Bellevue Elderly Disparity

Elderly Disparity

In the United States, the elderly are more likely to die of
a vaccine-preventable disease. Adult deaths from
influenza (≈36,000/y) (1,2), invasive pneumococcal disease
(≈9,000/y) (3), and hepatitis B (≈5,000/y) (4) exceed
vaccine-preventable deaths among children (≈50/y) by a
ratio of ≈1,000:1. For each of these diseases, case-fatality
rates rise with increasing age. This disparity can be
addressed through adult vaccination programs, which are
cost-effective and life-saving. Women constitute most of
the adult U.S. population >50 years of age (60% of those
75 years of age and 70% of those 85 years of age).
The immune system does not function as well with
advancing age (5). For example, T-cell functions diminish
with age, as evidenced by the increased prevalence of
anergy to mycobacterial and fungal skin-test antigens and
the increased frequency and severity of herpes zoster
infection with age. B-cell function diminishes, as seen with
the lessened humoral response (immunoglobulin [Ig] M,
IgG, and IgA) to certain vaccines (e.g., hepatitis B, influenza,
pneumococcal vaccine), and the protective efficacy of
these vaccines also decreases as recipients age (6,7).