Çalışan Sağlığının Geliştirilmesi Temelinde Erişkin Dönemde Bağışıklama
Özet
Yetişkin bağışıklaması koruyucu sağlık hizmetleri içinde ihmal edilen bir konudur. Dünya Sağlık Örgütü gibi uluslararası örgütlerin yayınladığı kılavuzlar arasında bile, yetişkin bağışıklaması için en uygun strateji konusunda bir fikir birliği eksikliği vardır ve en önemlisi, gelişmekte olan ülkelerde yetişkin bağışıklaması sorunu ele alınmamıştır. Yetişkinlerin aşıya ihtiyacı çok sayıda nedene atfedilir. Birincil nedenlerden biri, bireyin enfeksiyonlara karşı direncini azaltan yaşa bağlı immünosenesanstır. Dahası, yetişkinlik dönemi sıklıkla enfeksiyonlara karşı duyarlılığı artıran kronik hastalıklarla ilişkilendirilir. İlginç bir şekilde, her yıl aşıyla önlenebilir hastalıklardan ölen yetişkinlerin oranı, çocuklara karşılık gelen rakama kıyasla 350 kat daha yüksektir. Çocukluk çağı aşılamasının uzun vadeli faydalar sağlayamaması ve belirli hastalıkların (tüberküloz, sıtma) ortaya çıkması ve yeniden ortaya çıkmasıyla değişen hastalık epidemiyolojisi, yetişkin aşılamasının önemli olmasının bir diğer nedenidir. Kardiyovasküler komorbiditelerin ve hastaneye yatışların azaltılması açısından çalışan yetişkin nüfusra aşılamanın ilave faydalarının vurgulanmasını gerektirmektir. Çalışanların aşılanması işe devamsızlığı azaltır ve iş üretkenliğini artırır. Bu bölümde ulusal ve uluslararası kılavuzlar doğrultusunda erişkin dönemde bağışıklama önerileri ele alınmıştır.
Adult immunization is a neglected issue. Even among guidelines published by international organizations such as the World Health Organization, there is a lack of consensus on the most appropriate strategy for adult immunization and, most importantly, the issue of adult immunization in developing countries has not been addressed. The need for vaccination in adults is attributed to a number of reasons. One of the primary reasons is age-related immunosenescence, which reduces an individual’s resistance to infection. Furthermore, adulthood is often associated with chronic diseases that increase susceptibility to infection. Interestingly, the proportion of adults who die each year from vaccine-preventable diseases is 350 times higher than the corresponding figure in children. The lack of long-term benefits of childhood vaccination and the changing epidemiology of diseases, with the emergence and reemergence of certain diseases (tuberculosis, malaria), are another reason why adult vaccination is important. The additional benefits of vaccination in the working adult population in terms of reducing cardiovascular comorbidities and hospitalizations need to be emphasized. Vaccination of employees reduces absenteeism and increases work productivity. In this section, adult immunization recommendations in line with national and international guidelines are discussed.
Referanslar
Bajaj, S. (2018). RSSDI clinical practice recommendations for the management of type 2 diabetes mellitus 2017. Int J Diabetes Dev Ctries, 38(Suppl 1), 1–115. doi: 10.1007/s13410-018-0604-7.
Bonanni, P., Sacco, C., Donato, R., Capei, R. (2014). Lifelong vaccination as a key disease-prevention strategy. Clin Microbiol Infect, 20(Suppl 5), 32–6. doi: 10.1111/1469-0691.12537.
Bonanni, P. Bonaccorsi, G. Lorini, C. Santomauro, F. Tiscione, E. Boccalini, S. Bechini, A. (2018). Focusing on the implementation of 21st century vaccines for adults. Vaccine, 36, 5358–5365.
Cafiero-Fonseca, E.T., Stawasz, A., Johnson, S.T., Sato, R., Bloom, D.E. (2017). The full benefits of adult pneumococcal vaccination: A systematic review. PLoS One, 12, e0186903. doi: 10.1371/journal.pone.0186903.
Center for Disease Control and Prevention (CDC) (2024). Vaccine-Preventable Adult Diseases. https://www.cdc.gov/vaccines-adults/diseases/index.html.
Centers for Disease Control and Prevention (CDC). (2024). Advisory Committee on Immunization Practices. Recommended adult immunization schedule. https://www.cdc.gov/vaccines/imz-schedules/adult-easyread.html.
Centers for Disease Control and Prevention (CDC). (1999). Ten great public health achievements – United States, 1900–1999. MMWR Morb Mortal Wkly Rep, 48, 241–243.
