The use of a predictive, preventive, personalized, and participatory (P4) medicine approach to create a personalized vaccination schedule for older adults may help reduce their risk of infectious and non-infectious disease later in life, according to recent research in Gerontology.
“The promise of the P4 medicine approach is that by personalizing the risk and the treatment of identifiable risks, physicians may be able to identify high-risk individuals, while the perception that this is ‘their personal treatment’ may motivate individuals to be compliant with preventative behaviours,” T. Mark Doherty, PhD, Global Medical Affairs, GlaxoSmithKline in Wavre, Belgium, and colleagues wrote in their paper.
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Vaccination. Source: Getty
Evidence suggests vaccination against non-communicable diseases (NCDs) is effective for preventing ischemic heart disease, stroke, type 1 diabetes, and some forms of dementia. The effects of vaccination depend on the disease, the effects of the disease, and the patient’s age. In the case of influenza, vaccination can prevent hospitalization or mortality from the disease. Complications that result from NCDs can also affect patients later in life, triggering disease-related inflammation, risk activities associated with inflammation, and susceptibility to disease later in life, Doherty and colleagues noted.
“From a biological viewpoint, aging can be seen as the sum of all the changes to a person’s underlying biological state over time, rather than being directly linked to the number of years they have attained,” the authors said. “While some of this individual variation can be traced to inherent factors (e.g., genetic polymorphisms) and environmental factors (e.g., pollution), there is no doubt that preventative actions such as improved diet, exercise, smoking avoidance (or cessation), etc. can reduce the risk of developing many chronic diseases and also increase the number of years spent in good health.”
Applying precision medicine to a vaccination schedule in older adults to address vaccine-preventable diseases (VPDs) may seem like something most health systems are already accomplishing, yet there are gaps in patient and provider perceptions on the need for vaccination in healthy adults, Doherty and colleagues said.
“Unfortunately, current adult vaccination programs struggle to deliver the coverage levels that are routinely provided by paediatric vaccination programs, resulting in coverage well below the thresholds needed for effective herd immunity against most VPDs,” they said. “Increased uptake at the individual level means better coverage at the population level, and, potentially, improved outcomes for the whole community.
The process of applying precision medicine to a vaccination schedule will not only identify patients within a certain age range or risk group, but use that person’s complete health history to optimize wellness and stave off disease for as long as possible, the authors argued.
“What P4 medicine adds to this approach is the possibility to make the risks and benefits personal, rather than presenting them as unavoidable consequences of being a certain age and thus as potentially actionable,” Doherty and colleagues concluded.
