Think tank calls for improvements in immunisation for older people

A new report urges a rethink of how the UK organises and promotes immunisation, advocating among a raft of suggestions, a greater role for pharmacies and a more active part to be played by GPs.

Called ‘Immune’ Response, the report has been prepared by the leading think tank on longevity and demographic change, the International Longevity Centre – UK (ILC-UK) and sets out proposals for the UK to become a world leader in terms of the vaccination of older people.

‘Immune Response’ contends that while prevention is better than a cure, vaccination remains an underused public health strategy for adults in the UK and across Europe. ILC-UK argues that the growth of antibiotic resistance, the challenges of immunosenescence (the gradual deterioration of the immune system brought on by ageing) and increased migration mean that we need to put greater focus on improving adult vaccination in the UK.

The report highlights evidence, published by the pan-European partnership SAATI (Supporting Active Ageing Through Immunisation) last week in Brussels, which found evidence of cost effectiveness for vaccination of older people in relation to such diseases as herpes zoster, influenza, invasive pneumococcal disease and pneumonia and stated that for every €1 invested in adult vaccination commencing at the age of 50 years would yield €4.02 of future economic revenue for government.

The SAATI report also noted the ongoing impact of vaccine preventable diseases on health in the UK. For example, seasonal influenza in the 2010-11 winter period in the UK was more severe in terms of pressure on hospitals than during the 2009-10 pandemic winter. Furthermore, excess death rates from influenza In 2012-13 were the highest since 2008-09. When it comes to pneumonia, the UK has one of the highest reported mortality rates in Europe.

Baroness Sally Greengross, chief executive of ILC-UK said: “Innovations in public health over the past two hundred years have transformed life expectancy in the UK and we are living longer than ever before. Over recent decades, policymakers have begun to use vaccination to support good health later in life.

“So we start from a very positive place. But now is not the time to get complacent. The growth of antibiotic resistance, the challenges of immunosenescence and the context of migration mean that we need to put greater focus on improving uptake of adult vaccinations in the UK.”

Among the thirty-plus recommendations set out in the report, ILC-UK calls for the piloting of a voucher scheme for those eligible for the seasonal flu vaccine. Such vouchers could be used not just in GP’s surgeries, but also in registered high street pharmacies. It also asks Public Health England and the Department of Health to review whether the current approach to the vaccination of the social care workforce in England is appropriate. Flu vaccine uptake among frontline health and social care workers over the last few years has remained disappointingly low, averaging out at around 45 per cent in 2012/2013.

Other recommendations include encouraging GPs to carry out an annual check on the immunisation status of all their registered patients and health care professionals undertaking health check-ups of older people to check whether their patients are up to date with their vaccines.

More generally, ILC-UK also sets out a number of proposals to support the creation of a better informed and engaged health consumer including the introduction of an adult vaccination record card, a simplified adult vaccination checklist, and encouraging people to carry a record of their immunisation history with their passport.

David Sinclair, assistant director, Policy and Communications at ILC-UK said: “The UK takes a world leading approach to childhood immunisation. With an ageing society we must focus more on prevention of ill health and the vaccination of older people has to play an important role. We must improve the levels of vaccination amongst NHS staff while also ensuring that employees from the independent social care sector access the vaccinations they need.

“We must also make vaccination more accessible. An enhanced role for pharmacies could help achieve this. We need an informed consumer who knows what vaccinations they need across their life. An adult vaccination record card for all is vital.”

Professor David Taylor, professor of pharmaceutical and public health policy, The UCL School of Pharmacy agreed, and added: “Extending access to vaccination among older people has a significant potential for improving public health in the UK and Europe more broadly. The ILC-UK’s report highlights the fact that although the UK’s record is already relatively good we could do more to optimise immunisation rates throughout our life courses.”

According to the World Health Organisation (WHO), immunisation prevents between 2-3m deaths a year across all age groups.