How Can We Integrate Life Course Vaccination into the New WHO Definition of “Healthy Ageing”?

Abstract

The first global report on health and ageing published by the World Health Organization (WHO) in 2015 introduced a new and innovative concept, namely, the idea that healthy ageing encompasses more than just the absence of disease. The report considered healthy ageing to be a more holistic process of developing and maintaining the functional ability that enables well-being in older age. There are two major components to this concept, namely, personal and environmental determinants of ageing. Personal determinants of ageing correspond to our intrinsic capacity, including our genetic inheritance, personal characteristics, health-related behaviours, and risk factors. Living our daily lives in given surroundings creates opportunity for the environmental determinants of ageing, and the interplay between intrinsic capacities and surroundings yields our functional capacity. As age advances, there is a decline in both intrinsic capacity and functional ability, often leading to a significant loss of capacity towards the end of life. An increasing body of evidence shows that it is possible to prevent or delay the onset of chronic diseases and temper the negative impact of disease on daily functioning. However, despite all the potential areas suitable for intervention over the life course, there remain major gaps along this pathway, particularly vaccination, which has a major role to play in promoting healthy ageing.