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Query: UMLS:C0043167 (pertussis)
 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infections are a major cause of morbidity and mortality in the elderly. Although vaccination is crucial for preventing infectious diseases, the ability of the elderly to establish an effective immune response to vaccination is much lower compared to the younger population. In most industrialized countries, four vaccines are now recommended for people over 60 years of age: influenza vaccine, pneumococcal vaccine, herpes zoster vaccine, and a vaccine combining tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis. Only the last vaccine provides an adequate antibody response. The influenza and pneumococcal vaccines seem to be able to alleviate disease. The herpes zoster vaccine somewhat prevents reactivation of herpes zoster and decreases the severity of postherpetic neuralgia. Recent technological advances and novel adjuvants are providing new opportunities for improving vaccination of the elderly. Lifelong vaccination schedules should be promoted in order to achieve the herd immunity threshold. Maintaining the health of the population requires moving from a childhood-based vaccination strategy to a more balanced vaccination program throughout life.
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PMID:Vaccination indications and limits in the elderly. 2408 35

In vaccinating adults, clinicians face 2 types of challenges: (1) staying current on recommendations for influenza, pneumococcal, hepatitis A and B, zoster, and other vaccines and (2) addressing systemic barriers to implementing practices that increase vaccination rates. Although adult immunization rates remain suboptimal, there has been much good news in adult vaccination recently. New high-dose and adjuvanted influenza vaccines help improve immune response and may reduce influenza complications in older adults. The new recombinant zoster vaccine offers significantly more efficacy against zoster outbreaks and postherpetic neuralgia than zoster vaccine live. Pertussis vaccine given during the third trimester of pregnancy may prevent between 50% and 90% of pertussis infections in infants. Shorter time for completion (1 vs 6 months) of new, adjuvanted hepatitis B vaccine may increase adherence. Clinicians can address systemic barriers to increasing vaccination rates in their clinics and health care systems by following the Centers for Disease Control and Prevention's Standards for Adult Immunization Practice. Clinicians can help increase vaccination rates by writing standing orders and by advocating for nurses or medical assistants to receive training and protected time for assessing and documenting vaccination histories and administration. Strong recommendations that presume acceptance of vaccination are effective with most patients. Communication techniques similar to motivational interviewing can help with vaccine-hesitant patients. Clinicians, as experts on providing preventive services, can educate community leaders about the benefits of immunization and can inform vaccine experts about challenges of implementing vaccination recommendations in clinical practice and strategies that can work to raise vaccination rates.
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PMID:Vaccination of Adults in General Medical Practice. 3190 13