Chronic diseases such as cancer, cardiovascular disease, diabetes and mental and neurological conditions are on the rise. New research shows that these non-communicable diseases (NCDs) are responsible for 75 percent of deaths worldwide. Today, one in three people around the world live with a NCD. In addition to the huge impact these diseases have on individuals, they place enormous strain on health systems and reduce economic productivity. So much so, that it is estimated these diseases cost economies globally $2 trillion every year.
The underrecognized link between chronic diseases and vaccine preventable illnesses
It is well understood that prevention is better than the cure, and immunization campaigns are at the heart of robust, preventative healthcare. But it is often thought that vaccines are only relevant in preventing infectious disease, and the role they play in protecting people with chronic diseases as well as preventing those conditions in the first place is less understood.
It’s been encouraging to see that under the Hungarian presidency, the European Council has urged more robust efforts to prevent cardiovascular diseases — explicitly recognizing that vaccines against influenza, pneumococcal infections, SARS-CoV-2 and respiratory syncytial virus (RSV) offer crucial protection for patients living with cardiovascular diseases. The presidency has also called for action to integrate systematic vaccination alongside screening, treatment and rehabilitation into cardiovascular health action framework.
Later this year, the UN will discuss a new political declaration aimed at tackling the rise of NCDs, providing a key opportunity to maximize the benefits from vaccines and ensuring adult immunization is at the core of essential NCD prevention and management. This will not only help reduce the burden of these diseases on individuals and healthcare systems while supporting economic growth, but it will also help build better health for future generations.
Embedding adult immunization into NCD care pathways
Adult immunization offers a cost-effective way to protect people living with NCDs, particularly against common respiratory infections like COVID-19, influenza, pneumococcal disease and RSV. These infections can worsen chronic conditions, trigger complications and lead to preventable hospitalizations and death. For example, people living with diabetes are twice as likely to die from influenza than people with no underlying condition.
Immunizing people living with NCDs against respiratory diseases is a practical, evidence-based way to strengthen prevention, protect the vulnerable, and reduce the strain on health systems both in the short term during seasonal infection peaks and over the longer term as populations age and NCDs rise. Adult immunization programs also support productivity by enabling people to stay in education or employment for much longer.
For people living with cardiovascular disease, the flu vaccine may reduce the risk of death from stroke by 50 percent and from heart attack by 45 percent. For people living with a chronic respiratory disease — such as asthma or chronic obstructive pulmonary disease (COPD) — the COVID-19 vaccine can reduce the risk of hospitalization due to infection by around 80 percent.
Despite this, vaccine policies for adults with chronic illnesses remain limited, and when available they are not equitably implemented. Data shows that 58 percent of the World Health Organization’s member states report vaccination against flu for adults with chronic conditions, and only 23 percent against pneumococcal disease. The findings show persistent gaps in adult vaccination programs, with awareness and uptake remaining low in many parts of the world. This can also be observed in Europe, where meeting the target of 75 percent of people having had a flu vaccine has proven challenging. In 2022 half of people aged 65 years and over in the EU were vaccinated against influenza, with another global report showing that adult influenza vaccination rates ranged from a low of 6 percent to a high of 86 percent, highlighting huge disparities between countries. This is not just about statistics. It is about real people and their families. It is about missed opportunities to protect those most at risk.
Lowering the risks of developing cancer and dementia
Vaccines also play a critical role in lowering the risk of developing cancer. This is because some cancers are caused by viruses. By preventing these viral infections, vaccines can halt the rise in some types of cancer. For instance, the human papillomavirus (HPV) vaccine is highly effective in preventing HPV-related cancers. It has the potential to eliminate cervical cancer in certain countries during our lifetime and radically reduce the burden of other HPV-related cancers. Similarly, improving access to and uptake of highly effective vaccines against Hepatitis B is critical to reducing liver cancer. Together, vaccination against HPV and Hepatitis B could prevent over one million cancer cases worldwide every year.
In addition, emerging research suggests that vaccines, by helping to prevent infections and reducing inflammation, can help protect the brain from long-term damage, potentially lowering the risk of dementia. A recent study performed using the electronic health records of 280,0000 people in Wales demonstrated a 20 percent relative reduction of dementia risk after shingles vaccination. This finding highlights the importance of real-world evidence for understanding the full value of immunization, and how it prevents NCDs and promotes healthy aging.
Opportunity for action
This year, the UN will consider a political declaration aimed at addressing the rising number of people around the world living with NCDs. This presents a real opportunity to place vaccination at the heart of efforts to do so.
Recognizing the role of immunization as a central pillar of NCD prevention and management would be a significant step forward. To deploy lifelong routine immunization programs as fundamental components of NCD management, policy- and decision-makers should look to deliver decisive action across four policy priorities.
Firstly, we must ensure that adult immunization is at the core of essential NCD care in health care systems all over the world. That includes immunization against respiratory infections in national strategies and access through innovative outreach and delivery models.
Secondly, this should include expanded access to vaccines for people living with NCDs. This can help prevent complications, reduce hospitalizations and support system resilience, and enable more efficient use of existing prevention budgets.
Thirdly, we need to build awareness of the importance of immunization among people living with NCDs, by providing clear, trusted information and equipping healthcare professionals with the right knowledge and skills to communicate effectively about vaccines.
And, finally, we must make sure there is a system to capture what is going well and what can be improved, by tracking immunization coverage for people living with NCDs so that there is clear accountability for driving further progress.
Investing in social and economic resilience
Integrating routine adult immunization into NCD prevention and management offers a cost-effective opportunity to bend the curve on NCDs, helping people stay healthier for longer, alleviating pressure on healthcare systems, and delivering substantial economic benefits.
Data shows that adult vaccination programs deliver socio-economic benefits of up to 19 times the initial investment through benefits to individuals, health care systems and wider society. As countries confront rising rates of chronic disease, aging populations, workforce shortages and increasingly constrained budgets, investing in prevention today is not just good health policy — it’s smart economics.
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