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Spotlights

Do Vaccines Really Bring All Older Adults Closer?

As populations age, chronic health conditions such as diabetes, lung and heart disease prevail and leave many older adults at risk for serious complications from vaccine preventable diseases such as influenza, pneumococcal pneumonia, pertussis and shingles. Vaccination throughout life signifies a life course approach to not only immunisation but also to healthy ageing. Intergovernmental agendas such as the UN Decade of Healthy Ageing and the WHO Immunization Agenda 2030 call on governments to implement comprehensive public health programs including immunisation to save lives and maintain functional ability. ‘Vaccines bring us closer’ was the 2021 theme for World Immunization Week, highlighting the value of immunizations beyond the COVID-19 agenda. Awareness of the serious consequences of infectious diseases is often a barrier to population coverage. A recent article written by Sofiat Akinola, Chris Hardesty, and Ada Wong shines light on the severely low adult immunization rates across the Asia Pacific as a result of poor awareness compared to the rates in the United States and the United Kingdom. While it is useful to consider rates in other countries, work by the International Federation on Ageing is cautious in benchmarking and comparison because not only are the health systems vastly different, as are cultural influences. Akinola et al stressed the need for clear and transparent communication on the effectiveness and benefits of vaccination to an ageing population, and this was seen to be insufficient and inconsistent. The recent expert discussion conducted by Sanofi and KPMG in the Asia-Pacific region, with the support of World Economic Forum, showed that many older adults faced uncertainties and a lack of knowledge on the efficacy of vaccination as a key component of healthy ageing. Three pillars were identified to drive sustainable action towards equitable life course immunization: 1. Adult immunization being integrated into national immunization strategies and healthy ageing policies, and regularly reviewed through robust data collection efforts. 2. Targeted and consistent communication strategies that reach those who are currently marginalized and often invisible. 3. Ensuring that nations are able to implement novel models of sustainable healthcare funding beyond the reliance of income taxes. In order to ensure vaccines do bring us closer across the globe, collaborative action that recognizes the pressing barriers faced in developing regions is vital to increasing uptake rates. Aligned with the Decade of Healthy Ageing (2020-2030) and the WHO Immunisation Agenda 2030, the IFA’s Vaccines4Life Program envisions a world in which vaccination throughout life is a pillar to healthy ageing, recognized through appropriate governmental investment in prevention and promotion. Follow the #Vaccine4Life platform to learn more about the upcoming project on Ending Immunization Inequity which will provide findings on the significant inequities that contribute to low uptake rates, and sign the pledge to engage in this movement. To connect with an expert on this topic, engage with Dr Tam Yat-Hung, Honorary Clinical Assistant Professor at The University of Hong Kong. His practice is mainly focused on epidemiological investigation of disease outbreak and implementation of control and preventive measures with expertise in public health education.

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Forgetting Adult Immunization During Covid-19

Every day the COVID-19 pandemic continues to bring on new economic, social and health challenges for all members and especially those most at risk to severe consequences including older persons and those with chronic health conditions. Significant impacts have also been experienced in regular routine health care services including increasingly longer wait times, fear of in-person checkups, and a decline in routine immunizations such as influenza, pneumococcal pneumonia, measles, and shingles. The stark decline in routine adult immunizations as a consequence of the COVID-19 pandemic may not only impose serious implications to vulnerable groups at risk to life altering diseases but also to the health and safety of the general population. In a recent article published through the BioPharma- Reporter, Dr. Friedland, vice president, director scientific affairs and public health at GSK stresses attention to the decline in adult immunizations that may exacerbate serious strains on public health through increased exposure to non-COVID infectious diseases. Furthermore, Dr. Friedland points out that although there are a variety of barriers ‘in more normal times’ that can explain low adult vaccination rates including fear of adverse side effects and vaccine hesitancy, the pandemic has disrupted the vaccination pathway for routine vaccines. There is sustained need to increase knowledge and awareness of the safety, effectiveness and value of routine adult immunizations through the involvement of civil society advocates and public health experts. The International Federation on Ageing, through it is Vaccines4Life platform prioritizes bringing awareness on the safety and effectiveness of adult vaccinations to address vaccine hesitancy, build trust and improve equity among the most at risk groups including older adults. To learn more, check out the resources produced through IFA’s ’60 Second Fact Check: Vaccine Safety for Older Adults’ campaign. To engage in this campaign, contact Ms. Petek Yurt (pyurt@ifa.ngo). On 9 November, the IFA 15th Global Conference on Ageing will be hosting the first in person and virtual conference entitled ‘Rights Matter’ which aims to build global collective action to fight for the rights of older adults, under the four pillars aligned with the UN Decade of Ageing and WHO Immunization Agenda 2030: ageism, age-friendly cities and communities, primary health care, and long-term care alongside older people and pandemics. Delegates have the unique opportunity to engage, network, and learn from diverse experts from all around the world. To learn more and connect with an expert on this topic, contact Dr. Palle Valentiner-Branth, the Head of Vaccine-Preventable Disease Group of the Statens Serum Institute. He serves as the National Focal Point for vaccine preventable diseases in the European Center of Disease Prevention and Control (ECDC) and is the author/co-author of more than 70 peer reviewed publications with extensive research experience in vaccinology and infectious disease epidemiology.

