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

Abstract

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.

Keywords: acute hepatitis A, acute hepatitis B, acute hepatitis E, varicella and herpes zoster, vaccine-preventable infectious diseases, GBD, older adults.