title: [Adult immunisation: General points, hot topics and perspectives].
abstract: Vaccination in immunocompetent adult mainly concerns booster vaccination against diphtheria, tetanus, polio and pertussis. Some chronic diseases may also require the achievement of pneumococcal and influenza vaccines. In addition, from the age of 65, annual influenza vaccination as well as one dose of a live attenuated shingles vaccine between 64 and 75 years are recommended. Immunocompromised adults, due to the increased risk of serious infections responsible of significant morbidity and mortality, are particularly concerned by vaccination. Main issues in this population are the decreased immunogenicity and efficacy of vaccination and the risk of infection with live attenuated vaccines and. Depending on the type of immunosuppression, the recommended vaccines and vaccination schemes differ. Vaccination of healthy persons caring or residing with immunocompromised patients is an important point in the vaccine strategy. The current perspectives in vaccinology concern the development of vaccines against healthcare associated infections (Clostridium difficile and Staphylococcus aureus in particular), the strategy of vaccination during pregnancy to protect new-borns (respiratory syncytial virus, group B streptococcus) and the development of new adjuvants and new routes of immunization. With the overall decline in immunization coverage and increasing distrust of vaccination, the problem of vaccine hesitancy is also a hot topic. The reasons for doubt in the vaccine usefulness and the solutions to be applied are also crucial issues.
authors.affiliation: IAME, UMR 1137, Inserm, service de maladies infectieuses et tropicales, hôpital Bichat, université Paris Diderot, Sorbonne Paris Cité, AP-HP, 75018 Paris, France. Electronic address: paul.loubet@aphp.fr.
authors.forename: P
authors.initials: P
authors.lastname: Loubet
authors.affiliation: Inserm, CIC 1417, F-CRIN I-REIVAC, fédération d'infectiologie, hôpital Cochin, université Paris Descartes, Sorbonne Paris Cité, AP-HP, 75679 Paris cedex 14, France. Electronic address: odile.launay@aphp.fr.
authors.forename: O
authors.initials: O
authors.lastname: Launay
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007117:Immunization, Secondary / Q000379:methods / Q000592:standards / Q000639:trends; D007252:Influenza Vaccines / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D011247:Pregnancy; D014611:Vaccination / Q000379:methods / Q000592:standards / Q000639:trends
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines
keywords: Adult; Adultes; Immunisation; Immunocompromised; Immunodéprimés; Vaccination