隨著全球高齡化的快速發展，台灣亦不例外。老年人口的增加伴隨著感染性疾病造成的共病症與死亡率上升，成為重要的公共衛生挑戰。本篇文章聚焦於帶狀疱疹疫苗、呼吸道融合病毒疫苗、肺炎鏈球菌疫苗、新冠疫苗及流感疫苗的最新研究進展與各國相關指引，旨在為台灣高齡族群尋找最適合的疫苗接種策略。隨著年齡的增長，老年人逐漸面臨免疫系統功能下降的問題，這種現象稱為免疫老化(immunosenescence)。其特點包括細胞免疫功能減弱、抗體生成能力降低，以及疫苗效果減退。免疫老化顯著提高了老年人對感染性疾病（如流感、帶狀疱疹、肺炎鏈球菌感染）的易感性，同時也增加了感染後併發症及死亡的風險。疫苗接種是預防感染性疾病的有效手段，透過激發免疫系統產生特異性抗體，不僅能降低感染風險，亦可減輕疾病的嚴重程度。針對老年人群的疫苗通常經過劑量調整或加入佐劑（如高劑量流感疫苗或非活性帶狀疱疹疫苗），以增強免疫反應。大量研究顯示，疫苗接種不僅能有效減少感染性疾病的發生，還能顯著降低老年人的住院率及死亡率，是延緩健康衰退的關鍵策略。
(台灣家醫誌2025; 35: 76-86) DOI: 10.53106/168232812025063502002
 
關鍵詞： 帶狀疱疹疫苗、呼吸道融合病毒疫苗、肺炎鏈球菌疫苗、新冠肺炎疫苗、流感疫苗

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¹臺北醫學大學附設醫院家庭醫學科
²臺北醫學大學醫學系
受理日期：114年2月5日 修改日期：114年3月11日 同意刊登：114年3月23日
^*通訊作者：廖乙學、陳宥達 通訊地址：台北市信義區吳興街252號
E-mail：231012@h.tmu.edu.tw; 153072@h.tmu.edu.tw
 

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Vaccination Strategies in a Super-Aged Society by 2025:Challenges and Recommendations for AddressingInfectious Disease Risks
 
Yu-En Hsu¹, Yi-Hsueh Liao^1,2* and Yu-Da Chen^1,2*
 

As Taiwan has become super-aged since 2025, the increasing elderly population is expectedto drive a surge in comorbidities and mortality linked to infectious diseases, presenting significantpublic health challenges. This article examines the latest advancements in research and internationalguidelines concerning vaccines for herpes zoster, respiratory syncytial virus (RSV), pneumococcaldisease, COVID-19, and influenza, aiming to propose optimal vaccination strategies tailored toTaiwan’s aging demographic. Older adults experience a gradual decline in immune systemfunctionality, a process known as immunosenescence and characterized by weakened cellularimmunity, diminished antibody production, and reduced vaccine efficacy. Immunosenescencesubstantially increases their susceptibility to infectious diseases such as influenza, herpes zoster, andpneumococcal infections, while simultaneously elevating the risk of complications and mortality.Vaccination remains a pivotal preventive measure, stimulating the immune system to producespecific antibodies, thereby mitigating infection risk and disease severity. Vaccines developedspecifically for the elderly often involve modifying or adding adjuvants (e.g., high-dose influenzavaccines or recombinant herpes zoster vaccines) to enhance immune responses. Extensive studiesdemonstrate that vaccination not only effectively reduces the incidence of infectious diseases butalso significantly lowers hospitalization and mortality rates among older adults, making it essentialfor mitigating health decline and promoting healthy aging.
(Taiwan J Fam Med 2025; 35: 76-86) DOI: 10.53106/168232812025063502002
 
Key words: COVID-19, herpes zoster, influenza, pneumococcal vaccine,respiratory syncytial virus (RSV)

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¹Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan (R.O.C.)
²School of Medicine, Taipei Medical University, Taipei City, Taiwan (R.O.C.)
Received: February 5, 2025; Revised: March 11, 2025; Accepted: March 23, 2025.
^*Corresponding author