With the advancement of age, the immune system decreases its response capacity, making vaccine updates a crucial strategy to prevent serious illnesses, hospitalizations, and deterioration of quality of life. After turning 60, the body undergoes natural changes that compromise the functioning of organic defense, facilitating infections and their consequences.
This phenomenon is called immunosenescence, characterized by the progressive reduction of the organism's defensive capacity. According to Dr. Alfredo Gilio, coordinator of the Immunization Clinic at Einstein Israelite Hospital, just as muscle strength is lost, the immune system ages, increasing susceptibility to infections and decreasing the effectiveness of the body's response to them.
Dr. Isabela Ballalai, director of the Brazilian Society of Immunization (SBIm), emphasizes that vaccines help the body produce antibodies, offering protection upon contact with infectious agents.
In addition to immunosenescence, many elderly people deal with chronic conditions such as hypertension, diabetes, and cardiovascular problems, factors that intensify the danger of complications. Gilio points out that the flu in a young, healthy adult differs significantly from the flu in someone over 60, since the risk of pneumonia, need for hospitalization, and even death is higher.
Among immunizers, the influenza vaccine is the main suggestion for this group, especially during months of higher circulation of respiratory viruses. This annual application is part of the national immunization schedule established by the Ministry of Health. Pneumococcal vaccines aim to prevent pneumonias caused by pneumococcus and are relevant in this age group. However, in the public network, this immunizer is only accessible to bedridden elderly or residents of long-term care institutions.
COVID-19 vaccination remains recommended for those over 60 and is available only through the Unified Health System (SUS). Alfredo Gilio highlights that a large portion of COVID deaths and severe cases concentrates in this population, justifying the importance of boosters every six months.
Within the SUS framework, the National Technical Vaccination Schedule for the Elderly covers immunization against hepatitis B, and, in specific situations, double bacterial vaccines (tetanus and diphtheria), yellow fever, triple viral (measles, mumps, and rubella), and varicella. For those with access to the private sector, vaccination against herpes zoster, a painful disease caused by the reactivation of the chickenpox virus, and respiratory syncytial virus (RSV), responsible for severe respiratory infections in the elderly, is recommended.
Although children present the highest volume of severe acute respiratory syndrome (SARS) cases, individuals over 65 years old register the highest mortality rate, predominantly due to influenza A. Reports from the Infogripe Bulletin, from the Oswaldo Cruz Foundation (Fiocruz), dated July 2, indicate an increase in SARS cases among the elderly in the cities of Belém, Belo Horizonte, Curitiba, Manaus, and Rio de Janeiro.
The outlook is worsened by low vaccination coverage rates: according to the Ministry of Health's Influenza Vaccination Strategy panel, immunization of the elderly over 60 did not reach 50% in the 2026 campaign.
Several factors contribute to this reality. A doctor from Einstein mentions the persistent belief that vaccines are an exclusive topic for children, ignoring that immunization is part of healthcare in adulthood and aging. Ballalai adds that many people over 60 are unaware of the existence of a specific vaccination schedule for this age group, as they grew up without vaccines directed at adults. She stresses that it is vital for health professionals to review the vaccination history in every consultation.
Low risk perception is also an obstacle, as, according to the SBIm director, it is difficult to seek prevention when the disease ceases to be seen by people. However, Alfredo Gilio concludes that it is never too late to update the vaccination record, as preventing diseases through immunization is a way to preserve autonomy, quality of life, and promote healthier aging.
The National Health Surveillance Agency (Anvisa) issued a new regulatory instruction that requires manufacturers to modernize the composition of Covid-19 vaccines used in Brazilian territory. From this moment on, the immunizers must be monoclonal and adjusted to face the most recent variants of the coronavirus circulating.
This determination, formalized in regulatory instruction number 454 and published on page 113 of the Thursday (09) edition of the Official Gazette of the Union, aims to synchronize the population's immune protection with the genetic changes of SARS-CoV-2. The standard specifies that new batches must focus on the LP.8.1 strain or antigens from the JN.1 lineage, including variants such as XFG and NB.1.8.1.
The regulatory document also clarified that older vaccine stocks do not need to be discarded immediately, granting them a maximum usage period of up to nine months after the approval of the update carried out by each manufacturer.
The need for this continuous update mirrors the annual procedure applied to the flu vaccine. Due to the constant mutations of the Covid-19 virus, its structure changes, allowing it to partially evade defenses created by previous infections or outdated immunizers. Although reformulation does not mean that previous doses have lost their effectiveness, it ensures that the new doses provoke a more robust immune response.
To comply with this new directive, pharmaceutical companies responsible for the vaccines must submit a formal request for formula change to Anvisa. This process requires the presentation of detailed information about the production process, quality control of the modified immunizer, results of specific laboratory tests, and, if applicable, new clinical data on safety and efficacy.
The regulatory agency communicated that it will expedite the evaluation of these requests, using international parameters and taking into account the accumulated safety history of each vaccine platform. Since this is an adjustment to an already widely tested and validated technology, the release process for the renewed versions occurs more swiftly, dispensing with the complete repetition of testing stages.
With this decision, Brazil reinforces its model of genomic surveillance and continuous immunization, even after the most critical phase of the Covid pandemic. Instead of developing a completely new product with each outbreak, industry and diagnostic medicine adapt existing tools in real time. The ultimate goal is to ensure that both the Unified Health System (SUS) and the private network provide current and efficient compounds against current threats.
