Adjuvanted vaccines as tools to enhance immunity and support healthy aging in older adults

Older adults often experience reduced vaccine responsiveness, although varying between vaccines, resulting in persistently high morbidity from infections. This is in part mediated by immunosenescence, a significant decline in immune function associated with aging. Here, we discuss the role of adjuvanted vaccines in enhancing immune responses and supporting healthy aging in older adults. Adjuvanted vaccines offer a targeted strategy to counteract these age‑related immune deficits. Clinical evidence shows that MF59‑adjuvanted influenza vaccines and AS01‑based herpes zoster and RSV vaccines enhance immunogenicity. Mechanistically, adjuvants compensate for impaired innate signaling, improve antigen presentation, strengthen germinal center responses, and promote robust cell‑mediated immunity. Beyond pathogen‑specific protection, emerging data suggest potential broader benefits of adjuvanted vaccines, including effects on frailty progression, cardiovascular events, and possibly dementia, raising the hypothesis that adjuvants may improve overall immune and physiological resilience, through mechanisms not yet understood. Future research integrating mechanistic profiling with aging‑relevant clinical endpoints will be essential to determine whether adjuvanted vaccines can serve as tools for healthy aging.

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