International Journal of Molecular Medical Science, 2025, Vol.15, No.4, 165-174 http://medscipublisher.com/index.php/ijmms 170 Figure 2 Vaccine design strategies for elderly individuals include increasing the dose of antigen, preparing multivalent antigen vaccines, adding appropriate adjuvants, inhibiting chronic inflammation, and inhibiting immunosenescence (Adopted from Hou et al., 2024) Image caption: AS adjuvant system, MPL monophosphoryl lipid, TLR toll-like receptor, MAPK mitogen-activated protein kinase, NF-κB nuclear factor kappa-light-chain-enhancer of activated B cells; COX cyclooxygenase; mTOR mammalian target of rapamycin; APC antigen-presenting cell; MHC major histocompatibility complex; TCR T cell receptor; PD-1 programmed death receptor-1 (Adopted from Hou et al., 2024) 5.3 Adjust the vaccination plan Changing the schedule of vaccination is a feasible way to improve the efficacy of vaccines for the elderly. If vaccination is chosen when the physical condition is good and the inflammation is mild (considering the best reaction at this time), the effect may be better, especially for those whose physical condition is deteriorating (Kim et al., 2021; Hou et al., 2024). It has been confirmed that booster shots (an additional dose or a regular dose) can increase protective antibodies and provide longer protection, especially for those with weakened immunity or poor response to the first shot (Caldera et al., 2020; Qiu et al., 2023). Arranging injections based on blood test results and an individual's risk situation (depending on the individual's circumstances) can help elderly people with weak constitutions receive sufficient protection in the long term. These methods, combined with the improvement of the vaccine itself and immune regulation, form a comprehensive approach to address the problem of poor vaccine efficacy caused by aging of the immune system and physical weakness (Kim et al., 2021; Qiu et al., 2023; Hou et al., 2024). 6 What Will be Studied in the Future 6.1 More accurate immune assessment and risk grouping To ensure better vaccination outcomes for elderly people with weak constitutions, more accurate assessment methods are needed. These methods should not only be based on actual age, but also take into account a person's "biological age", "immune age", genetic background and immune status before vaccination. Recent studies have found that examining multiple aspects of the immune system before vaccination (using new technologies and computer models) can predict vaccine responses in different individuals, thus guiding the formulation of individualized vaccination plans. These models can identify who may have a poor response and provide specialized information to assist them, potentially transforming vaccination from a "uniform approach" to a "customized approach based on demand" (Tsang et al., 2020; Goudsmit et al., 2021). Scientists are developing tools that combine physical conditions, blood indicators and immune markers to better predict the response of the elderly to vaccines. Artificial intelligence and machine learning methods (such as elastic net regression and random forest models) are increasingly being used to analyze complex immune data and establish reliable predictive tools. These methods can identify which physical changes related to aging and which immune indicators most affect the efficacy of vaccines, helping to more effectively divide people into different risk groups and plan how to intervene (Goudsmit et al., 2021).
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