Huge savings to healthcare budgets can be made if gaps in adult immunisation programmes are filled in a rapidly ageing global population, experts have said.
By 2030, one in six people will be over the age of 60, equivalent to the entire population of Europe and surpassing the number of children under five for the first time, World Health Organisation figures show.
Meanwhile, factors such as economic challenges, reduced health funding, climate change and mass migration caused by conflict and unrest are causing a surge in non-communicable diseases around the world.
Effective childhood vaccination programmes prevent many of these diseases, but in older populations with waning immunity – many are exposed.
To mark the World Health Organisation’s World Immunisation Week, global health experts called on governments to invest in adult immunisation, and offer more safety education to eliminate the rising threat of vaccine hesitancy.
“We live in an unprecedented time of ageing populations and the systems in place are not yet ready to keep up,” said Dr Jane M Barratt, a global adviser at the International Federation on Ageing.
“Everybody is a burden if they're not vaccinated and they have life-altering changes to their function and their ability to be part of society.”
The narrative needs to change in terms of investment, she said.
“Immunisation needs to be part of a health prevention promotion package,” Dr Barratt added.
“Every person has a right to be vaccinated from the time they are born to the time that they die.”
Preventable disease
Preventable lower respiratory infections such as influenza, pneumococcal disease and respiratory syncytial virus, contribute to a significant number of deaths in the over 60s.
A recent study by independent researchers at the UK-based Office of Health Economics, looked at the financial burden of unvaccinated adults in ten countries.
The cost-benefits of four vaccines were assessed for flu, herpes, influenza, pneumococcal disease and respiratory syncytial virus (RSV), with each individual vaccinated generating an average societal value of up to $4,637.
Currently, costs to vaccine-preventable disease due to missed work days or healthcare fees are about $1 trillion a year in G20 economies in those aged 60-64, the study said.
Immunisation programmes for adults were examined in Australia, Brazil, France, Germany, Italy, Japan, Poland, South Africa, Thailand, and America to provide a balanced mix of societies.
Across the sample of countries, analysts said adult vaccination programmes could return up to 19 times their initial investment in productivity and reduced healthcare costs.
“It is not a lack of belief in vaccines, but many people think they have done their vaccines as a child and that is not true,” said Dr Jamie Rutland, a pulmonary and critical care physician at the Rutland Medical Group.
“We have to help people understand what is next in their immunisation programme.
“This is really simple. Everybody needs to be vaccinated.”
During the UN Decade of Healthy Ageing from 2021-2030, the number of those aged 60 or above is expected to increase by 34 per cent, from 1 billion to 1.4 billion.
By 2050, the global population of older people will have more than doubled, to 2.1 billion, the UN has said.
The fastest growth in the number of older people is in Africa, followed by Latin America, the Caribbean and Asia with projections indicating almost 80 per cent of the age group will live in less developed countries in 2050.
“I don’t want to sound alarmist, but we are in a very challenging context,” said Sibilia Quilici, executive director of vaccines at Vaccines Europe, who was speaking at a GlaxoSmithKline-backed awareness event on adult immunisation.
“We have an ageing population that will be more prone to infectious disease, and the shrinkage of workforce is in its infancy.
“That includes healthcare providers, meaning we will have less people to take care of the sick.
“We clearly need to prevent, to avoid increasing the pressure on all systems, whether it is the healthcare system or our economy.”
Global approach
In the UAE, a study published in Frontiers in Public Health in 2022 showed, of 500 physicians asked, fewer than 25 per cent were aware of which adult vaccines to recommend.
Flu was the most recommended adult jab, with the recommendation rate decreasing as the patient’s age increased for all vaccines, except pneumococcal and herpes zoster.
Approaches to adult immunisation vary around the world. In France, pharmacists and nurses can now administer vaccines across all ages, but in Canada that is not the case.
In India, meanwhile, outreach programmes to rural and remote areas are scaling up vaccinations in communities.
A similar method was used in Hong Kong during the Covid-19 pandemic, when health workers went door-to-door administering vaccines.
“When I see the outbreaks we are facing in Europe with measles, we have an issue,” said Ms Quilici.
“The other challenge we have to face is the low investment that we have seen over the last decades on immunisation.
“Less than 0.5 per cent of the healthcare budget is dedicated to immunisation by the member states in European countries.
“This is clearly not enough to protect the population under current national immunisation programmes because we see the rise of outbreaks that should not be happening.”