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Access to adult vaccination for older people in remote, rural and hard-to-reach communities

The United Nations (UN) has previously stressed the risk of COVID-19 for indigenous communities since they are among the most vulnerable, with higher rates of communicable and non-communicable diseases, poorer sanitation and inadequate access to healthcare. Additionally, indigenous peoples often experience stigma and discrimination in healthcare settings and distrust in government, resulting in difficulty with COVID-19 management and vaccine delivery.According to a recent report by the Thomas Reuters Foundation, Brazilian indigenous communities have been particularly devastated by COVID-19, with nearly a thousand deaths within this population due to the pandemic. Many of those who died were indigenous elders, over the age of 60. Like many indigenous peoples, elders transmit traditional knowledge, practices and languages to future generations. For Brazil’s indigenous communities, the loss of elders represents the death of traditions, culture and knowledge. COVID-19 destroyed a “library” of knowledge and identity held by community elders. As COVID-19 vaccination is well underway in many countries, it is important that the principles of prevention, access and equity are upheld throughout the rollout of vaccination strategies. These principles are detailed in the Immunization Agenda 2030, which outlines a global strategy to ensure equitable and community-centred delivery of immunization services to ensure good health and well-being for everyone. Exercising these principles means ensuring that hard-to-reach and vulnerable communities have access to vaccines and contextually appropriate information on vaccine preventable diseases. COVID-19 vaccination of remote and hard-to-reach populations is an opportunity to bolster adult immunization strategies, expand immunization infrastructure and establish adult vaccination policy for other vaccine preventable diseases, such as influenza, pneumonia and shingles. Implementation of vaccination policy for older people may help preserve the culture and traditions of communities, allowing libraries to remain intact longer.In Brazil, COVID-19 vaccination of indigenous communities is a priority, however some older people in the community oppose the vaccine. Glades Kokama, a leader of the Kokama indigenous community in the Amazon region, says, “Some (elders) believe in the vaccine, but some don’t. We try to explain it to them, but we have to respect our elders.” Combating vaccine hesitancy amongst older people is needed to improve healthy ageing through vaccination. It is important that communication is targeted and specific to the population context and needs. For indigenous and hard-to-reach communities, distribution of information and promotion of vaccination requires partnership with community leaders and culturally appropriate messaging.The International Federation on Ageing (IFA) is committed to addressing barriers to adult vaccination for older people by expanding knowledge and access to vaccination, and improving vaccination messaging. The 15th Global Conference on Ageing entitled “Rights Matter” provides a global platform to inspire, enquire, learn and advocate for immunization policies and practices that create an environment that enables older people to do what they value. Visit the conference website to learn about the pre-conference Vaccines 4 Life Summit “Beyond the Pandemic: Driving Policy to Improve Adult Immunization Rates” and the Presidential Symposium on Adult Vaccination “Together Towards Tomorrow: Post-pandemic Action on Adult Vaccination”. To learn more about adult vaccination for older people and combating vaccine hesitancy, contact these experts. • Lois Privor-Dumm, Director of Adult Vaccines, Senior Advisor, Policy Advocacy and Communications at the International Vaccine Access Center • Dr. José F. Parodi, Professor of Geriatrics and Public Health in the Faculty of Human Medicine at the Universidad de San Martin de Porres of Peru (FMH-USMP) and Director of Center for Ageing Research – CIEN of the FMH-USMP. • Dr. Holly Seale, Associate Professor at the School of Population Health, Faculty of Medicine and Health, University of New South Wales.

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Vaccine Hesitancy as a Consequence of Social Media Misinformation

The rise of mass media and exposure to diverse sources of information can impose both positive and negative implications to influence a view, opinion and attitude towards an issue, especially with regard to vaccines. Messages based upon fear, lack of evidence or even myths may impact the decisions individuals make in being vaccinated against infectious diseases such as influenza, pneumonia as well as COVID-19. A recent article written by Karen Nikos-Rose suggests that credible sources such as Universities and health institutions can generate positive attitudes toward vaccines rather than misinformation, especially with the help of fact check tags or when a post is verified. These simple actions can play a vital role in combating vaccine myths. Contrary to some beliefs it is vital that health experts respond to misinformation immediately. Prof. Jingwen Zhang, lead author from the University of California study states, “The most important thing I learned from this paper is that fact checking is effective…giving people a simple label can change their attitude. Secondly, I am calling for more researchers and scientists to engage in public health and science communications. We need to be more proactive. We are not using our power right now.” Facts about the effectiveness of vaccines in protecting and maintaining the health and well-being of at-risk populations including older persons and those with chronic conditions is available yet the risk of misinformation continues to influence behavior towards vaccines. Combating misinformation on vaccines through social media is a tested action to prevent the growth of vaccine hesitancy and encourage positive messages towards vaccines to reduce the spread of diseases that burden global public health. It is also imperative to understand the perspectives, views and opinions of at-risk populations towards vaccines to better respond to knowledge gaps and ensure messages are not only evidence based but tailored to answer health concerns and needs. As a proud member of the Vaccine Safety Net, the IFA is committed to building awareness, knowledge and improving messaging on vaccine safety through a collaborative effort between physicians, public health professionals, policy makers, and civil society to ensure older persons, including those with complex health needs, are confident to access safe and affordable vaccines to live healthily. To join this global movement of combating vaccine hesitancy and building trust and confidence in vaccines that will enable protection against life altering diseases, connect with experts and learn more in our monthly newsletter. Dr. Gaëtan Gavazzi is a Professor at Grenoble-Alpes University and expert specializing in Geriatrics, Internal Medicine, Vaccines and Healthy Aging. He has published more than 120 peer reviewed papers and participated in nearly 500 events at national and international levels. His research related to this topic includes communicating the benefits of vaccines and analyzing vaccine hesitancy and acceptance. Mr. Gary Finnegan is Editor of Vaccines Today, an online platform that facilitates an informed discussion on vaccinations. The content of Vaccines Today is produced through interviews with experts from academia, patient groups, and industry experts, along with reports based on scientific literature and conferences. Gary is also the author of the Vaccine Misinformation Management Field Guide, which provides strategic guidance and coordinated action to rapidly counter vaccine misinformation. IFA is always looking to expand resources on vaccine safety for older adults and those with chronic conditions and welcomes you to submit it to VacciNet.

