Vaccines in adults.

The proportion of adult population has increased globally and the current projections indicate that, by 2050, the group of 60 years and older will represent 21.1%. There are now vaccines exclusively designed for adults and others that are applied in early life but need to be updated later in life. Vaccines for adults are not only based on their respective age group but are also linked to risk factors like occupation, life style, health situation, among others. At the same time, longevity brings with it a weakening of the immune response to vaccines, a process known as immunosenescence representing an increasing challenge to adequately protect this age group. For some time, WHO has been promoting the term "Vaccination through the life course" allowing for an extension of the vaccination vision and taking adults as an integral part into the national vaccination programs and calendars. There are several vaccine preventable diseases affecting adults, but those associated with influenza virus and pneumococcus are the ones that affect the largest age group. Several recommendations include, additionally, others to prevent diphtheria, tetanus, whooping cough, hepatitis A and B, meningococcus, chickenpox, measles, rubella, mumps, herpes zoster, human papilloma virus and others. There are still many challenges to overcome in order to fully include adults, particularly health personnel, and to make vaccines extensively valued as a prevention tool in order to achieve a healthy life.

La proporción de población de adultos se ha incrementado globalmente y las proyecciones muestran que para el año 2050 los mayores de 60 años representarán el 21.1%. Actualmente se dispone de vacunas dirigidas exclusivamente a adultos y otras que se aplican en niños pero que se deben actualizar a lo largo de la vida. Las vacunas en adultos se administran, no solo por el grupo de edad al que pertenecen, sino también por factores como ocupación, estilos de vida o estado de salud. Al mismo tiempo, la longevidad disminuye la respuesta inmune a las vacunas por el fenómeno de inmunosenescencia, lo cual representa un desafío para proteger adecuadamente a este grupo. Desde hace varios años la OMS, ha propiciado la utilización del término "Vacunación en el curso de la vida" lo cual permite extender la visión de la vacunación y considerar al adulto como una parte integral de los planes y calendarios de inmunización. Existen varias enfermedades prevenibles por vacunas en adultos, pero aquellas asociadas al virus de influenza y al neumococo, son las que comprenden el grupo más extenso. Diversas recomendaciones incluyen, además de estas vacunas, otras dirigidas a prevenir difteria, tétanos, tos convulsa, hepatitis A y B, meningococo, varicela, sarampión, rubéola, parotiditis, herpes zóster, virus del papiloma humano y otras enfermedades. Se reconocen muchos desafíos a superar para poder incorporar plenamente al adulto, incluyendo al personal de salud, y lograr que la vacunación sea una herramienta de prevención valorada ampliamente para el desarrollo de una vida saludable.

The past, present, and future of immunization in the Americas

The Pan American Journal of Public Health recognizes with appreciation the contributions of the members of the Editorial Committee, and authors of the Overview article. Their contributions and dedication to this issue on immunization in the Region of the Americas were extraordinary and helped make the manuscripts more interesting, more accurate, and more useful to our readers and all others who work to improve the health of the peoples of the Americas. The Journal would like to give special thanks to the General Coordination of the National Immunization Program, Department of Transmissible Disease Surveillance, Health Surveillance Secretariat, Ministry of Health, Brazil, whose financial and programmatic contributions were essential to the publication of this special issue.