Istat: by 2050, over 65s will constitute 34% of the population

Rome. Italy is among the longest-lived countries in the world. This was reported by Istat, according to which by 2050, those over 65 will constitute 34% of the population, with significant growth also among those over eighty-five. However, this demographic transition poses significant challenges in the health, social and economic fields, linked to the increase in frailty, chronicity and demand for assistance.

A profound rethinking of welfare models is therefore necessary, in order to guarantee a healthy and active aging of the population. The increase in longevity is, in fact, an achievement of our society, a sign of progress in medicine, nutrition and quality of life.

This and more were discussed today in Rome during the first meeting of the series "Apco Health Talks: Exploring the Health System ," dedicated to the role of prevention in protecting the elderly. Hosted in the Sala Perin del Vaga of the Luigi Sturzo Institute, the event offered an opportunity to take stock of one of the most complex and strategic challenges facing our country, focusing on the socioeconomic value of vaccination among the elderly population, current health policies in this area, and the importance of timely access to prevention.

In this context, health prevention plays a crucial role. In particular, vaccination of the elderly is a strategic lever to reduce the incidence of serious infectious diseases such as pneumococcus, herpes zoster, RSV, as well as influenza and Covid-19 and to contain the costs of the health system. But not only that: strengthening vaccination adherence in the over 65s also means contributing to the reduction of the inappropriate use of antibiotics and countering the growing threat of antimicrobial resistance, as recognized internationally.

It is therefore essential to reorient healthcare spending towards a proactive approach, which places prevention at the centre and guarantees the sustainability of the system and quality of life in all its phases.

However, in Italy there is a significant drop in spending on prevention (-18,6% between 2024 and 2023, according to the Gimbe Foundation) and an alarming trend in vaccination coverage among over 65s, far from the recommended objectives. According to data from the Ministry of Health, flu coverage, for example, in the 2023-24 flu season recorded a drop of 3,4 percentage points compared to the previous season (reaching only 53,3%, compared to a minimum target of 85%).

Even more worrying are the data relating to the anti-Covid-19 vaccination, which reached only 4,47% of the population over 60 in the 2024-25 campaign. Also for pneumococcus and herpes zoster a decreasing trend in adhesions is estimated even if, however, a structured monitoring system is not currently foreseen. Finally, the case of the Respiratory Syncytial Virus (RSV), recommended at European level but not in Italy, is pregnant.

The reasons for this negative trend are many: from the poor perception of risk by the adult population to the lack of timely updating of the National Vaccination Prevention Plan based on the most recent vaccination innovations, through strong inhomogeneities between regions, costs sometimes borne by citizens and governance models that are not always coordinated and efficient. To reverse this trend, a joint and structural commitment is needed by national and regional institutions, scientific societies and all the actors of the Health System.

We need to promote a culture of prevention as an investment, strengthen access to vaccine innovation and enhance the virtuous models already in place: Lazio with its digital network of vaccination hubs, Lombardy with the involvement of general practitioners and pharmacies, and Tuscany with the integrated and institutional approach.

These are the themes at the center of the speeches of the speakers present at the event, which was held with the unconditional contribution of Pfizer: the Head of the Department of Prevention, Research and Health Emergencies of the Ministry of Health, Maria Rosaria Campitiello, the Honorable Ylenja Lucaselli and Ilenia Malavasi, the Senators Francesco Zaffini, Ignazio Zullo and Guido Quintino Liris, the President of the Technical Scientific Committee of HappyAgeing, Michele Conversano, the Professor of Hygiene at the University of Florence, Paolo Bonanni, the researcher of the Altems of the Catholic University of the Sacred Heart, Eugenio Di Brino, the President of the Italian Society of Hygiene, Preventive Medicine and Public Health of the Lazio region and Health Director of the ASL Roma 4, Simona Ursino, the Director of the School of Specialization in Hygiene and Preventive Medicine of the Vita-Salute San Raffaele University and President of the National Technical Advisory Group on Vaccinations of the Ministry of Health, Carlo Signorelli, the Member of the Coordination of Policies for the health of Cittadinanzattiva, Maria Eugenia Morreale, the director of the Prevention, Food Safety and Veterinary Department of the Veneto region, Francesca Russo, the infectious disease specialist and vaccinologist, Roberto Ieraci, the vice president of the Health Commission of the Regional Council of Tuscany, Donatella Spadi, and the general director of Welfare of the Lombardy region, Mario Giovanni Melazzini.

"Among the elderly population - stated the president of the Technical Scientific Committee of HappyAgeing, Michele Conversano - there remains a poor perception of the risk associated with the complications of infectious diseases preventable by vaccines. Many do not fully understand the usefulness of vaccination and for pathologies such as those caused by pneumococcus there is a tendency to think that antibiotics are enough, ignoring the importance of vaccination prevention. It is clear that targeted actions are needed both towards doctors and towards elderly citizens, to make them understand the real danger of diseases such as Covid-19, influenza, pneumococcus, herpes zoster and also RSV and the opportunities offered by vaccination".

"However - he continued - without an effective monitoring system and with data published promptly, it is difficult to intervene in a targeted manner. We need a structured strategy of active calling: starting from the age of 65 or in the presence of chronic pathologies, every citizen should be reached by clear and coordinated communication. Only in this way can we truly protect the health of the elderly and guarantee healthy aging".

“The aim of the Altems Advisory study – the words of Eugenio Di Brino, researcher at the High School of Economics and Management of Health Systems – Altems, Catholic University of the Sacred Heart Rome – was to quantify the cost of 'failure to vaccinate', in terms of lower health and higher costs in the different regional contexts identified by enhancing the economic and social implications of the expansion of vaccination coverage and methods as envisaged by the National Plan for Vaccination Prevention 2023-2025”.

“We have measured the value of vaccinations by broadening the very concept of value by introducing a measurement of the impact of the effects of the disease preventable by vaccination on the gross domestic product (GDP) due to the exhaustion of labor and capital – he highlighted – and we have estimated the economic value that we can obtain by increasing vaccination coverage at 10 billion euros”.

"Vaccination - explained the president of the Italian Society of Hygiene, Preventive Medicine and Public Health of the Lazio region and health director of the ASL Roma 4, Simona Ursino - is not only an intervention for individual health, but for collective health. It is a fundamental public health tool that protects the entire community, in particular the most fragile and elderly people, who are more exposed to the complications of infectious diseases".

“Ensuring high levels of vaccination coverage – he concluded – means strengthening the resilience of our health system and ensuring its sustainability, especially in a context of an aging population”.