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Walking the Talk: Equity in the COVID-19 Vaccine Rollout

As the world enters its second year living with COVID-19, much of the public attention and investment has shifted to large scale vaccination efforts. Scientists around the world have been called upon to dedicate unprecedented time, resources and energy to the development of a COVID-19 vaccine. The urgency is unquestionable, yet in the rush to vaccinate and be vaccinated personal and global ethics are on the line. We must avoid repeating the same mistakes that have been so starkly illuminated across the global response to the pandemic, namely increasing health disparities and health inequities in many marginalized populations. In a recent article published in the Atlantic entitled “The Vaccine Line Is Illogical” author, Epidemiologist and Professor at the Yale School of Public Health, Dr Gregg Gonsalves reflects on his own experience with the COVID-19 vaccine rollout and the implications of exciting strategies for vaccine distribution both nationally (in the United States) and internationally. While equity has been at the forefront of preliminary discussions regarding vaccine distribution, Dr Tedros Adhanom Ghebreyesus, Director General of the WHO has stated that while many countries “speak the language of equitable access, some countries and companies continue to prioritize bilateral deals, going around COVAX, driving up prices and attempting to jump to the front of the queue.” Dr Tedros warns that “the world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries and the world’s poorest people.” Unfortunately, the reality of these disparities are already present. More than 39 million vaccine doses had been distributed across 49 rich countries, while one poorer nation—Guinea—has received just 25 doses. These trends not only exist between high-income and low-income countries, but these disparities are also mirrored within countries. Despite efforts to ensure that those in greatest need of vaccination receive it first, fundamental issues regarding barriers to access have been all but ignored. A recent article entitled “Older adults without family or friends lag in race to get coronavirus vaccines” illustrates that despite the “prioritization” of vaccinating older adults (a population that has been disproportionately affected by COVID-19) many of this population face significant barriers in accessing vaccination gateways and services. Those living alone or with limited mobility may be unable to travel to vaccination sites while others may not have access to the internet, or the digital literacy required to register online for appointments or receive notifications when vaccines become available. Dr. XinQi Dong, Director, Institute for Health, Health Policy and Aging Research at Rutgers University has expressed increasing concern that “barriers to getting vaccines are having unequal impacts on our older population.” Those with limited resources and social supports, the very individuals most in need and at risk of COVID-19, the least likely to receive timely access to vaccination are being left behind. This situation is painfully ironic when leave no one behind (LNOB) is the central, transformative promise of the 2030 Agenda for Sustainable Development and its Sustainable Development Goals. Initial reporting has indicated that Black and Hispanic individuals in the United States are two to three times less likely than Caucasians to have been vaccinated as of now. These trends extend beyond the United States and beyond even discussions specific to a COVID-19 vaccine. While COVID-19 has shone an unflattering light on public health shortcomings in addressing equity it also provides an opportunity to examine these issues more broadly. Issues of accessibility be it transportation, language or even time are all factors that impact access to other lifesaving vaccinations such as influenza, pneumococcal and shingles. It is imperative that global leaders in public health continue to refine strategies for the equitable distribution of a COVID-19 vaccine, and these lessons learned, and policies developed extend beyond this time of crisis and become foundational to future discussions towards ending immunization inequity. To learn more about the COVID-19 vaccine and immunisation amongst at-risk populations, contact Dr Holly Seale, Senior Lecturer at the School of Public Health and Community Medicine (SPHMC), University of New South Wales from the IFA Expert Centre. If you are an individual who works with older adults, IFA wants to hear from you to better understand how equity is conceptualized and operationalized within your organizations and countries of origin. To learn more about how to contribute to this important dialogue connect with Ms Anna Sangster (asangster@ifa.ngo), and sign the IFA pledge to End Immunization Inequity. 

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New research suggests influenza and pneumonia vaccines can reduce the risk of Alzheimer’s disease. Talk to our IFA experts to learn more

By Megan Acton - Program Manager, International Federation on AgeingNew research suggests that the same vaccines that protect older adults against influenza and pneumonia may also reduce the risk of Alzheimer’s disease.Researchers at the University of Texas searched through medical records of around 9,000 people 60 years old and older, and found that those who had at least one flu shot were 17% less likely to have Alzheimer’s disease, and those who had regular influenza vaccination reduced their risk by an additional 13%.Researchers at Duke University and the University of North Carolina also examined medical records of close to 5,000 people aged 65 years and older and found that those who received vaccination against pneumonia before the age of 75 had a 25% less chance of being diagnosed with Alzheimer’s.Experts in the field of cognition found these research findings surprising, with Dr. Paul Schulz, Director of the Neurocognitive Disorders Center at McGovern stating, "To have these guys come out and say, well it looks like getting the vaccine is associated with less [Alzheimer's] was totally the opposite of what any of us thought." Further research has demonstrated that vaccine preventable diseases such as influenza may other have secondary protective effects, especially for adults with chronic disease, that information can be found in the IFA’s report, The Secondary Benefits of Influenza Vaccination. This is a fascinating development and if you are a journalist covering this subject – then let our experts help. • Dr. Mine Durusu-Tanriover is a professor of internal medicine in Hacettepe University School of Medicine (Ankara, Turkey) and the author of more than 40 peer-reviewed articles, with expertise in adult vaccination. • Dr. Samir Sinha is a passionate and respected advocate for the needs of older adults, with expertise in adult vaccination, public policy, quality of care, and frailty. Dr. Sinha's breadth of international training and expertise in health policy and the delivery of services related to the care of the elderly have made him a highly regarded expert in the care of older adults.Dr. Durusu-Tanriover and Dr. Sinha are available to speak with media. Simply click on either expert’s icon to arrange an interview today.

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When COVID-19 meets Flu Season

