• Molly Sauer, Prarthana Vasudevan, Ankita Meghani, Karuna Luthra, Cristina Garcia, Knoll Maria Deloria MD International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington St, 5(th, and Lois Privor-Dumm.
• International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 415 N Washington St, 5(th) Floor, Baltimore, MD 21231 USA. Electronic address: msauer@jhu.edu.
• Vaccine. 2021 Mar 12; 39 (11): 1556-1564.

AbstractBy 2050, the number of adults over 65 years of age will be double the under-5 population, and heavily concentrated in low- and middle-income countries. Population growth and increasing life expectancies call for effective healthy aging strategies inclusive of immunization to reduce the burden of vaccine-preventable diseases, improve quality of life, and mitigate antimicrobial resistance. Based on a review of available literature on the pneumococcal disease, influenza, and herpes zoster epidemiology and economic burden, and the health systems and policy barriers for adult immunization, we identified evidence gaps and considerations for prioritizing adult immunization. The body of evidence for adult immunization and the health and economic burden of adult disease is heavily concentrated in high-income countries. The few countries reporting adult immunization policies generally focus on high-risk groups. Despite robust child immunization programs in most countries, adult immunization programs and policies lag far behind and there is a general lack of appropriate delivery platforms. Global adult disease burden and economic costs are substantial but evidence from low- and middle-income countries is limited. There is a need for a strengthened evidence base and political commitment to drive a comprehensive, global technical consensus on adult immunization.Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

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