There is so much that vaccination can give in terms of prolonging life, saving lives as well as the economy, according to Dr. Lulu Bravo, founder and executive director of the Philippine Foundation for Vaccination (PFV).
At the event hosted by the PFV and Philippine College of Geriatric Medicine, Bravo said that people should realize that it is so much easier to prevent illness, and not spend so much for hospitalization. A vaccine may be able to do that.
She also stressed many of the elderly and those with comorbidities die not because of their age or comorbidities, but because of purely preventable ailments like flu and pneumonia, both preventable by the vaccines.
Dr. Remedios Coronel, council of adviser of the Philippine Society for Microbiology and Infectious Diseases, talked about the current state of health of the older adults in the Philippines.
A health burden in the country, influenza associated with excess mortality is highest among individuals 60 and above, followed by children less than five years of age. Influenza has a devastating impact on the body, with complications leading to heart attack and pneumonia.
“The flu illness is associated with an increase in stroke (eight times), heart attack (10 times), and pneumonia (eight times), and a rise in blood sugar levels (75 percent),” she noted.
“Older adults are more vulnerable to influenza infection,” she added as aging leads to immunosenescence, underlying conditions, and frailty, making them vulnerable to increased hospitalization, reduced autonomy, and increased mortality.
She also said that two to 10 percent of vaccinated individuals are unable to produce adequate levels of antibodies following vaccination “due to genetic characteristics, state of immunity, previous contact with closely related viruses, age-related changes of the immune system, changes in the immune system induced by comorbidities, immunosuppression, medication.”
According to Coronel, the enhanced influenza vaccines address the decline in immunity as they have higher antibody levels and cause less influenza illness, better efficacy compared with standard vaccines, fewer respiratory-related and all-cause hospitalizations, reduced health care costs, disease protection and reduced risk of complications, and fewer serious cardiovascular, respiratory and CNS events.
To overcome poor vaccine effectiveness in the elderly, “the dose of HA antigen within the vaccine must be increased. There must be changes in vaccination route and an addition of adjuvants,” Coronel recommended.
The current licensed vaccines’ protective efficacy varies from year to year, depending on the antigenic match between circulating viruses and vaccine strains. “The host’s immune status can also affect vaccine efficacy, particularly in elderly individuals who are more susceptible to influenza-related complications,” she explained.
Dr. Rontgene Solante, chair of the Adult Infectious Diseases and Tropical Medicine Fellowship Program at San Lazaro Hospital, shared the value of influenza vaccination among this population.
“We need to decrease hospitalization, which will decrease the overwhelming capacity of hospitals,” Solante said. As much as possible, “we want to protect this population because it is not just the respiratory tract infection that is a complication of influenza, they are also prone to pneumonia,” he added.
“We also want to protect them against exacerbation of other infections, not to mention that decreasing hospitalization will have an implication on complications like diabetes and stroke,” he stressed out.
The influenza has an indirect effect on the heart, leading to cardiac complications. When hospitalization is prevented, so is mortality. “There is compelling data that when flu vaccine is given, there is 36 to 40 percent reduction of adverse events,” Solante said.
There are ongoing challenges in influenza vaccination in adults/elderly, he pointed out, such as the low vaccination rate and the absence of government programs on adult vaccination.
Vaccination campaign is always private physician driven, which means that it is out of pocket from the patient.
The medical societies have an important role, and that the Department of Health’s role should be strengthened, Solante stressed.