Grohskopf, L. A., Ferdinands, J.M., Blanton, L.H., Broder, K.R., Loehr, J. (2024). Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2024–25 Influenza Season. MMWR Recomm Rep, 73(No. RR-5), 1–25. doi: http://dx.doi.org/10.15585/mmwr.rr7305a1.
He, W., Goodkind, D., Kowal, P. (2016). An aging world: 2015. US Census Bureau International Population Reports P95/16-1. https://www.census.gov/content/dam/Census/library/publications/2016/demo/p95-16-1.pdf.
Hung, I.F.N., Leung, A.Y., Chu, D.W., Leung, D., Cheung, T., Chan, C.K., et al. (2010). Prevention of acute myocardial infarction and stroke among elderly persons by dual pneumococcal and influenza vaccination: A prospective cohort study. Clin Infect Dis, 51, 1007–16. doi: 10.1086/656587.
Kobayashi, M., Leidner, A.J., Gierke, R., et al. (2024). Use of 21-valent pneumococcal conjugate vaccine among U.S. adults: Recommendations of the advisory committee on ımmunization practices — United States, 2024. MMWR Morb Mortal Wkly Rep, 73, 793–798. doi: http://dx.doi.org/10.15585/mmwr.mm7336a3.
Laupèze, B., Del Giudice, G., Doherty, M.T. et al. (2021). Vaccination as a preventative measure contributing to immune fitness. NPJ Vaccines 6, 93. https://doi.org/10.1038/s41541-021-00354-z).
Looijmans-Van den Akker, I., Verheij, T.J., Buskens, E., Nichol, K.L., Rutten, G.E., Hak, E., et al. (2006). Clinical effectiveness of first and repeat influenza vaccination in adult and elderly diabetic patients. Diabetes Care, 29, 1771–6. doi: 10.2337/dc05-2517.
MacIntyre, C.R., Mahimbo, A., Moa, A.M., Barnes, M. (2016). Influenza vaccine as a coronary intervention for prevention of myocardial infarction. Heart, 102, 1953–6. doi: 10.1136/heartjnl-2016-309983.
Mitra, S., Stein, G.E., Bhupalam, S., Havlichek, D.H. (2016). Immunogenicity of 13-valent conjugate pneumococcal vaccine in patients 50 years and older with end-stage renal disease and on dialysis. Clin Vaccine Immunol, 23, 884–7. doi: 10.1128/CVI.00153-16.
Mohan, V., Unnikrishnan, R., Thomas, N., Bhansali, A., Wangnoo, S.K., Thomas, K. (2011). Pneumococcal infections and immunization in diabetic patients. J Postgrad Med, 57, 78–81. doi: 10.4103/0022-3859.74299.
Nelson, N.P., Weng, M.K., Hofmeister, M.G., et al. (2020). Prevention of hepatitis A virus infection in the United States: Recommendations of the advisory committee on ımmunization practices, 2020. MMWR Recomm Rep, 69(No. RR-5), 1–38. DOI: http://dx.doi.org/10.15585/mmwr.rr6905a1.
Poudel, S., Shehadeh, F., Zacharioudakis, I.M., Tansarli, G.S., Zervou, F.N., Kalligeros, M., et al. (2019). The effect of influenza vaccination on mortality and risk of hospitalization in patients with heart failure: A systematic review and meta-analysis. Open Forum Infect Dis, 6, ofz159. doi: 10.1093/ofid/ofz159.
Ren, S., Newby, D., Li, S.C., Walkom, E., Miller, P., Hure, A., et al. (2015). Effect of the adult pneumococcal polysaccharide vaccine on cardiovascular disease: A systematic review and meta-analysis. Open Heart, 2, e000247. doi: 10.1136/openhrt-2015-000247.
Sadighi Akha, A A. (2018). Aging and the immune system: an overview. J Immunol Methods, 463, 21–26.
Swanson, K. A., Schmitt, H. J., Jansen, K.U., Anderson, A. S. (2015). Adult vaccination. Hum Vaccin Immunother, 11(1), 150-5. doi: 10.4161/hv.35858.
Tanriover, M.D., Soyler, C., Ascioglu, S., Cankurtaran, M., Unal, S. (2014). Low seroprevalence of diphtheria, tetanus and pertussis in ambulatory adult patients: the need for lifelong vaccination. Eur J Intern Med, 25(6), 528-32. doi: 10.1016/j.ejim.2014.04.010.
