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Childhood Immunization Leaves Adults Behind

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The World Vaccine Congress meets this week for its annual marquee event in Washington D.C.

For an event that is supposed to "tackle the full spectrum of industry concerns," one item is conspicuously missing from their agenda: adult vaccines. As the global population ages, a "life-course approach" to immunization -- one that stresses vaccination in the adult years -- may become one of the great drivers of health and wellness in the 21st century.

The Vaccine Congress isn't alone in missing this point. The global health community has barely begun to recognize how vaccination can enable a healthy, active aging process. This aha! moment had better come soon, because vaccination isn't just good health policy, it's great economic policy. We learned this lesson with childhood vaccination -- which was, to be sure, one of the 20th century's greatest public health victories and economic achievements.

Indeed, notwithstanding pseudo-scientific quackery attributing autism to vaccinations - a truly unfounded claim -- childhood vaccination programs are an unfettered story of success. The U.S.'s Centers for Disease Control and Prevention got it exactly right when they declared childhood immunizations to be one of the 20th century's great achievements. And we're not done yet. New global initiatives are underway.

However, in the 21st century, childhood immunization won't be enough to ensure increasing levels of public health. As the global population ages -- as the over-60 population outnumbers those under-14 -- the next frontier in immunization will be to do for aging adults what we have already done for children. With an aging population, adult immunization becomes increasingly important. Indeed, it is a public health priority to take a "life-course approach" to vaccination -- one that administers vaccination throughout all stages of life in order to prevent disease and enable healthy, active, and productive aging.

Like babies and young children, older adults run an increased risk of contracting vaccine-preventable diseases like pneumonia, influenza, herpes zoster, shingles, and more. Consequently, in an aging population, rates of vaccine-preventable diseases rise, and the costs to both the individual and health systems at large are exponential. The CDC estimates that, in just the U.S., costs related to vaccine-preventable diseases in adults are roughly $10 billion annually.

Or consider that there are over 600,000 pneumonia-related hospitalizations each year in the U.S. alone, resulting in over 24,000 deaths. Public health officials have found that vaccination against influenza and pneumococcal pneumonia are extremely effective preventive services, ranking among smoking cessation and cancer screening.

Public, private, and philanthropic leaders have done an absolutely outstanding job with childhood vaccination. Now, we must bring the same commitment, dedication, and creativity to adult and "life-course" vaccination. It's a question of public health, economics, and ethics.

So, as the vaccine community gathers at the self-proclaimed "world's largest vaccine conference and expo," they must ensure that life-course vaccination is embedded in the larger socio-economic milieu of the 21st century. When the old outnumber the young, good health becomes the "least common denominator" that is essential to success. If the Vaccine Congress can add adult immunization to their agenda -- and influence subsequent policy and practice -- then this year's world immunization week may mark a historic turning point in one of this century's greatest health challenges.