RA, Strutton DR, Pelton SI. Rates of pneumococcal disease in adults with chronic medical conditions. Open Forum Infect Dis. 2014;1(1):ofu024.CrossRefGoogle Scholar
  13. 13.
    Wyrwich KW, Yu H, Sato R, Strutton D, Powers JH. Community-acquired pneumonia: symptoms and burden of illness at diagnosis among US adults aged 50 years and older. Patient. 2013;6(2):125–34.CrossRefGoogle Scholar
  14. 14.
    Sandvall B, Rueda AM, Musher DM. Long-term survival following pneumococcal pneumonia. Clin Infect Dis. 2013;56(8):1145–6.CrossRefGoogle Scholar
  15. 15.
    Fine MJ, Smith MA, Carson CA, Mutha SS, Sankey SS, Weissfeld LA, et al. Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis. JAMA. 1996;275(2):134–41.CrossRefGoogle Scholar
  16. 16.
    Feikin DR, Schuchat A, Kolczak M, Barrett NL, Harrison LH, Lefkowitz L, et al. Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995–1997. Am J Public Health. 2000;90(2):223–9.CrossRefGoogle Scholar
  17. 17.
    Restrepo MI, Mortensen EM, Velez JA, Frei C, Anzueto A. A comparative study of community-acquired pneumonia patients admitted to the ward and the ICU. Chest. 2008;133(3):610–7.CrossRefGoogle Scholar
  18. 18.
    Klausen HH, Petersen J, Lindhardt T, Bandholm T, Hendriksen C, Kehlet H, et al. Outcomes in elderly Danish citizens admitted with community-acquired pneumonia. Regional differences, in a public healthcare system. Respir Med. 2012;106(12):1778–87.CrossRefGoogle Scholar
  19. 19.
    Burke BL, Steele RW, Beard OW, Wood JS, Cain TD, Marmer DJ. Immune responses to varicella-zoster in the aged. Arch Intern Med. 1982;142(2):291–3.CrossRefGoogle Scholar
  20. 20.
    Pinchinat S, Cebrian-Cuenca AM, Bricout H, Johnson RW. Similar herpes zoster incidence across Europe: results from a systematic literature review. BMC Infect Dis. 2013;13:170.CrossRefGoogle Scholar
  21. 21.
    Johnson RW, Wasner G, Saddier P, Baron R. Postherpetic neuralgia: epidemiology, pathophysiology and management. Expert Rev Neurother. 2007;7(11):1581–95.CrossRefGoogle Scholar
  22. 22.
    Gabutti G, Serenelli C, Cavallaro A, Ragni P. Herpes zoster associated hospital admissions in Italy: review of the hospital discharge forms. Int J Environ Res Public Health. 2009;6(9):2344–53.CrossRefGoogle Scholar
  23. 23.
    Levi M, Bellini I, Capecchi L, Pieri L, Bechini A, Boccalini S, et al. The burden of disease of Herpes Zoster in Tuscany. Hum Vaccin Immunother. 2015;11(1):185–91.CrossRefGoogle Scholar
  24. 24.
    World Health Organisation. A report on the epidemiology of selected vaccine-preventable diseases in the European Region. WHO EpiBrief. 2017;1:1–12.Google Scholar
  25. 25.
    Filia A, Bella A, von Hunolstein C, Pinto A, Alfarone G, Declich S, et al. Tetanus in Italy 2001–2010: a continuing threat in older adults. Vaccine. 2014;32(6):639–44.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Infectious Diseases and ImmunologyItalian National Institute of HealthRomeItaly

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