Coronavirus disproportionally affects vulnerable populations including older people and those with chronic diseases such as diabetes, and heart and lung disease. Every year, these same individuals are most impacted by seasonal influenza, with CDC estimates suggesting that 70-85% of influenza related deaths have occurred among people aged 65 years and older. Where death is not the result, influenza can lead to hospitalizations, long standing diminished function as well as acute or long-term complications. A recent Vaccines Today article written by IFA Expert Mr. Gary Finnegan, Editor of Vaccines Today, explains that although a coronavirus vaccine will not be available for the winter of 2020/2021, vaccines are available that protect against influenza. Mr Finnegan goes on to explain that despite this “every year, huge numbers of people who should be vaccinated are not.” The public often underestimates the impact of influenza on the individual and their family; as well as health and social care systems.Vaccinations against diseases such as influenza have been proven to effectively reduce the risk of adverse consequences for adults with chronic diseases and prevent decline in functional ability of older people. A life course approach to vaccination is therefore critical to healthy ageing. Secretary General of IFA, Dr Jane Barratt adds to this point: “We need to look at flu vaccination rates, but also immunization against pneumococcal disease and shingles. Many of the same people suffering the worst of the COVID-19 outbreak are also those who would benefit from these vaccines.”It is for these reasons that IFA, for over 9 years now, has been advocating for a life course approach to vaccination, with focus on at-risk groups. IFA’s work on vaccination, Vaccines4Life, is set within the context of the WHO Decade of Healthy Ageing, and is aligned with the WHO Immunization Agenda 2030. Under this portfolio of work, IFA envisions a world of healthy older people whose rights to safe and appropriate vaccines are respected through programs that hold high the principles of prevention, access and equity. Removing barriers impeding access to vaccination such as cost and complex vaccination pathways are critical to ensuring people of all ages are protected and no one is left behind. One way influenza vaccination rates could be improved is through pharmacists as a vaccinator gateway. In countries such as Portugal, Switzerland, Norway and the United Kingdom, pharmacists are able to administer vaccinations if they complete the required training. This can allow for greater reach to at-risk groups such as older people who may not typically go out of their way to be vaccinated by their doctor. The pharmacist-vaccinator gateway is important for not only influenza season, but also could be useful when a COVID-19 vaccine is released. Do you have an interesting article, video, webinar or podcast that speaks to improving vaccination rates for at-risk groups? Submit your document to the new IFA VacciNet database to share this important knowledge, and reach out to IFA experts Mr Finnegan and Dr Barratt for further comments on the topic area. To learn more on the interrelationship between COVID-19 and other age-related matters (including grandparenting, technology and ageism) visit IFA’s COVID-19 resource library.

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Enriching Immunization Strategies Post-COVID-19

The recovery of health systems around the world post-pandemic will depend upon a re-evaluation and re-orientation of national health priorities and investment strategies. Faced with the unprecedented impact of the COVID-19 pandemic on the most vulnerable including older people and those of all ages with underlying conditions, a thoughtful evidence-based approach to priority-setting must commence now. A reliable framework to improve the health of older people and reduce the health system burden of many infectious diseases is a strong immunization strategy founded upon a life course approach. The WHO Immunization Agenda 2030 in the context of the Decade of Healthy Ageing provides evidence-based guidance to Member States to pursue the benefits of vaccines through four core principles:1.      Placing people in the centre of strategic priorities 2. Securing national leadership of immunization strategies 3. Establishing broad partnerships for implementation 4. Using data as the driving force of national policies A recent article by Devex describes how adoption  of and adherence to strategic priorities outlined in the WHO Immunization Agenda 2030 can be a game-changer in the field of global health.This is a critical time for concerted focus and solidarity around strengthening immunization policies that leave no one behind. The momentum around vaccine development and promotion in light of COVID-19 can build upon existing immunization policies and focus attention on increasing access to vaccines across all ages and socio-economic backgrounds.The link between uptake of existing vaccines against diseases such as influenza or pneumonia and the health system burden of the COVID-19 pandemic is increasingly evident.  As adult vaccination uptake increases, three benefits emerge: 1. Older adults experience fewer complications and outcomes from influenza and pneumonia such as hospitalizations; 2.  Fewer hospitalizations for vaccine-preventable disease complications means that more health care resources, including health professionals, are available to treat COVID-19 patients; and 3.  A long-term reduction in the burden to health systems can result in greater workforce productivity and economic benefits for communities and countries.World Immunization Week (WIW), taking place 24-30 April 2020, is an opportunity for the global community to reflect upon the social and economic benefits of standing-up for the WHO Immunization Agenda 2030. #VaccinesWork for All, the theme of WIW further emphasizes the need to improve access to vaccines globally in an equitable manner that leaves no one behind. The International Federation on Ageing’s (IFA) World Coalition on Adult Vaccination serves as a platform for connecting thought leaders in the field of life course vaccination. The IFA Expert Centre provides a point of contact to specialists in the fields of epidemiology, vaccination and more. For more information on immunization strategies as they relate to older people, contact Prof. Raina MacIntyre, Head of Public Health and Community Medicine in Sydney, Australia or Dr. Isabella Ballalai, President of the Brazilian Immunization Society in Rio de Janeiro, Brazil.The IFA 15th Global Conference on Ageing “Rights Matter” in Niagara Falls, Canada 3-5 March 2021 is an international forum for knowledge exchange among global thought leaders in the field of vaccination throughout life. The Vaccines4Life Summit and the IFA Presidential Symposium on Vaccination will feature presentations and interactive workshops from leading experts. Registration is open; visit www.ifa2021.ngo.

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Stop the “dreaded duo” of influenza and COVID-19

While many are focusing on the COVID-19 pandemic and its serious global and local impacts, we should not ignore the concurrent threat of seasonal influenza. According to the US CDC (Center for Disease Control and Prevention), there were an estimated 39 million cases of influenza illness; 400,000 hospitalizations and 24,000 deaths have been linked to influenza during the 2019-2020 season. Flu season in the US is still going strong and could actually last through late May.   Australia and other countries of the south are heading for similar trouble as the oncoming flu season could add further strain to an already overwhelmed health system.There are currently no licensed vaccines or therapeutics for COVID-19. In contrast, vaccines are available for influenza and remain the most effective way to protect against the infection and related life-threating complications.  In line with the most recent WHO guidance for immunization activities during the COVID-19 pandemic, influenza and pneumococcal vaccines are advised for people who are at greatest risk of developing respiratory illness, including health workers, older adults, and pregnant women.  Australia is proactive in its action to advance the annual flu vaccination period to April, which usually started from May. Health authorities are urging Australians to have their flu shot as soon as possible amid concerns that influenza and COVID-19 can be a quite deadly combination. "This year, because we have a vulnerable population from COVID-19, it's super important that those people get protected from the normal flu”, says Dr Antonio DiDio, the Australian Medical Association ACT branch president. However, visiting vaccination clinics at a time of pandemic might be problematic for people at risk. Contact IFA expert Prof. Ross Andrews for best practice for immunizations in the context of COVID-19, who used to be the Chair of the Australian Technical Advisory Group on Immunisation (ATAGI), Australia's peak ministerial immunisation advisory committee. Also consider register for IFA “Vaccines4Life Summit” and the IFA Presidential Symposium on Vaccination at www.ifa2021.ngo. You will have opportunity to network with professionals from various fields, understand the burden of vaccine preventable diseases, and share proven best practices and resources to catalyze action. 

