Wang Ping advised her mother to get vaccinated many times, but her mother always prevaricated with various worries. Until last year, Wang Ping's mother met a colleague who retired in the same year, "got shingles, was so painful that she couldn't sleep all night long, and was tortured enough." When her mother told Wang Ping about the experience, Wang Ping once again taught her the importance of vaccination.
Wang Ping's mother is not alone. The "Mainland Health Protection Initiative for the Elderly" proposed that the elderly should enhance their awareness of vaccination and disease prevention, and take the initiative to vaccinate against influenza, pneumococcal vaccine and herpes zoster vaccine.
However, according to the "Middle-aged and Elderly Common Infectious Disease Prevention Cognition Research Report", the older the age, the higher the proportion of vaccine hesitancy; 33% of respondents over 50 years old have not received any of the pneumonia vaccine, influenza vaccine or herpes zoster vaccine; Less than 35% of respondents over 50 years of age were vaccinated against shingles and pneumonia.
With the rapid development of the aging of the Chinese population, active health and vaccination are an important part of the health management of the elderly. The last week of April is World Immunization Week, and we found through street harvesting that the current situation of the elderly's awareness of autoimmune aging still needs to be improved.
The elderly are hesitating
When it comes to vaccination, 65-year-old Uncle Wu hesitates: "Is it safe to get vaccinated?" ”
In fact, there are still many misunderstandings in the cognition of vaccination among the elderly. According to Chen Qiuping, head of the preventive health department of Liulitun Community Health Service Center, safety and effectiveness are the most concerned issues for the elderly when vaccinating.
"Some elderly people who have fever after vaccination, or redness, swelling, induration in the eye of the needle, think that this is caused by the insafety of the vaccine, in fact, this understanding is wrong."
She explained that each vaccine is supported by clinical research and data before it is approved for marketing, and after each vaccine is approved for marketing, each batch of vaccine must obtain a certificate issued by the national certification agency before it can be used. Quality monitoring must also be carried out on each batch of vaccines once they are put into service. Common adverse reactions: can be divided into local reactions and systemic reactions. Local reactions include redness, swelling, heat, pain, etc. at the vaccination site. Systemic reactions include fever, loss of appetite, and fatigue. However, these symptoms are usually mild, short-lasting, usually disappear in 1-2 days, and most require no treatment. "This is not equivalent to the insafety of vaccines."
In addition, "I will not be 100% sick if I get this vaccine", "After one injection, will I not have to take this disease in the future" ... These questions are often asked by Chen Qiuping in her work.
"The duration of protection is also different for different vaccines, and all vaccines cannot achieve 100% protection." For example, she said, taking the flu vaccine as an example, because the flu virus mutates quickly, the composition of the flu vaccine will also vary according to the change of the strain, so a new flu vaccine needs to be vaccinated every year.
Vaccines support the "immunization umbrella"
"Primary prevention is the most important cause prevention, vaccination is a very important means in primary prevention, for the elderly to reduce the disease and improve their quality of life; For families, it will reduce the time and economic costs caused by caregiving, caregiving; For society, build a friendly aging society and make the quality of life of the elderly higher. Chen Qiuping said.
In order to reduce vaccine hesitancy and vaccination misunderstandings among the elderly, on April 22, the first "Vaccination Science Handbook for the Elderly" (hereinafter referred to as the "Manual") was released, helping to further provide scientific guidance for the public and the elderly on the value of vaccination and action.
The Handbook states that the decline in immune function with age is referred to as "immunosenescence"1. Due to degenerative changes in the body, decreased immune function, and decreased physical function caused by chronic diseases, the elderly are prone to become susceptible to infectious diseases/infectious diseases. Vaccination can help the body obtain a specific immune response to the vaccine against the disease and prevent the corresponding disease; Vaccination can slow the progression of chronic disease in older people by preventing infection, reduce the risk of adverse outcomes from chronic disease complications2, and improve patients' quality of life.
Can people with chronic diseases and immunocompromised be vaccinated? In response to this problem, the Handbook points out that people with chronic diseases are more susceptible to infectious diseases because of their low immunity, which will also increase the difficulty of chronic disease management, so they need to be vaccinated and actively prevent corresponding diseases. Taking shingles as an example, people with diabetes, chronic kidney disease, cardiovascular disease, COPD, and rheumatoid arthritis have an increased risk of developing shingles compared to the general population3.
