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An old problem with new solutions: Strategies to improve vaccine efficacy in the elderly

Journal

ADVANCED DRUG DELIVERY REVIEWS
Volume 183, Issue -, Pages -

Publisher

ELSEVIER
DOI: 10.1016/j.addr.2022.114175

Keywords

Age; Elderly; Innate immunity; Adaptive immunity; Inflammaging; Influenza; SARS-CoV-2; Varicella Zoster; Clostridioides difficile; Vaccination; mRNA vaccine; Adjuvant

Funding

  1. Pennsylvania Department of Health Com-monwealth Universal Research Enhancement program
  2. Pennsylvania Department of Community and Economic Develop-ment COVID-19 Vaccines, Treatments, and Therapies (CV-VTT) Pro-gram [C000074810]

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As people age, their immune system becomes less able to protect against infections and develop immunity from vaccination. With a growing elderly population and increased risk of pandemics, strategies to enhance vaccine responses in the elderly need to be developed and improved.
Vaccination is the most effective measure to protect against infections. However, with increasing age, there is a progressive decline in the ability of the immune system to both protect against infection and develop protective immunity from vaccination. This age-related decline of the immune system is due to age-related changes in both the innate and adaptive immune systems. With an aging world population and increased risk of pandemics, there is a need to continue to develop strategies to increase vaccine responses in the elderly. Here, the major age-related changes that occur in both the innate and adaptive immune responses that impair the response to vaccination in the elderly will be highlighted. Existing and future strategies to improve vaccine efficacy in the elderly will then be discussed, including adjuvants, delivery methods, and formulation. These strategies provide mechanisms to improve the efficacy of existing vaccines and develop novel vaccines for the elderly.

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