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Less Shingles, Less Stroke

Shingles (herpes zoster) is a viral infection that causes a painful rash and blisters, instigated by the same virus that causes chickenpox. Older people are at higher risk of shingles, with one in three adults in the US developing the disease. Fortunately, vaccination can reduce risk of shingles by nearly 50%. A recent WebMD news article highlights the importance of being vaccinated against shingles, and the surprising other benefit vaccination against the disease can bring – reduced risk of stroke. The article explains that the risk of having a stroke was reduced by 20% for people under 80 years old who received the shingles vaccine. Why? Researchers suggest the answer may be related to inflammation. When people develop shingles, there is an increased inflammatory response which can increase risk for heart attack and stroke. Avoiding shingles through vaccination then, can reduce the inflammatory response and therefore reduce risk of stroke. IFA strongly believes vaccination against infectious diseases such as shingles, pneumonia and influenza brings many more benefits than just protecting against the disease for older adults. Vaccination can help to prevent functional decline, hospitalizations and complications resulting from the disease. To learn more about the protective effects of vaccination for other diseases such as influenza, read the IFA Report “The Secondary Benefits of Influenza Vaccination”, and consider contacting IFA Experts Dr Serhat Unal, Chair of Department of Infectious Disease, Hacettepe University (Turkey), and Prof Raina MacIntyre, international expert in infectious diseases and vaccinology among older adults. The IFA will host the 15th Global Conference on Ageing “Rights Matter” in November, where the Presidential Symposium on Vaccination “The Social and Economic Value of Adult Vaccination: Why Prevention is Wealth” will be held. One day prior to the conference (31 October) the IFA will convene the “Vaccines4Life Summit” a full day program that aims to inform the global agenda for a life course approach to vaccination, serving as an opportunity to network with professionals from various fields, understand the burden of vaccine preventable diseases, and share proven best practices and resources to catalyze action.

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Life Course Immunization: More Than Just Flu Season

Immunization is recognized globally as an effective means of preventing and minimizing the impact of infectious diseases such as influenza, pneumonia and shingles. An article in the Press Telegram “Senior Living: Scheduling your immunizations as you age” offers an informed perspective on the importance of vaccination throughout a person’s life course. Dr. David Michalik, a pediatric infectious disease specialist in Long Beach, California said “vaccinations that you received as a child also can wear off over time, requiring revaccination or a booster shot to boost your immune system’s ‘memory.’” In the absence of revaccination or booster shots in later life and as the immune system “memory” declines, older adults are more susceptible to vaccine preventable diseases. This is particularly amplified in the presence of behavioural risk factors like smoking and/or chronic conditions including diabetes, cardiovascular disease, or respiratory ailments.  Although local vaccination schedules vary considerably, Dr. Michalik provided a general statement of recommended vaccinations for adults in the local situe: - 50 years or over: annual influenza vaccination, a Tdap (tetanus, diphtheria and pertussis) booster every 10 years, and two doses of the shingles vaccine; - 60 years or over: pneumonia vaccination; and - 65 years or over: annual high-dose flu vaccine can provide additional protection and is specifically developed for this age group. Global efforts to increase vaccination rates over the past few decades have resulted in a decrease in mortality of communicable diseases from 33% in 1990, to 25% in 2010. While European Union public health policies recommend at least a 75% rate of influenza vaccination among high-risk groups all countries, with the exception of the United Kingdom, are well below the target. In a report from the European Centre for Disease Prevention and Control (ECDC), under 50% of older French adults aged over 65 years reported being vaccinated against influenza in the 2014-15 season. An IFA led multidisciplinary expert meeting “Vaccination in France: Changing the Public Perception” in Lyon in December 2019 aimed to reconcile perspectives from important stakeholder groups in the current vaccination discourse and identify challenges and opportunities for improving participation in vaccination campaigns. Prof. Jean-Pierre Michel of Geneva University’s Medical School reported during the meeting that effective adult vaccination schedules can support maintenance of functional ability and help prevent 2.5 million deaths annually due to communicable diseases. An underestimated benefit of both influenza and pneumonia immunization is the growing evidence of a reduction in cardiovascular complications including stroke and heart failure in adults over 65 years of age.  To learn more about secondary benefits of vaccination and related emerging research areas in cardiovascular and pulmonary diseases, contact IFA Experts Prof. Jean-Pierre Michel, Professor of Geriatric Medicine in Geneva, Switzerland, Prof. Catherine Weil-Olivier, Professor of Pediatrics at Paris Diderot University, or Prof. Antoni Torres, Professor of Medicine and Head of the Respiratory Intensive Care Unit at Barcelona University’s Hospital Clinic. In addition, consider following the @Vaccines4Life Twitter page, and being involved with the World Coalition on Adult Vaccination, where stakeholders collaborate on a common agenda around a life course approach to vaccination, with special attention to later life.

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Bad heart? Don't forget your flu shot.