In addition, vaccination in immunocompromised people is important, as they have a greater burden of disease than immunocompetent people, and vaccination reduces the risk of infection with the corresponding disease, thereby avoiding a greater burden of disease. Common immunocompromised diseases such as solid organ malignancies, hematologic malignancies, solid organ transplantation, hematopoietic stem cell transplantation, human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS), end-stage renal disease, congenital immunodeficiencies and autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, multiple sclerosis, polymyalgia rheumatica, psoriasis, autoimmune thyroiditis, type 1 diabetes, Vasculitis and other autoimmune/collagen connective tissue diseases), etc. 4.
Chen Qiuping specifically analyzed that when vaccinating the elderly, it is necessary to carefully understand his physical condition and grasp the contraindications clearly. "For example, the elderly have underlying diseases, but they are not in the acute phase of the disease, and they can be vaccinated in the stable period; But there are some special cases, such as his immunity is particularly low, or the immune function is compromised, such as live attenuated vaccine can not be vaccinated, inactivated vaccine or recombinant protein vaccination is no problem. ”
The manual emphasizes that under the guidance of a doctor, you need to choose the vaccine that suits you after comprehensively considering your physical condition, as well as the applicable age, immunization program, contraindications, technical route and other contents of the vaccine. In addition, if you need more information about the protective efficacy and durability of vaccines, you can consult a medical professional, such as a vaccinator at a community health service center.
Strengthening the active immunity of the elderly, reducing the risk of diseases caused by immune aging through vaccination, and improving the enthusiasm of middle-aged and elderly people for vaccination are the keys to promoting healthy aging and achieving high-quality longevity. As Yang Weizhong, vice president of the Chinese Preventive Medicine Association and dean of the School of Medicine and Public Health of Peking Union Medical College, said: "In addition to scientific eating, wearing, living, and maintaining a happy mood, vaccination should also become one of the healthy lifestyles." ”
Improve access to vaccination services
In addition to cognition, the convenience and accessibility of vaccination services are also important factors affecting the enthusiasm of the elderly for vaccination.
For 70-year-old Zhang Meilan, who lives alone for many years, although she understands the role of vaccines, when and where to get vaccinated has stumped her. "Either you wait in a few meters long line as soon as you go to get an injection, or you tell me that there is no such vaccine here, and you run for nothing."
Promoting healthy aging and improving the happiness of the elderly is an important part of the mainland's "Healthy China 2030" strategic plan. In recent years, governments at all levels have successively issued various policies to provide guidance on the deployment of healthy aging, of which "moving forward and prevention first" is the key word that cannot be avoided.
In promoting vaccination initiatives for the elderly, communities play an important role in promoting the "last mile" of vaccination for older adults. Chen Qiuping took the Liulitun Community Health Service Center as an example, on the one hand, strengthen vaccination science education, not only through health lectures and other ways to the elderly to popularize science, but also to general practitioners to carry out health education, "science popularization of some common diseases of the elderly, especially diseases that can be prevented by vaccines, through general practitioners to tell this information to elderly patients." "On the other hand, through the establishment of special vaccination venues for the elderly and the announcement of vaccination time through multiple channels, the convenience and accessibility of vaccination services will be improved.
"To improve the enthusiasm of the elderly for vaccination, in fact, it is necessary to do health education and health science popularization. There is a long way to go to enhance their confidence in the effectiveness and safety of vaccines through health science popularization and health education, and to value the value of vaccines. Chen Qiuping said.
According to the forecast of the Chinese and Development Research Center, the number of elderly people over 80 years old on the mainland will quadruple by 2050, which means that China has now entered the era of longevity. In the era of longevity, people are more in pursuit of a healthy life. Supporting the "immunization umbrella" for the elderly requires the efforts of all parties in society, and there is the power of medical innovation and the power of medical workers on this road.
(The characters in the article Wang Ping, Uncle Wu, and Zhang Meilan are pseudonyms)
【Reference】
1.Weiskopf D, et al. The aging of the immune system. Transpl Int. 2009 Nov;22(11):1041-50.
2.LalH, et al. Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults[J]. NEnglJMed,
2015,372(22):2087‐2096.
3. MARRA F, PARHAR K, HUANG B, et al. Risk Factors for Herpes Zoster Infection: A Meta-Analysis [J].
Open Forum Infect Dis, 2020, 7(1): ofaa005.
4. Yang Yingying. Study on the incidence and economic burden of shingles and its complications in immunocompromised population[D].Zhejiang University of Chinese Medicine,2022.)
Author: Ma Meng