| Developing a Latin American Delphi consensus on vaccination for respiratory diseases in older adults |
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José F. Parodi1,2, Fernando M. Runzer-Colmenares1,3, Carlos Cano-Gutiérrez1,4,5, José Luis Dinamarca-Montecinos1,6,7, Patricio Buendía-Gomez de La Torre1,8, Paulo Fortes Villas Boas1,9, Javier A. Flores-Cohaila10, Diego Urrunaga-Pastor3, Luis Miguel Gutiérrez-Robledo1,11 |
1Academia Latinoamericana de Medicina del Adulto Mayor – ALMA
2Universidad de San Martín de Porres, Facultad de Medicina, Centro de Investigación del Envejecimiento, Lima, Peru
3CHANGE Research Working Group, Universidad Científica del Sur, Carrera de Medicina Humana, Lima, Peru
4Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
5Hospital Universitario San Ignacio, Bogotá, Colombia
6Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
7Hospital Dr. Gustavo Fricke, Viña del Mar, Chile
8Pontificia Universidad Católica del Ecuador, Quito, Ecuador
9Botucatu Medical School, São Paulo State University, São Paulo, Brazil
10Hospital Nacional Víctor Larco Herrera, Lima, Peru
11Instituto Nacional de Geriatría, Ciudad de México, México |
Correspondence:
Diego Urrunaga-Pastor,
Email: diego.urrunaga.pastor1@gmail.com
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Received: 4 June 2025 • Revised: 2 September 2025 • Accepted: 10 September 2025 |
| Abstract |
Background
Respiratory infections significantly impact older adults in Latin America, highlighting the need for regionally adapted consensus-based vaccination recommendations to guide preventive strategies. This study aimed to develop a consensus among Latin American experts on vaccination against respiratory diseases in older adults in the region, including influenza, Streptococcus pneumoniae pneumonia, COVID-19, respiratory syncytial virus (RSV), and pertussis.
Methods
A two-round Delphi methodology was employed, involving 35 specialists from various medical fields. A rapid evidence review was conducted using scientific databases and clinical practice guideline repositories. Participants evaluated each recommendation on a 1-to-5 scale; recommendations with 80% acceptance (score of 4 or higher) were approved.
Results
The consensus resulted in recommendations for administering Tdap boosters every 10 years for pertussis and annual influenza vaccination in adults aged 65 years or older, using high-dose or adjuvanted formulations. Additionally, primary and annual booster COVID-19 vaccinations were recommended, along with a single dose of RSV vaccine for individuals aged 75 years and older, providing protection for at least two winter seasons. Routine administration of Pneumococcal Conjugate Vaccine (PCV) 15 or PCV20 was also recommended for adults aged 65 years or older who had not previously received a pneumococcal conjugate vaccine.
Conclusions
The consensus provides a vaccination guide tailored to the Latin American context, aiming to bridge gaps in vaccination coverage among older adults in the region. This effort seeks to reduce the burden of respiratory diseases on frail healthcare systems and promote healthy aging in Latin America. |
| Key Words:
Influenza, COVID-19, Respiratory syncytial virus, Pertussis, Delphi consensus, Vaccine |
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