Amid a turbulent flu season, where discussion seems to have centered around the efficacy of this year’s flu vaccine, heartening news from a study done by Public Health Ontario is showing that the flu vaccine may offer secondary protection against heart attacks.Protection from heart attacks has been shown particularly for groups such as older people, and people with cardiovascular and other chronic conditions, who are at high risk of complications.Not only is the risk of heart attack moderated by the flu vaccine, but the vaccine has been compared to other long-term health measures, for example quitting smoking, in its prevention capacity.This news is especially important considering recent additional research showing that the risk of heart attack increases sixfold in the week following a positive flu diagnosis, particularly among vulnerable groups.While younger, healthier people may not be at as high risk of complications from the flu, they too can transmit the influenza virus to others who may be at greater risk.The International Federation on Ageing (IFA) 14th Global Conference theme Toward Healthy Ageing will feature current research on the connections between influenza, ageing, and chronic conditions.For more information on these connections, contact the following experts from the IFA Expert Centre:Source:

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Vaccines are Our Weapon in the Fight for Quality of Life

Diseases such as influenza, pneumococcal pneumonia and herpes zoster (shingles) are preventable through immunization. Preventing these diseases decreases hospital admissions, preserves functional ability and prevents death.In an interview with the IFA, Expert Dr. Mine Durusu-Tanriover describes vaccines as a weapon for fighting off these potentially debilitating diseases, enabling at-risk groups such as older adults to age in a healthy manner. She also emphasizes the power of vaccines in maintaining functional ability and quality of life among older adults.“No one wants to live a long life bedridden” – Dr. Mine Durusu-Tanriover Unfortunately, vaccination uptake rates among older people are below targets. Dr. Durusu-Tanriover argues doctors should educate patients on how vaccines are a powerful tool in preventing diseases in order to shift the paradigm.As a consultant of acute care in Ankara, Turkey and Professor of Internal Medicine at Hacettepe University with over 40 peer-reviewed articles, Dr. Durusu-Tanriover is an expert in the field of adult vaccination and can be contacted through the IFA Expert Centre.This week during World Immunization Week, the IFA joins national and international partners such as Dr. Durusu-Tanriover in spreading knowledge on the importance of vaccination, providing resources and advocating for the use of vaccines to protect people from all ages against preventable diseases.

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Flu Season Continues to Worsen

If you have been following the news lately, you might have noticed headlines warning that influenza risk is especially high this flu season - having already resulted in a significant number of hospitalizations and deaths. What’s more, experts are saying influenza is likely to result in more hospitalizations and deaths as we have not yet reached “peak season.”According to CBC News, this year’s flu strain, H3N2, tends to cause more severe illness, particularly in children and older people, as well as those with compromised immune systems. CBC reports that in Canada so far in 2017-2018, 68% of hospitalizations from the flu have been in people over the age of 65.For those who are not well-versed in the scientific jargon that can accompany warnings about flu season, it can be difficult to recognize what makes this flu season worse than previous ones. As a result, headlines warning of an impending flu catastrophe can be alarming, leading to concern about what can be done.The good news is, despite which flu strain is most prevalent in any given year, the measures taken to protect against flu remain the same. Taking precautions such as getting the flu vaccine not only protect you, but can also help protect vulnerable people in the community. Other safeguards, such as handwashing and remaining home from work when ill can also be taken.With some months to go until the end of winter, it’s not too late to protect yourself, your family and your community against the flu.Find out more about influenza, its consequences, and the importance of flu vaccination through experts on the International Federation on Ageing's Expert Centre. Just click one of their icons to arrange an interview.Source:

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Influenza vaccination in Europe

The rates of influenza vaccination are low and even decreasing in many European nations, with two million preventable cases of influenza occurring in Europe each year. To reach the target of providing 75% of at-risk people with the influenza vaccine, an additional 60 million people would need to be vaccinated in Europe.The Steering Group on Influenza Vaccination recently outlined key methods to increase influenza vaccination rates in the “EU Manifesto on Influenza Vaccination.” The Steering Group consists of various scientific and medical associations (such as the Pharmaceutical Group of the European Union) and aims to produce effective strategies to reach the target of providing 75% of the population with the influenza vaccine.The EU Manifesto on Influenza Vaccination advises health care providers to promote the influenza vaccine, explains the need to focus on at-risk groups such as older people and emphasizes the need for an improved societal understanding of the value and safety of the vaccine within the EU population. Overall, the Steering Group strives for an improved and collaborative practice between professionals in Europe in order to increase influenza vaccination rates.If you would like to learn more about the importance of vaccines for at-risk groups such as older people, consider attending the IFA 14th Global Conference on Ageing, which includes discussion from experts on a life course approach to vaccination. Visit www.ifa2018.com for details.For more information on vaccinations, connect with one of our IFA experts such as Dr. Mine Durusu Tanriover, who was involved in the Global Influenza Hospital Surveillance Network project.Source:

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Vaccination is Europe's greatest public health asset

Written for Parliament magazine, this article discusses vaccination as a crucial public health prevention strategy and stresses the need to boost vaccination coverage rates across the European Union (EU) to protect individuals and others who are vulnerable such as older people and people with immunocompromising conditions.The International Federation on Ageing (IFA) and the IFA World Coalition on Adult Vaccination work toward increasing vaccination uptake rates on a global scale, particularly among older people and at-risk groups, as well as bringing awareness to the role vaccination plays in healthy ageing and preservation of functional ability.The IFA’s work on adult vaccination has been done jointly with stakeholders in the fields of vaccination, ageing, public health, and non-communicable diseases. Stakeholders include Dr. Mine Durusu Tanriover, an expert in acute diseases and adult vaccination who speaks to the combined effects of chronic diseases and vaccine preventable diseases on long-term health, and Dr. Jean-Pierre Michel, an expert in the biology of aging who can speak to the decline in immune system function associated with age.The IFA has found similar barriers to those noted in the article in conducting national and regional meetings on vaccination as a public health priority. A recent report from the Nordic ‘Adult Vaccination: A Public Health Priority’ meeting identified key vaccination barriers including the need for better vaccine registries and surveillance; the need to prioritize vaccination among healthcare professionals; the need for stronger public health messaging around the benefits of vaccination; the need for more effective vaccines; and the need for more cohesive mechanisms of vaccine delivery. These barriers can be elaborated on by adult vaccination expert Dr. Serhat Unal, an attendee of an early IFA adult vaccination expert meeting in Belgium.The life course approach to vaccination is the focus of the IFA’s World Immunization Week 2018 campaign (24-30 April 2018), and will be showcased at the IFA 14th Global Conference on Ageing, happening 8-10 August 2018 in Toronto, Canada.Source:

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The Need for a Lifelong Vaccination Strategy in An Ageing Population

