Vaccination: Our Best Hope For Healthy Aging

Healthy Aging is inherently more than simply blowing more candles on a birthday cake. I personally think it's agreeable to most of us that we all hope to age well, in good health and well-being.  Vaxcorp Indonesia is dedicated to helping people live not only longer, but healthier lives.

It has long been known that aging, at both the cellular and organismal levels, contribute to the development and progression of the pathology of many chronic diseases. In simple terms, the older you get the higher you're likely to get ill. However, there is much less people talking about the inverse relationship—the contribution of diseases and their treatments to the progression of aging-related phenotypes. Robust literature are now available, providing light on the fact that telomere shortening precedes the onset of cardiovascular disease and diabetes. Early telomere attrition creates risk for early diseases of aging. However, once one has a chronic disease, many aspects of the disease process can promote accelerated telomere attrition. While there are a myriad of biochemical alterations in each disease, a common triad underlying many diseases of aging is oxidative stress, inflammation, and hyperglycemia/insulin resistance. Treatments for diseases may further affect the rate of telomere attrition, either speeding it up or slowing it down. Few studies have directly examined the effects of medications. For example: Statins and possibly metformin may prevent telomere attrition. In contrast, highly active antiretroviral therapy (ART) in HIV appears to accelerate telomere attrition. Chemotherapy increases telomere damage on both cancerous cells and healthy cells.

Aging has been recognized for years as a major risk factor for most chronic diseases and increased susceptibility for infection that affect the aged population. However, it has traditionally been overlooked as a nonmodifiable risk factor, and thus neglected in most of our approaches to medicine. This concept has recently changed because of the recognition, of the pillars that seem to be the main drivers of the aging process; caloric restriction, cellular senescence, and free radicals.

It has recently been well established by Richard J. Hodes et. al, that acceleration of aging and disease susceptibility are highly variable among individuals within the human population, most likely due to variations in the well-known interactions between genes and environment. With this in mind, a major environmental variable known epidemiologically to affect the “rate of aging” is the exposure to early serious disease. It has been well established, at the epidemiological level, that early exposure to severe diseases and/or their treatments leads to an acceleration of aging, as defined by an increased and premature risk of developing diseases and conditions that are associated with increased age.

The Second Geroscience Summit, held on April 13–14, 2016 in New York, focused on three examples: cancer, HIV/AIDS, and diabetes. This was driven simply by the need to limit the scope of the discussions, but it is expected that the issues raised will apply, with modifications, all or most diseases that, while curable, nevertheless leave sequelae (a condition which is the consequence of a previous disease or injury) that are likely to affect later increased susceptibility to age-related diseases and conditions.

Our team in Vaxcorp Indonesia recognize that an essential part of healthy aging is the implementation and advocation on disease prevention. Vaccines are an easy way to prevent serious infectious diseases that lead to thousands of hospitalizations and deaths each year, and cause millions of people to lose productive time with families, at work, and tending to other important responsibilities.  Vaccines are also proven to have saved millions of lives.

Indonesians, somehow seem to realize the value of community health.  An internal survey conducted on December 2018, involving 282 Indonesian citizens living in Jakarta found that 88% of the respondents think vaccines are very important to the health of our society. However, as it is consistent in a lot of other more developed countries such as the United States of America, this knowledge isn't leading into tangible actions. Despite the effectiveness of vaccines, multiple campaigns launched to encourage vaccination in adulthood, and the potentially devastating effects that vaccine-preventable diseases can have on the elderlies, adult vaccination rates in Indonesia are still dangerously low. To take it further, there are still no known national targets set by the Ministry of Health regarding adulthood vaccinations.

This fact may be in part due to a common misconception among the people that vaccines are mainly for kids. In reality, all adults should be vaccinated to protect not only their own health, but the health of their loved ones. As we have previously discussed in this article, unvaccinated adults increases the risk to spread diseases to children and the elderlies. To take matters worse, in the recent years, misinformation, black campaigns, and circulating housewife rumors regarding the safety, effectiveness, and halal/haram-ness of vaccines has also been increasing. This has created fear and doubt among a large number of Indonesians, that may potentially bear serious consequences. Furthermore, the recent blunder–although later rectified–made by the current Governor regarding the revocation of priorly enforced regulation requiring Child Vaccination Records (Kartu Imunisasi Anak) as a mandatory condition in school registration, has raised inquietude to vaccinate. Even for those eager to get their vaccines, there can be issues with access and payment.

In an effort to debunk myths and educate older adults about vaccines, Vaxcorp Indonesia hope to lead an awareness campaign "#AGEWELL" to encourage adults and older adults to schedule their prevention visits, share the facts about vaccines, and get vaccinated themselves.  We will also plan to provide all of the resources that community health leaders and social media health influencers need to put on educational events for their members and audiences.

In this campaign, we plan to emphasize preventive visits as great opportunities to make sure older adults are up-to-date on important screenings and vaccines, talk with them about their family history, and make a plan for them to stay healthy.  We also know that many older adults remember what times were like before vaccines existed for people with serious infectious diseases such as polio.  We truly hope that this campaign will empower them to play an influential role in their families and social circles by spreading the truth about vaccines.

With Happy and Healthy Aging as our goal, Vaxcorp Indonesia encourages everyone to put vaccination at the very top of their list.

 

dr. A. Nadim, MD
Executive Director,
Vaxcorp Indonesia