Türkiye Enfeksiyon Hastalıkları Ve Klinik Mikrobiyoloji Uzmanlık Derneği. Erişkin Bağışıklama Rehberi 2019.
U.S. DHHS Healthy People (2011). 2020 U.S. DHHS, Washington, DC.
Udell, J. A., Zawi, R., Bhatt, D.L., Gaughran, F., Phrommintikul, A., Ciszewski, A., et al. (2013). Association between influenza vaccination and cardiovascular outcomes in high-risk patients: A meta-analysis. JAMA, 310, 1711–20. doi: 10.1001/jama.2013.279206.
Vlachopoulos, C.V., Terentes-Printzios, D. G., Aznaouridis, K. A., Pietri, P. G., Stefanadis, C. I. (2015). Association between pneumococcal vaccination and cardiovascular outcomes: A systematic review and meta-analysis of cohort studies. Eur J Prev Cardiol, 22, 1185–99. doi: 10.1177/2047487314549512.
Weng, M. K., Doshani, M., Khan, M. A., et al. (2022). Universal hepatitis B vaccination in adults aged 19–59 years: Updated recommendations of the advisory committee on ımmunization practices —United States, 2022. MMWR Morb Mortal Wkly Rep, 71, 477–483. DOI: http://dx.doi.org/10.15585/mmwr.mm7113a1.
World Health Organization (WHO). (2020). The global strategy and action plan on ageing and health. http://www.who.int/ageing/global-strategy/en/.
World Health Organization (WHO) (2024). Vaccines and immunization. https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1.
Referanslar
Bajaj, S. (2018). RSSDI clinical practice recommendations for the management of type 2 diabetes mellitus 2017. Int J Diabetes Dev Ctries, 38(Suppl 1), 1–115. doi: 10.1007/s13410-018-0604-7.
Bonanni, P., Sacco, C., Donato, R., Capei, R. (2014). Lifelong vaccination as a key disease-prevention strategy. Clin Microbiol Infect, 20(Suppl 5), 32–6. doi: 10.1111/1469-0691.12537.
Bonanni, P. Bonaccorsi, G. Lorini, C. Santomauro, F. Tiscione, E. Boccalini, S. Bechini, A. (2018). Focusing on the implementation of 21st century vaccines for adults. Vaccine, 36, 5358–5365.
Cafiero-Fonseca, E.T., Stawasz, A., Johnson, S.T., Sato, R., Bloom, D.E. (2017). The full benefits of adult pneumococcal vaccination: A systematic review. PLoS One, 12, e0186903. doi: 10.1371/journal.pone.0186903.
Center for Disease Control and Prevention (CDC) (2024). Vaccine-Preventable Adult Diseases. https://www.cdc.gov/vaccines-adults/diseases/index.html.
Centers for Disease Control and Prevention (CDC). (2024). Advisory Committee on Immunization Practices. Recommended adult immunization schedule. https://www.cdc.gov/vaccines/imz-schedules/adult-easyread.html.
Centers for Disease Control and Prevention (CDC). (1999). Ten great public health achievements – United States, 1900–1999. MMWR Morb Mortal Wkly Rep, 48, 241–243.
Grohskopf, L. A., Ferdinands, J.M., Blanton, L.H., Broder, K.R., Loehr, J. (2024). Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2024–25 Influenza Season. MMWR Recomm Rep, 73(No. RR-5), 1–25. doi: http://dx.doi.org/10.15585/mmwr.rr7305a1.
He, W., Goodkind, D., Kowal, P. (2016). An aging world: 2015. US Census Bureau International Population Reports P95/16-1. https://www.census.gov/content/dam/Census/library/publications/2016/demo/p95-16-1.pdf.
Hung, I.F.N., Leung, A.Y., Chu, D.W., Leung, D., Cheung, T., Chan, C.K., et al. (2010). Prevention of acute myocardial infarction and stroke among elderly persons by dual pneumococcal and influenza vaccination: A prospective cohort study. Clin Infect Dis, 51, 1007–16. doi: 10.1086/656587.
Kobayashi, M., Leidner, A.J., Gierke, R., et al. (2024). Use of 21-valent pneumococcal conjugate vaccine among U.S. adults: Recommendations of the advisory committee on ımmunization practices — United States, 2024. MMWR Morb Mortal Wkly Rep, 73, 793–798. doi: http://dx.doi.org/10.15585/mmwr.mm7336a3.
Laupèze, B., Del Giudice, G., Doherty, M.T. et al. (2021). Vaccination as a preventative measure contributing to immune fitness. NPJ Vaccines 6, 93. https://doi.org/10.1038/s41541-021-00354-z).
