Be Healthy

Seniors are at increased risk of infectious diseases due to a decline of their immune function with age (also called immunosenescence). Infectious diseases, especially when chronic diseases are present, can disrupt a fragile equilibrium in seniors and lead to functional decline and loss of autonomy.

Annual influenza epidemics are associated with high morbidity and mortality affecting 5 to 20% of the population each year despite national policies to vaccinate the most vulnerable populations. Nearly 40,000 people in the EU die prematurely each year due to causes associated with influenza. Up to 90% of these deaths occur in individuals older than 65 years, especially among those with chronic health conditions[1].

Influenza increases also the risk of pneumococcal disease incidence especially in the elderly.

Pneumococcal diseases are caused by infections of the bacterium Streptococcus pneumoniae (S. pneumoniae), a leading cause of community acquired pneumonia (CAP: i.e. pneumonia in individuals who have not been recently hospitalised)[2]. S.pneumonia is the most common cause of pneumonia, accounting for 30-50% of hospitalised community-acquired pneumonia in Europe. Pneumococcal disease can occurs at any time during a year, peaking in winter months, and can also be a serious complication of influenza.[3]

Almost 1.5 million elderly (aged 65 and more) develop invasive pneumococcal disease annually in Europe among which 20-40% have fatal outcome despite appropriate medical and therapeutic care7,[4].

Herpes Zoster (HZ) is a common, painful and debilitating condition that results from reactivation of the varicella zoster virus (VZV) which remains latent in the body after primary VZV infection (chickenpox). This means that every adult who had chickenpox is at-risk[5] and VZV virus reactivation is primarily related to the age-related decline of immunity.[6]

More than 1.7 million people suffer from HZ each year in Europe[7], two thirds of these cases occurring in ³ 50 y.o[8],[9]. The severity and burden of HZ significantly rises with age; around 25% of HZ patients aged 50 develop severe and long-lasting complication called post-herpetic neuralgia (PHN), and this increases to 50% in those aged 70 years[10].  This older population still suffers from pain at one year in half of the PHN cases[11]. In 10 to 20% of the cases, HZ involves the ophthalmic division of the trigeminal nerve leading to severe complications (50%) and even blindness[12].

In this context, vaccination is an important preventative measure to be offered to the senior population.   

However, despite national recommendation, the adherence to existing senior vaccination programmes in Europe remains low.

The aim of ALOHA is to address this concerned for an improved adherence to national senior immunisation programmes as part of a healthy ageing strategy in Europe.

[1] European Center for Disease Prevention and Control. Mortality from Influenza. Available at

[2] Lode H, Ludwig E, Kassianos G. Pneumococcal Infection - Low Awareness as a Potential Barrier to Vaccination: Results of a European Survey. Adv Ther 16-4-2013;30:387-405. http://webposter/biblio2006/intrabib52438.pdf

[5] Sengupta N, Booy R, Schmitt HJ, Peltola H, Van-Damme P, Schumacher RF, et al. Varicella vaccination in Europe: are we ready for a universal childhood programme? Eur J Pediatr 2007.

[6] Arvin A. Aging, immunity, and the varicella-zoster virus. N Engl J Med 2005;352:2266-2267

[7] Pinchinat S et al. Similar herpes zoster incidence across Europe: results from a systematic literature review Submitted to BMC Infect Dis. Oct 2012

[8]  Johnson RW et al.  Postherpetic neuralgia: epidemiology, pathophysiology and management. Expert Rev Neurother 2007;7:1581-1595.

[9]   Sentinelles. Annual reports (2007-2011) – available at URL:  (Accessed 01 March 2012)

[10] Lang PJ, Michal JP. Herpes zoster vaccine: What are the potential benefits for the ageing and older adults? European Geriatric Medicine 2011; 2: 134–139.

[11] Kost RG, Straus SE. Postherpetic neuralgia: pathogenesis, treatment and prevention. N Eng J Med 1996; 335(1): 32-42.

[12] Opstelten W, Zaal MJ. Managing ophthalmic herpes zoster in primary care. BMJ 2005;331: 147-151.