International Journal of Molecular Medical Science, 2025, Vol.15, No.4, 165-174 http://medscipublisher.com/index.php/ijmms 167 The combined impact of physical weakness and an aging immune system is not only a reduction in antibody production, but also affects the effectiveness of cellular immunity and the body's overall ability to respond effectively to vaccines. This combined effect indicates that we need to design special vaccination programs and new methods for physically weak elderly people to enhance their immune protection capabilities (Oh et al., 2019; Moehling et al., 2020; Pereira et al., 2020; Aiello et al., 2022). 3 Daily Physical Factors that Affect Vaccine Efficacy 3.1 Nutrition and body Metabolism Whether one eats well or not is the key to determining the immunity of the elderly and the effectiveness of vaccines. The elderly need to consume sufficient protein, vitamins (such as A, C, D, and E), and minerals (such as zinc, selenium, and iron) so that the vaccine can function better in their bodies. The elderly often lack these nutrients, which can affect the body's antibody production and reduce T cell function, making the vaccine less effective (Gasmi et al., 2022). For instance, supplementing the elderly with selenium and vitamin E can help them respond better to the flu vaccine and the polio vaccine. Iron deficiency can reduce the efficacy of vaccines (Falahi and Kenarkoohi, 2021; Abavisani et al., 2024). The metabolic condition of the body is also very important. Many elderly people suffer from obesity or metabolic syndrome (such as problems with blood sugar, blood lipid and blood pressure), which can cause long-term mild inflammation in the body and abnormal functioning of the immune system. Fat in the body releases some inflammatory substances and hormones (such as leptin), which can aggravate inflammation and damage the body's first line of defense against vaccines and its specialized defense capabilities (Falahi and Kenarkoohi, 2021; Honce et al., 2024). In animal experiments, if one can lose weight or eat healthier before vaccination, it is possible to help the immune system restore its function and enhance the protective effect of the vaccine (Honce et al., 2024). 3.2 The Impact of long-term illness and taking many medications simultaneously on the immune system The elderly often suffer from long-term diseases such as diabetes, heart disease, kidney disease and lung disease, which can reduce the effectiveness of vaccines. These diseases usually cause systemic inflammation, disrupt the function of immune cells, accelerate the aging of the immune system, and further weaken the protective effect of vaccines. For instance, people with poor kidney function tend to have a weaker response to the COVID-19 vaccine. People with multiple diseases at the same time may also have poor intestinal protective function, leading to aggravated inflammation and poor vaccine efficacy (Falahi and Kenarkoohi, 2021). Taking many kinds of medicine at the same time (multimedication) is also very common among the elderly, which can also affect their immunity. Some drugs, such as hormones (corticosteroids), immunosuppressants, and some hypoglycemic drugs, may weaken the immune response triggered by vaccines or even "fight" with vaccines (Falahi and Kenarkoohi, 2021; Gasmi et al., 2022). The combined effect of long-term illness and taking a lot of medicine indicates that physically weak elderly people need specially designed vaccination plans and careful management of medication. 3.3 Living habits and physical capabilities Daily living habits, such as physical activity, sleep quality and whether there is care and support from others, have a significant impact on the efficacy of vaccines for the elderly. Regular exercise such as walking and swimming usually enables the production of more antibodies after vaccination and enhances the function of immune cells. However, if one is always inactive, the effect will be relatively poor (Gasmi et al., 2022; Hodges and Lamotte, 2022). Exercises like Tai Chi have also been proven to help the elderly develop a better immune response to vaccines (Abavisani et al., 2024). Whether one sleeps well and is in a good mood are also key factors in regulating immunity. Insufficient sleep, long-term high stress, and lack of care (social isolation) can all suppress the immune response, reducing the antibodies produced by vaccines and making people more prone to illness (Gasmi et al., 2022; Hodges and Lamotte, 2022; Abavisani et al., 2024). Conversely, having the care and support of family and friends and finding
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