Looijmans-Van den Akker, I., Verheij, T.J., Buskens, E., Nichol, K.L., Rutten, G.E., Hak, E., et al. (2006). Clinical effectiveness of first and repeat influenza vaccination in adult and elderly diabetic patients. Diabetes Care, 29, 1771–6. doi: 10.2337/dc05-2517.
MacIntyre, C.R., Mahimbo, A., Moa, A.M., Barnes, M. (2016). Influenza vaccine as a coronary intervention for prevention of myocardial infarction. Heart, 102, 1953–6. doi: 10.1136/heartjnl-2016-309983.
Mitra, S., Stein, G.E., Bhupalam, S., Havlichek, D.H. (2016). Immunogenicity of 13-valent conjugate pneumococcal vaccine in patients 50 years and older with end-stage renal disease and on dialysis. Clin Vaccine Immunol, 23, 884–7. doi: 10.1128/CVI.00153-16.
Mohan, V., Unnikrishnan, R., Thomas, N., Bhansali, A., Wangnoo, S.K., Thomas, K. (2011). Pneumococcal infections and immunization in diabetic patients. J Postgrad Med, 57, 78–81. doi: 10.4103/0022-3859.74299.
Nelson, N.P., Weng, M.K., Hofmeister, M.G., et al. (2020). Prevention of hepatitis A virus infection in the United States: Recommendations of the advisory committee on ımmunization practices, 2020. MMWR Recomm Rep, 69(No. RR-5), 1–38. DOI: http://dx.doi.org/10.15585/mmwr.rr6905a1.
Poudel, S., Shehadeh, F., Zacharioudakis, I.M., Tansarli, G.S., Zervou, F.N., Kalligeros, M., et al. (2019). The effect of influenza vaccination on mortality and risk of hospitalization in patients with heart failure: A systematic review and meta-analysis. Open Forum Infect Dis, 6, ofz159. doi: 10.1093/ofid/ofz159.
Ren, S., Newby, D., Li, S.C., Walkom, E., Miller, P., Hure, A., et al. (2015). Effect of the adult pneumococcal polysaccharide vaccine on cardiovascular disease: A systematic review and meta-analysis. Open Heart, 2, e000247. doi: 10.1136/openhrt-2015-000247.
Sadighi Akha, A A. (2018). Aging and the immune system: an overview. J Immunol Methods, 463, 21–26.
Swanson, K. A., Schmitt, H. J., Jansen, K.U., Anderson, A. S. (2015). Adult vaccination. Hum Vaccin Immunother, 11(1), 150-5. doi: 10.4161/hv.35858.
Tanriover, M.D., Soyler, C., Ascioglu, S., Cankurtaran, M., Unal, S. (2014). Low seroprevalence of diphtheria, tetanus and pertussis in ambulatory adult patients: the need for lifelong vaccination. Eur J Intern Med, 25(6), 528-32. doi: 10.1016/j.ejim.2014.04.010.
Türkiye Enfeksiyon Hastalıkları Ve Klinik Mikrobiyoloji Uzmanlık Derneği. Erişkin Bağışıklama Rehberi 2019.
U.S. DHHS Healthy People (2011). 2020 U.S. DHHS, Washington, DC.
Udell, J. A., Zawi, R., Bhatt, D.L., Gaughran, F., Phrommintikul, A., Ciszewski, A., et al. (2013). Association between influenza vaccination and cardiovascular outcomes in high-risk patients: A meta-analysis. JAMA, 310, 1711–20. doi: 10.1001/jama.2013.279206.
Vlachopoulos, C.V., Terentes-Printzios, D. G., Aznaouridis, K. A., Pietri, P. G., Stefanadis, C. I. (2015). Association between pneumococcal vaccination and cardiovascular outcomes: A systematic review and meta-analysis of cohort studies. Eur J Prev Cardiol, 22, 1185–99. doi: 10.1177/2047487314549512.
Weng, M. K., Doshani, M., Khan, M. A., et al. (2022). Universal hepatitis B vaccination in adults aged 19–59 years: Updated recommendations of the advisory committee on ımmunization practices —United States, 2022. MMWR Morb Mortal Wkly Rep, 71, 477–483. DOI: http://dx.doi.org/10.15585/mmwr.mm7113a1.
World Health Organization (WHO). (2020). The global strategy and action plan on ageing and health. http://www.who.int/ageing/global-strategy/en/.
World Health Organization (WHO) (2024). Vaccines and immunization. https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1.
