Zusammenfassung
In der Krankheitsprävention gehören Impfungen zu den effektivsten Maßnahmen. Gerade chronisch Kranke und ältere Patienten sind vermehrt durch Infektionskrankheiten gefährdet. Paradoxerweise wird die Impfprävention bei chronisch Kranken häufig aus einer falsch verstandenen Zurückhaltung gegenüber medizinischen Maßnahmen und deren potentiellen Nebenwirkungen vernachlässigt. Gerade bei diesen Patienten haben zahlreiche Impfungen einen sehr hohen, in Studien gut dokumentierten Stellenwert zur Verringerung des Erkrankungsrisikos und damit Erhöhung der Lebensqualität und -dauer. Dennoch bestehen häufig erhebliche Impflücken: anstehende Auffrischungen und zusätzlich indizierte Impfungen werden nicht durchgeführt. Jeder Arztbesuch sollte stets auch zum Anlass genommen werden, den Impfstatus zu klären. Die Indikation für die Durchführung von Impfungen wird durch zahlreiche Faktoren beeinflusst, die meist sehr stark individuell geprägt sind, daher sollte stets eine umfassende individuelle Beratung erfolgen.
Abstract
Vaccinations are among the most effective preventive health measures for adults. In particular chronically ill and elderly persons are at an increased risk for acquiring infections. Yet, especially chronically ill patients are frequently not fully counselled in regard to the immunisations they should receive. Studies show a clear benefit of a number of vaccinations in terms of reduced illness and ultimately increased quality of life and survival time. Gaps in immunisation schedules are common in adults: boosters and new vaccinations are regularly missed. Every visit to a physician should trigger inquiries about the current immunisation status. The indication for vaccination is influenced by a variety of individual factors; thus comprehensive counselling is essential.
Literatur
Anonymus (2009) Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut. Epidemiol Bull 30
Arnou R, Icardi G, De Decker M et al (2009) Intradermal influenza vaccine for older adults: A randomized controlled multicenter phase III study. Vaccine 27(52):7304–7312
Bennett GJ, Watson CP (2009) Herpes zoster and postherpetic neuralgia: past, present and future. Pain Res Manag 14:275–282
Calcagnile S, Zuccotti GV (2010) The virosomal adjuvanted influenza vaccine. Expert Opin Biol Ther 10:191–200
Castle SC (2000) Impact of age-related immune dysfunction on risk of infections. Z Gerontol Geriatr 33:341–349
Castle SC (2000) Clinical relevance of age-related immune dysfunction. Clin Infect Dis 31:578–585
CRM (2009) Handbuch für Reisemedizin. CRM Centrum für Reisemedizin, Düsseldorf. Thieme, Stuttgart
Donahue JG, Kieke BA, Gargiullo PM et al (2010) Herpes zoster and exposure to the varicella zoster virus in an era of varicella vaccination. Am J Public Health (Epub ahead of print)
Ellebedy AH, Webby RJ (2009) Influenza vaccines. Vaccine 27(Suppl 4):65–68
Engels EA, Falagas ME, Lau J, Bennish ML (1998) Typhoid fever vaccines: a meta-analysis of studies on efficacy and toxicity. Br Med J 316:110–116
Grubeck-Loebenstein B, Della Bella S, Iorio AM et al (2009) Immunosenescence and vaccine failure in the elderly. Aging Clin Exp Res 21:201–209
Iyer A, Fairlie DP, Prins JB et al (2010) Inflammatory lipid mediators in adipocyte function and obesity. Nat Rev Endocrinol 6:71–82
Jelinek T, Kollaritsch H (2008) Vaccination with dukoral against travelers‘ diarrhea (ETEC) and cholera. Expert Rev Vaccines 7:561–567
Jelinek T (2009) Reiseimpfungen. Public Health Forum 17:27–28
Johnson RW, McElhaney J (2009) Postherpetic neuralgia in the elderly. Int J Clin Pract 63:1386–1391
Kang JH, Ho JD, Chen YH, Lin HC (2009) Increased risk of stroke after a herpes zoster attack: a population-based follow-up study. Stroke 40:3443–3448
Keech M, Beardsworth P (2008) The impact of influenza on working days lost: a review of the literature. Pharmacoeconomics 26:911–924
Keitel WA, Atmar RL (2009) Vaccines for pandemic influenza: summary of recent clinical trials. Curr Top Microbiol Immunol 333:431–451
Kieny MP, Costa A, Hombach J et al (2006) A Global pandemic influenza vaccine action plan. Vaccine 24:6367–6370
Leber B, Mayrhauser U, Rybczynski M, Stadlbauer V (2009) Innate immune dysfunction in acute and chronic liver disease. Wien Klin Wochenschr 121:732–744
Monto AS, Ansaldi F, Aspinall R et al (2009) Influenza control in the 21st century: Optimizing protection of older adults. Vaccine 27:5043–5053
Monto AS (2009) The risk of seasonal and pandemic influenza: prospects for control. Clin Infect Dis 48(Suppl 1):20–25
McElhaney JE, Effros RB (2009) Immunosenescence: what does it mean to health outcomes in older adults? Curr Opin Immunol 21:418–424
Nicolas JF, Guy B (2008) Intradermal, epidermal and transcutaneous vaccination: from immunology to clinical practice. Expert Rev Vaccines 7:1201–1214
Oxman MN, Levin MJ, Johnson GR et al (2005) A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med 352:2271–2284
Pichichero ME (2009) Booster vaccinations: can immunologic memory outpace disease pathogenesis? Pediatrics 124:1633–1641
Poland GA, Ovsyannikova IG, Jacobson RM (2008) Immunogenetics of seasonal influenza vaccine response. Vaccine 26(Suppl 4):35–40
Prausnitz MR, Mikszta JA, Cormier M, Andrianov AK (2009) Microneedle-based vaccines. Curr Top Microbiol Immunol 333:369–393
Sangaré L, Manhart L, Zehrung D, Wang CC (2009) Intradermal hepatitis B vaccination: a systematic review and meta-analysis. Vaccine 27:1777–1786
Saville M, Marsh G, Hoffenbach A (2008) Improving seasonal and pandemic influenza vaccines. Influenza Other Respi Viruses 2:229–235
Thomas C, Moridani M (2009) Interindividual variations in the efficacy and toxicity of vaccines. Toxicology (Epub ahead of print) PMID: 19837123
Torrell JM, Aumatell CM, Ramos SM et al (2009) Reduction of travellers‘ diarrhoea by WC/rBS oral cholera vaccine in young, high-risk travellers. Vaccine 27:4074–4077
Interessenkonflikt
Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jelinek, T. Impfprävention bei chronischen Erkrankungen. Praev Gesundheitsf 5 (Suppl 1), 5–9 (2010). https://doi.org/10.1007/s11553-010-0247-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11553-010-0247-0
Schlüsselwörter
- Allgemein empfohlene Impfungen
- Indikationsimpfungen
- Impfungen bei Immundefizienz
- Impfungen bei chronischer Krankheit