IFA Expert Dr Mine Durusu-Tanriover is a consultant of acute care in Ankara, Turkey and Professor of Internal Medicine at Hacettepe University. Dr Durusu-Tanriover notes that people with chronic disease are frequently admitted to the hospital due to vaccine preventable diseases such as influenza and pneumonia, despite the availability of vaccines.Last year, none of the EU member states achieved the target of 75% for vaccinating at-risk groups such as older people and those with chronic disease with the influenza vaccine, according to a report released by the European Centre for Disease Prevention and Control (ECDC). Dr Durusu-Tanriover also notes the alarmingly low rates of pneumococcal vaccination uptake amongst at-risk groups, emphasizing the necessity of creating a lifelong vaccination strategy for an ageing population."We have a very big problem in vaccinating patients with chronic diseases. We're not reaching the goals. (…) At a global level, we have to share positive messages [about adult vaccination] (…) But in order to solve the problems, we have to act on the local basis, inside the community." - Dr Durusu-Tanriover As a researcher in adult vaccination for close to ten years with over 40 peer-reviewed articles, the IFA was proud to have Dr Durusu-Tanriover participate in the 14th Global Conference on Ageing, where she presented on a plenary panel, Not Just for Kids: Supporting Healthy Ageing through Vaccination in At-risk Groups, that contextualized the intervention of adult vaccination in healthy ageing. The IFA’s Adult Vaccination Program aims to help build a world where healthy ageing and functional ability of older people are maintained. Intrinsic to this focus is improving the uptake rates of adult vaccination by understanding local barriers and building the capacity of in-country collaborators to influence policy. Contact experts like Dr Durusu-Tanriover to discuss the critical and often neglected topic of adult vaccination.For more information on the importance of vaccination to adults with chronic disease, browse recently released reports from the IFA: Vaccinations and the At-risk Adult Population of Diabetes Vaccinations and the At-risk Population of Adults with Heart and Lung Conditions

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Addressing the public health impact of vaccine hesitancy

In recent news, vaccine-preventable diseases (VPDs), specifically measles, are making a resurgence. According to the World Health Organization (WHO), cases of measles have increased by 30%, and outbreaks of measles in Europe and the United States have prompted expansive dialogue on the threat of reappearing VPDs. There is real danger with outbreaks of VPDs and as such it has prompted the WHO to name vaccine hesitancy as one of the top 10 threats to global health in 2019. Vaccine hesitancy is defined by the World Health Organization (WHO) as a delay in acceptance or refusal of vaccines despite availability of vaccination services.Vaccine hesitancy is complex, and there are many reasons why someone may be resistant to vaccination. According to the WHO:“The reasons why people choose not to vaccinate are complex; a vaccines advisory group to WHO identified complacency, inconvenience in accessing vaccines, and lack of confidence are key reasons underlying hesitancy.” The prevention of VPDs can require coverage rates as high as 90-95% to achieve herd immunity; at this rate, communities are protected from VPDs by the high number of vaccinated individuals. Sources such as UNICEF USA warn that without a concerted effort to combat vaccine hesitancy and improve vaccination rates universally, preventable diseases such as pertussis, diptheria and mumps may dip below rates required for herd immunity, increasing incidence of these, and other, diseases and threatening health at all ages. Contact Prof. Ross Andrews for information on the effect of VPDs in diverse populations. Connected to vaccine hesitancy is the threat of a global influenza pandemic, also identified by the WHO as a forthcoming concern. While many dismiss the serious and pervasive nature of influenza, the CDC asserts that as many as 646,000 people may die from influenza each year, with vaccine hesitancy and other barriers to information and access affecting uptake of influenza vaccination globally. What remains clear is that without major changes to vaccination attitudes and uptake rates, new and emerging VPDs will put the health of global populations in jeopardy. Left as it is now, populations will continue to become reacquainted with diseases that were thought to have been eradicated, calling into question why vaccination, one of the most effective public health tools, is not being utilized effectively to preserve health and well-being. The International Federation on Ageing focuses on vaccination within the context of healthy ageing, including addressing barriers like vaccine hesitancy and working to increase access to vaccination information and services as a necessary tool for maintaining functional ability at all ages. For more information on vaccination and ageing, contact Dr Stefania Maggi, an expert in the impact of lifelong health promotion and disease prevention programs on healthy ageing. 

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The Outbreak of Vaccine Hesitancy

According to the World Health Organization (WHO), measles cases have skyrocketed with a 300 % increase worldwide in the first three months of 2019 alone, when compared to last year. Public health officials are concerned over the impact of growing anti-vaccination campaigns.Vaccine hesitancy, which is defined by the WHO as a “delay in acceptance or refusal of vaccines despite availability of vaccination services”, has been reported in more than 90% of countries in the world. Mr Gary Finnegan, Editor of Vaccines Today and IFA Expert, notes in an article from The Independent that although nothing is 100% safe, vaccines have fewer side effects than most medical interventions.With a degree in physiology, an MSc in science communication and a special interest in vaccination, Mr Finnegan has a unique combination of knowledge and experience in the field of health communications.  He can be contacted to learn about the importance of immunization across the life course and how public health officials, health care workers and governments can tackle the increasing uneasiness over vaccines through various platforms, such as social media.While he doesn’t agree with the concept behind anti-vaccination, Mr Finnegan can empathize with some of the concerns:“I took my own kids to have a meningitis vaccine recently and one of them had a temperature afterwards. This usually doesn't happen but I can see that when it does it's unpleasant. However, now he's very unlikely to get this very serious disease and I take a lot of comfort from that.” – Gary Finnegan The public health and science communities are called to improve accessibility, communication and listening. A Lancet article notes that physicians’ advice has been shown to be the most influential factor in the decision to vaccinate. For Mr Finnegan, communication should be a combination of storytelling and science.“…it is essential that when people go online for information they are left with the clear impression that vaccines are safe and effective." – Gary Finnegan, WIRED Vaccination is a critical disease prevention tool and is needed throughout the life course. Physicians are also raising awareness about under vaccination among adults, a recent CBC article notes.  Immunity can wear off over time for some vaccines taken in childhood, and the need for booster shots is highlighted. Older adults in particular are vulnerable to the effects of infectious diseases and should be educated on the importance of immunization to foster healthy ageing. In addition to addressing vaccine hesitancy, this is one of the many conversations the IFA’s World Coalition on Adult Vaccination has taken the lead on to improve vaccination uptake rates globally.

