Vaccination Gap Threatens Senior Health in the Dominican Republic: Lessons for the U.S.
By archyde News
The Unseen Threat: Vaccine Hesitancy and Aging Populations
Santo Domingo faces a critical public health challenge: a important gap in vaccination awareness among its older adult population. While the Dominican Republic’s Ministry of Public Health offers a vaccination booklet specifically for seniors, its existence remains largely unknown.This situation mirrors concerns in the United States, where vaccine hesitancy and lack of awareness about recommended vaccinations for older adults present ongoing challenges.
This knowledge gap, according to health experts, represents a “worrying gap in health promotion and prevention.” The implications extend beyond individual health, impacting the broader healthcare system and economy.
Immunosenescence: Understanding the Aging Immune System
At a conference organized by Pfizer focusing on the importance of immunization throughout life, notably among older adults, Dr. Alexandra Castillo, president of the Dominican Society of geriatrics, highlighted a key factor: immunosenescence. “It is indeed normal for the immune system to decrease its capacity wiht age, a phenomenon known as immunosenescence. For this reason, older adults are more susceptible to infectious diseases, and vaccines play a crucial role in their protection,” Dr. Castillo explained.
Immunosenescence affects older adults in the U.S. similarly. As the immune system weakens with age, seniors become more vulnerable to severe complications from preventable diseases. This vulnerability underscores the necessity for targeted vaccination programs and improved public health messaging.
The Impact of Pneumonia and Other Preventable Diseases
Dr. Castillo lamented the “lack of a culture of vaccination in older adults in the country, despite the existence of a vaccination booklet.” She emphasized that “Vaccinating our older adults considerably reduces the risk of diseases such as pneumonia, which is often fatal in this population.”
Pneumonia remains a leading cause of death among older adults in the U.S. as well. According to the Centers for Disease control and Prevention (CDC), thousands of seniors are hospitalized and die from pneumonia each year. vaccination against pneumococcal disease offers a critical layer of protection.
In 2023,the CDC updated its recommendations for pneumococcal vaccines,advising adults 65 years and older who have not previously received a pneumococcal conjugate vaccine or whose previous vaccination history is unknown to receive a dose of PCV20 or PCV15,followed by a dose of PPSV23 (if PCV15 is used). These updated guidelines reflect the evolving understanding of vaccine effectiveness and the need for tailored strategies to protect vulnerable populations.
Recommended Vaccines for Seniors: A Thorough Approach
The panel of specialists recommended several key vaccines for older adults, including:
- Influenza vaccine
- Pneumococcal vaccine
- Diphtheria and tetanus vaccine (often given as a Tdap booster)
- herpes Zóster vaccine (Shingles)
Regarding the Herpes Zóster vaccine, Dr. Castillo warned that “Herpes Zóster can cause serious complications, such as postherpetic neuralgia, which causes intense and prolonged pain,” recommending the vaccine from age 50.
The Shingrix vaccine,available in the U.S., has demonstrated high efficacy in preventing shingles and postherpetic neuralgia. The CDC recommends Shingrix for healthy adults 50 years and older, regardless of whether they have had shingles previously.
Immunocompromised Individuals: A Population at High Risk
Infectologist Dr. Héctor Balcácer pointed out that individuals taking “high-cost medications to treat diseases such as psoriasis, rheumatoid arthritis and lupus, among others, should also consider vaccination.” He explained that “These medications can weaken the immune system, which increases the risk of infections.”
This is particularly relevant in the U.S., where a significant portion of the population uses immunosuppressant drugs. these medications, while effective in managing chronic conditions, can compromise the immune system and increase the risk of infection.Vaccination becomes even more critical for this vulnerable group.
Accessibility of Vaccines: A Crucial Factor
Dr. Roberto Nina, president of the Dominican Society of Obstetrics and Gynecology, mentioned that there are “2,000 centers that offers free vaccines.” while the Dominican Republic is providing free vaccines, access in the US can be complex and vary, based on insurance status and location.
Addressing Vaccine Hesitancy in the U.S.
vaccine hesitancy poses a significant obstacle to achieving optimal vaccination rates among older adults in the U.S. Factors contributing to hesitancy include misinformation, distrust of healthcare providers, and concerns about vaccine safety and effectiveness.
Effective strategies for addressing vaccine hesitancy include:
- Clear and consistent communication: Public health campaigns should provide accurate and accessible information about the benefits and risks of vaccination.
- Healthcare provider recommendations: Physicians and other healthcare providers are trusted sources of information and can play a crucial role in encouraging vaccination.
- Community engagement: Tailoring messages to specific communities and addressing their concerns can increase vaccine confidence.
- Addressing misinformation: Countering false or misleading information about vaccines is essential to preventing the spread of hesitancy.
Comparative Analysis: Dominican Republic vs. United States
| Factor | Dominican Republic | United States |
|---|---|---|
| Vaccination Booklet Awareness | Low awareness among the public | No equivalent nationwide booklet, but resources are available from the CDC and other organizations. |
| Vaccine Accessibility | 2,000 centers offer free vaccines | Accessibility varies based on insurance and location; programs like Vaccines for Adults (VFA) exist for the uninsured. |
| Vaccine Hesitancy | Present, contributing to low vaccination rates | Significant issue, fueled by misinformation and distrust. |
| Recommended Vaccines for Seniors | Influenza, pneumococcus, diphtheria/tetanus, herpes zoster | Same recommendations, aligned with CDC guidelines. |
Recent Developments and resources in the U.S.
- Updated CDC Guidelines: The CDC regularly updates vaccine recommendations based on the latest scientific evidence.
- National Foundation for Infectious Diseases (NFID): NFID is a non-profit organization dedicated to educating the public and healthcare professionals about infectious diseases, including the importance of vaccination.
- Immunization Action Coalition (IAC): IAC works to increase immunization rates by providing educational resources for healthcare professionals.
Conclusion: Bridging the Vaccination Gap
The challenges faced by the Dominican Republic in promoting vaccination among older adults offer valuable lessons for the U.S. By increasing awareness, improving access, and addressing vaccine hesitancy, the U.S. can better protect its aging population from preventable diseases.
