As we age, our immune systems gradually deteriorate. This increases the risk of contracting an infectious disease – and can increase the risk of hospitalisation or death.
The burden of flu, RSV, shingles and pneumococcal disease can be reduced through vaccination. However, uptake of these vaccines in older people is much lower than uptake of childhood vaccines.
Highlights
- Older people say they they need more information about vaccines
- Healthcare professionals are a trusted source of health advice
- GPs and pharmacists want training on (a) the science of vaccines and (b) how to communicate with older people on a complex topic
- The VITAL Educational Platform provides healthcare professionals with free videos, infographics, answers to frequently asked questions, and links to training courses.
‘Children’s vaccination programmes are well known by the population and by healthcare professionals, but there has been less focus on older adults,’ explains Prof Zoltán Vokó, Semmelweis University and Syreon Research Institute, Budapest. ‘Elderly people are more prone to infectious diseases because of immunosenescence [immune system ageing] so improving vaccination rates is important.’
Prof Vokó worked on an EU-project called Vaccinating Elderly for Healthy Ageing (VITAL) which has developed and curated educational materials for healthcare professionals. The aim is to help clinicians to protect more of their adult patients against potentially life-threatening infections.
First, researchers asked older people in four countries (Hungary, Italy, France, and the Netherlands) what information they would like to have before they made decisions about recommended vaccines. Then they interviewed clinicians to find out what scientific knowledge and communication tools they need to engage with their patients.
‘In focus groups, it was clear that elderly people require a lot of information before coming to a decision. They want to know about the severity of the disease, the availability and cost of vaccines, the efficacy and safety of vaccines, and how vaccines are administered, among other things,’ Prof Vokó says.
Unlike other medical interventions, such as surgery or chemotherapy, which are recommended when people are ill, the decision to embrace preventative measures can involve more scrutiny from individuals. In addition, especially since the Covid pandemic, there has been a lot of debate – and some misinformation – about vaccines.
On the positive side, researchers found that while older people gather information from a range of sources, most still view their healthcare professionals as trustworthy. GPs in particular, along with pharmacists, are often the first port of call when older people have questions about their health.
However, healthcare professionals say they need additional information to supplement their knowledge. And they would prefer short, accessible training materials such as videos and podcasts.
‘This includes communication skills suitable for engaging with older people,’ Prof Vokó says. ‘It’s important to approach elderly adults with different strategies to those that might be used when speaking with parents of young children. They have differing needs and expectations.’
The VITAL project has recorded a series of videos covering topics such as informing older people about immunisation, addressing vaccine hesitancy, and soft skills. Infographics which summarise relevant evidence in this area, as well as Frequently Asked Questions and links to training courses are also provided.
‘Healthcare professionals want to know more about vaccines, but they need a quick and easy way to obtain information,’ Prof Vokó says. ‘They need to convey scientific messages which are easily understood – for example, about vaccine composition, about risks and benefits, and how to offer counter-arguments to misinformation in a way that is persuasive.’
To ensure the materials offered to healthcare professionals are effective, researchers conducted a review of various educational programmes and interventions to find out what works best. Tailored reminders, where a clinic’s computer system prompts clinicians to offer vaccination to those who may benefit – for example, based on their age or medical history – have been shown to be effective.
‘Integrating reminders into staff training and quality assurance programmes is particularly impactful,’ Prof Vokó says.
Read: Vaccine conversations: a new way to tackle misinformation
While the VITAL project has now concluded its funded work, a group of researchers continues to review material on the educational platform to keep it up to date.
‘We want to point GPs, pharmacists and others towards effective existing material,’ he says. ‘But we also acknowledge that there are gaps. Digestible training resources on vaccines and communication are required to support healthcare professionals in answering questions from older people.’
‘Health professionals need vaccine information’
Dr Francesco Nicoli, an immunologist at the University of Ferrara, says training in vaccinology is limited on some healthcare courses at university. However, the Covid pandemic and ongoing outbreaks of infectious diseases show the importance of understanding infection and immunisation.
‘GPs may be exposed to microbiology curriculum early in their training or as part of hygiene and public health modules,’ he says. ‘But some of these courses are optional so there is limited discussion about vaccines. That’s a problem which has consequences for how healthcare professionals engage with people on this subject.’
Dr Nicoli says the VITAL platform provides some new material and a repository for quality training and educational content. It was built based on engagement with healthcare professionals and older people. A sample platform was built and tested in workshops in four countries to see if it met the needs of healthcare professionals.
‘There’s a clear need for more information on this topic, including for GPs, pharmacists, geriatricians and others who engage with older people. A lot of effort has gone into developing the platform. We believe it is a valuable tool that meets a real need. That is why we are keeping it alive.’