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Putting Your Vision First on #WorldSightDay

World Sight Day on the 10th October is a time to encourage friends, family and colleagues to have an eye exam. It is also a time draw attention to conditions that can lead to blindness and visual impairment. As people get older, many will develop aged-related eye diseases such as cataract, glaucoma and age-related macular degeneration (AMD). Much less known is that older people are at greater risk of complications of shingles, which can develop in the eyes and cause vision loss. A recent study from the Kellogg Eye Center at the University of Michigan revealed that women and adults over age 75 years are most vulnerable to shingles in the eye, which will trigger corneal complications and result in permanent visual impairment, and, in rare cases, blindness. The diagnosis and treatment of shingles in the eye is often delayed, increasing the risk of sight-threating complications.  "Sometimes people complain of a headache, or think it's a skin infection, or allergy.  It's only when the characteristic rash comes out that patients are more definitively diagnosed, and that can lag.” says the lead James Chodosh, an ophthalmologist with expertise in viruses at Massachusetts Eye and Ear in Boston. The good news is that there are effective vaccines for shingles, some being more than 90% effective in preventing the infection and recommended for people aged 50 years or over. “Older patients were at far greater risk for shingles in the eye highlighting just how important it is for older adults to get the shingles vaccination,” says Nakul Shekhawat from the Kellogg Eye Center study. As an important element of public health agendas older people must have the right to access eye exams and safe and effective vaccines so that they can contribute to their family and society.  Over 3 out of 4 of the world’s vision impaired are avoidably so.  Join the IFA and the International Agency for the prevention of Blindness (IAPB) and millions of people around the world by giving your voice to #WorldSightDay. To learn more about vision health and the importance of regular eye exams, please contact IFA expert Dr. Juan Carlos Silva, Regional Adviser on eye care for Latin America and the Caribbean at the Pan American Health Organization. 

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Age and Estrogen: Immunosenescence in Older Women

While the natural phenomenon of declining immunological function with age (aka immunosenescence) has been well documented, researchers have discovered that older women experience this more so than men. A recent study led by Dr Sabra Klein from Johns Hopkins Bloomberg School of Public Health suggests that age in addition to declining estrogen levels in menopausal women can decrease immunological response to the influenza vaccination.  This poses a challenge in the development of critical antibodies needed to protect against the virus. “What we show here is that the decline in estrogen that occurs with menopause impacts women’s immunity… these findings suggest that for vaccines, one size doesn’t fit all,” said Klein. This research highlights the need for efforts that explore the ways in which human biological differences impact vaccine effectiveness.  Older adults deserve the right to vaccines that will promote health, longevity, and the maintenance of functional ability.  As menopause is a natural part of female ageing, understanding the hormonal and cellular changes within the body can lead to the development of more effective vaccines for this demographic, thus promoting health for all. If interested in learning more about the impact of menopause on immunological function, contact IFA expert Dr Marla Shapiro, menopause specialist.  Dr Shapiro is the President Elect of the North American Menopause Society, and a Member of the Order of Canada for her commitment to producing high-quality health information.  She is a highly respected health and medical expert in popular media, being featured on such programs as CANADA AM and CTV News Channel.Additionally, consider attending the IFA’s 15thGlobal Conference on Ageing “Rights Matter”in 2020 which will feature “Addressing Inequalities” as a key theme, where topics pertinent to older women’s health will be explored.   

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Prevention Before Antibiotics

“There is not enough awareness about the risk associated with infections and about the importance of preventing them with the vaccines we have now (...)” says Dr Eva Polverino, IFA Expert and pulmonology expert in respiratory infections affiliated with the European Respiratory Society.During an interview at the IFA 14th Global Conference on Ageing, Dr Polverino highlights the importance of vaccines not just in preventing the diseases, but also reducing the use of antibiotics.“The only way to reduce the risk of antimicrobial resistance is to reduce the inappropriate use of antibiotics.” - Dr Eva Polverino Vaccines can help reduce the spread of antibiotic resistance by “reducing the use of antibiotics and the development of resistance” (WHO, 2016). For example, people often take antibiotics unnecessarily when they have flu-like symptoms, which could have been prevented through the influenza vaccine. For these reasons, experts such as Dr Polverino argues prevention should be the goal before prescribing antibiotics. In honour of World Immunization Week (24-30 April), the IFA will be releasing joint statements, social media, blogs and articles to raise awareness on the importance of vaccination. Check out @Vaccines4Life to help spread the important message. 

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The Impact of Ageism on the Health of Older People – World Health Day 2019

7 April marks World Health Day, and this year, the International Federation on Ageing wants to highlight the importance of addressing ageism to ensure the health of older people is taken into consideration across the globe.Older people are often neglected in the planning of public health strategies due to ageist and false beliefs from government and policymakers that older people only contribute in small ways to the economy. A recent Guardian article explains that ageism may increase ill-health in older age. "Jackson and colleagues suggest that among the possible ways ageism could take a toll are difficulties in adopting a healthy lifestyle – such as gym-going – for fear of discrimination, worse care and less timely diagnoses by health professionals, and even stress – which might affect the body through inflammatory mechanisms, triggering unhealthy behaviours or psychological distress." - Nicola Davis, The Guardian There are countless ways health can be preserved in later life, from regular vision check-ups, to keeping up to date on adult vaccinations such as influenza, pneumonia and shingles. Vaccination is often considered “just for kids”, however it is pertinent in preserving health and functional ability in older age. Contact IFA expert Gary Finnegan, Editor of Vaccines Today to learn more about the importance of vaccination to healthy ageing, and IFA expert Dr. Michele Corcio, Vice President of the International Agency for the Prevention of Blindness on the important role vision plays in healthy ageing. This year’s World Health Day theme is “Universal Health Coverage.” Read the following expert spotlight which discusses the importance of universal health care to older people, and consider registering for the IFA 15th Global Conference on Ageing which will feature experts from around the world discussing the importance of healthy ageing.

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