The challenges of vaccination in older people

The challenges of vaccination in older people

We hear a great deal about the UK’s ageing population and the increasing demand this is generating for health and social care services.

There are many specific health problems that come with older age and one of these is a poor response to vaccination – not a small issue, when you remember that the national flu vaccination programme targets older people because 95% of deaths from infectious respiratory disease each year in the UK are of older patients. Where older people are admitted to hospital for a serious infection, but ultimately recover, there is also evidence that a significant number will die within one year, so the impact on individuals, families and health services is greater than the headline statistics reveal.

Researcher Dr Michelle Linterman, working at the Babraham Institute, has received funding from the Evelyn Trust to research the causes of this problem. This will help us to understand whether older people need different vaccines, or therapeutic interventions to improve the performance of the vaccinations given.

“Vaccination relies on the body to generate antibodies specific to a particular virus or bacterium. These are produced in the ‘germinal centre’ of the lymph nodes and are co-ordinated by follicular helper T cells, called Tfh for short, that interact with B cells to produce antibodies. These Tfh cells are key white blood cells in antibody production. In older age, the white blood cells don’t work so well - the response of the germinal centre declines due to defects in these Tfh cells. Before my team began this research, there was no understanding of how these defects in the Tfh cells relate to ageing,” explains Michelle.

Michelle’s research has focussed on the genetic differences in these cells in older and younger people.

“We have studied gene expression – the process by which information from a gene is used to produce a product, such as a protein - and we’ve identified 46 genes whose expression is more than double in younger people, compared to people over the age of 60. There are also seven genes that show four times the expression in older donors than in younger individuals.”

Now this initial research project is complete, but the next step is to find out how these changes in gene expression relate to the function of Tfh cells. Michelle’s ultimate aim is to discover new targets for treatment that will help vaccinations do their job of restricting the spread of infectious disease and so reduce suffering and save lives.

To find out more about Michelle Linterman’s work visit her page on the Babraham Institute website.

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