Global, regional, and national burdens of vaccine-preventable infectious diseases with high incidence among middle-aged and older adults aged 55-89 years from 1990 to 2021: Results from the global burden of disease study 2021.

OBJECTIVE

To evaluate the global, regional, and national burden of four vaccine preventable infectious diseases (VPDs) among adults aged 55-89 years from 1990 to 2021, in the context of an aging population.

METHODS

Data from the Global Burden of Disease Study 2021 on acute hepatitis A, B, E, and varicella and herpes zoster were analysed for incidence rates and disability-adjusted life years (DALYs), stratified by sex, age, Social Development Index (SDI), and region. Joinpoint regression analysis was used to assess trends.

RESULTS

In 2021, the global incidence of four VPDs among adults aged 55-89 years was 1698.8 cases per 100,000 population, with a total of 25,243,776 (95 % UI 17301929-34,959,277) new cases and 719,888 (95 % UI 534782-992,800) DALYs. From 1990 to 2021, the incidence rates of acute hepatitis A and acute hepatitis B consistently declined, whereas those of acute hepatitis E, varicella and herpes zoster moderately increased, with EAPCs of 0.13 (95 % UI 0.12-0.15) and 0.14 (95 % UI 0.09-0.19), respectively. In 2021, sub-Saharan Africa had the highest overall burden of the four diseases, whereas high-income Asia Pacific (945.7 per 100,000 population) and Western Europe (840.7 per 100,000 population) had the highest incidence rates of varicella and herpes zoster. Acute hepatitis A and acute hepatitis B were more prevalent in low- and middle-SDI regions, whereas increasing trends for acute hepatitis E and varicella and herpes zoster were observed in higher-SDI regions. The incidence rates of acute hepatitis A and acute hepatitis B were higher in males than in females and decreased with age.

CONCLUSIONS

Despite overall declines in VPDs among older adults, disparities remain. Public health efforts must focus on improving vaccine access and targeting at-risk populations, especially older adults, to address the burden of VPDs.