Vaccination against COVID-19 or pneumococcal and influenza can avoid a number of complications and reduce the risk of death from cardiovascular causes. In the case of COVID-19, especially in the senior group, access to antiviral treatment is as important as vaccination.

As Prof. Joanna Zajkowska says, the COVID-19 pandemic is not over yet. Only the global threat has ended. The virus is still present and transmitting, and can also evolve. It is particularly dangerous for immunocompetent people. Vaccines are constantly being improved, and one is being prepared that will protect against the entire omicron mutation family. The vaccine, while significantly reducing the risk of infection, does not protect against it completely. Therefore, it is also very important to use therapy to fight the virus after infection.

- By reducing its amount, our immune system can better cope with the disease. The less virus, the less malignant the symptoms and the lower the risk of complications. So both are extremely important, especially when it comes to risk groups that for some reason will not respond to vaccination. These are oncology patients, those on biologic or immunosuppressive treatment. The sequelae of COVID-19 disease can be immunological, cardiovascular, but also related to diabetes, parkinsonism," points out Prof. Zajkowska.

The oral anti-COVID-19 drug consists of two active substances. When used together, they very effectively block the viral protease enzyme that coronavirus uses for its replication. It is due to this that it loses its ability to multiply. As a result, the drug can also be effective against other coronavirus variants, as well as against other human coronaviruses. The drug's efficacy is 89 percent, which means it protects against severe illness, complications, hospitalization and long-term effects (known as long COVID). The drug can be used at home in the form of oral tablets, making it convenient and easy to use. Meanwhile, this therapy is still inaccessible to Polish seniors and chronically ill patients, despite the fact that, according to the World Health Organization, it should be given to patients with mild to moderate COVID-19, while carrying the highest risk of hospital admission - so mainly the elderly and those with chronic diseases. According to the data, doutne treatment reduces the risk of hospitalization by as much as nearly 90 percent, provided that the drug is administered within five days of the first symptoms.

Although there has been a lot of talk about COVID-19 in recent years, prevention of other infectious respiratory diseases is not worth forgetting either. After all, we are not able to avoid contact with the pathogens that cause them.

- Pneumococcus is such an example. It is said to be a disease of grandparents and grandchildren, because the microbiomes of children and the elderly collide. Children have very extensive contacts, so the exchange of pathogens is very intense in them. For children, the basic protection is provided by the vaccination calendar. However, this does not protect against transmission to particularly vulnerable people, such as the elderly or those with multimorbidity," points out Prof. Zajkowska.

Pneumococci colonize the mucosa and can cause ear infections or sinusitis, among other things, but they can also cross the mucosal barrier, enter the blood and cause meningitis or even sepsis. What's more, the pneumonia they cause, meanwhile, is among the leading causes of death in people over 65. A 20-valent pneumococcal vaccine is currently dedicated to the elderly.

Importantly, it turns out that immunizations, in addition to arming us against a specific pathogen, also mobilize various other memory cells.

- However, after the age of 65, the thymus gland involutes, which means that the part of the immune system that is responsible for fighting viruses is aging. Vaccination makes it possible to mobilize immunity non-specifically and have an effect for specific diseases in which inflammation is a component of pathogenesis, notes Prof. Zajkowska.

Much of the research confirming the relationship between immunization and other diseases has focused on the influenza vaccine and its importance in reducing the risk of death from cardiovascular causes.

According to the results of the 2021 IAMI study, administration of the influenza vaccine reduces the risk of myocardial infarction, stent thrombosis and death from any cause by 28 percent and death from cardiovascular causes by 41 percent within 12 months. The study involved more than 2,500 patients aged 75 and older with an increased risk of cardiovascular disease who underwent coronary angioplasty. Three days after the procedure, half of the group received a high dose of flu vaccine, while the other half received a placebo.

- The effect of reducing cardiovascular deaths begins as early as two weeks after vaccination, regardless of when the vaccine was administered. This may be influenced by the mechanism of atherosclerotic plaque stabilization. This is extinguishing the inflammatory process. The pathomechanism is probably that the flu itself already gives an increased stimulation of the inflammatory reaction. The vaccine, by eliminating the inflammatory reaction, stabilizes the atherosclerotic plaque," points out Prof. Krzysztof Filipiak.

On the other hand, the results of the DANFLU-1 study, which involved 12,500 Danish residents over the age of 65, were published in 2022. One group of subjects received a normal flu vaccination, while the other received a double dose. Patients in the second group had a 36 percent reduced risk of hospitalization and a 50 percent reduction in mortality from any cause.

- In Denmark, there is an ongoing discussion about whether to double the dose of vaccine given to patients or to increase the frequency of vaccination to twice a year: during the spring flu season and for the fall season, the professor points out.

Further evidence of the relationship between vaccination and a reduced risk of cardiovascular disease and death from it comes from a British study of 200,000 people between the ages of 40 and 84 who were vaccinated against influenza. Risk reduction was observed in them within four months after vaccination. It turns out, however, that the risk of stroke, among other things, also fell after administration.

According to Dr. Jakub Gierczynski, an expert on the health care system, however, an area that needs improvement is the availability of vaccinations and funding for all at-risk groups. Today, free flu vaccinations are available to people over 75 and pregnant women.