This is a non-promotional article developed in partnership with GSK. The views expressed in this article are those of the author
(Prof. Martin Green).
GSK is a global biopharma company with a purpose to unite science, technology, and talent to get ahead of disease together.
Introduction
Prevention has become familiar language in health and social care. It sits comfortably in policy statements, long‑term plans, and workforce strategies. Vaccination, in particular, is rightly described as one of our most powerful tools, protecting individuals, reducing avoidable illness, and relieving pressure on already stretched services. And yet, when we look carefully at how prevention operates for older adults, a difficult question emerges: are we turning intent into action quickly and fairly enough to match the reality of people’s lives?
When Evidence Outpaces Delivery
A recurring challenge in prevention policy is the gap between expert guidance following vaccine approval and what is delivered on the ground, highlighting the potential for opportunities in the period between approval and administration. Independent clinical advice and expert recommendations continue to evolve, yet eligibility criteria, funding decisions and delivery models often move at a slower pace. For older adults, particularly those living with frailty, multiple long‑term conditions or compromised immunity, these delays are not abstract. Risk shifts in real time, while systems take longer to respond, resulting in avoidable exposure not because prevention tools do not exist, but because implementation has not kept pace with evidence. If prevention is to be meaningful, it must be capable of translating insight into access without unnecessary delay.
Prevention as Long‑Term Investment
Prevention should be understood as a long‑term investment rather than a short‑term cost. There is strong and consistent evidence that adult immunisation delivers sustained value over time, reducing avoidable illness, hospitalisation and pressure across health and care services. When prevention is delayed or fragmented, costs are not avoided; they are simply deferred and often increased. Taking a longer‑term view allows systems to invest earlier, protect capacity and support healthier ageing.
Vaccination Cannot Sit in Isolation
Vaccination is still too often treated as a standalone intervention rather than an integral part of everyday care. Older people do not experience their health through organisational silos, and prevention works best when vaccination is embedded within routine contact, linked to regular reviews, and supported by trusted professionals. This matters because later life is shaped by inequality. Socioeconomic status, ethnicity, and age all influence access, confidence, and support, meaning a universal offer does not always result in a fair outcome.
Social care has a critical role in addressing this. Care workers understand daily routines, communication needs and concerns that may not surface in clinical settings. Many fellow professionals share the belief that having social care involved may allow for more personal care and potentially better chances of success.
From Rhetoric to Responsibility
The health and social care committee are clear about what supports effective prevention: timely access, consistent information, trusted relationships, and systems that do not expect individuals to navigate complexity alone. Listening, however, must go beyond consultation. It requires programme design that reflects lived experience and the willingness to change approach when delivery is not working. When uptake is lower than expected, it should prompt reflection on system design rather than assumptions about reluctance or resistance.
Meaningful prevention requires sustained investment, long‑term planning, and a clearer commitment to reducing inequalities in access. Without this, the ambition of prevention will continue to fall short of the realities faced by older people.
