Preventing infections in older people is hit and miss, says England’s chief medic | Health

The medical profession must do more to prevent and manage infections in older people because current methods are “haphazard”, England’s chief medical officer has said.

In his annual report for 2025, Professor Chris Whitty said the prevention and treatment of infections had led to “extraordinary improvements in life expectancy over the past 150 years”.

But he stressed that there was not enough research into infections among older people, a growing segment of society.

“Although we are very systematic in reducing and preventing infections in children and young adults, in older people it is often much more haphazard,” he said during a press briefing.

Data for England from 2023 reveals that the vast majority of deaths from infectious diseases were among older people and that, in this group, most were caused by respiratory infections or Covid.

Dr Thomas Waite, Deputy Chief Medical Officer, has championed raising the age at which older people are eligible for a Covid booster, and Whitty said the current priority is to encourage older people to take other vaccines, including the new RSV vaccine.

Whitty said the problem of infections among older adults isn’t just about hospitalizations and serious illnesses. “Even seemingly mild illnesses like cellulitis can cause very significant quality of life problems for older adults,” he said, noting that such infections could lead to people being stuck in their homes and unable to socialize.

Additionally, he added, older adults could face an increased risk of stroke after a bacterial or viral infection, while some evidence suggests that infections could also increase the risk of heart attack or other heart problems.

Infections can also lead to delirium, and there is an association between serious infections and dementia – although Whitty noted that it was not yet clear whether this was causal or whether infections accelerated the onset.

Whitty said hand washing, careful food preparation, vaccination and encouraging people with recent infections not to come until they are healthy were among the steps individuals could take to protect themselves from infections.

He said while it was important to maintain “firm control” over the prescribing of antibiotics to help combat the threat of antimicrobial resistance, there should be a lower threshold for prescribing these drugs in older people because the chances of an infection turning into sepsis are much higher.

UCL’s Professor Arne Akbar, chair of the British Society for Immunology’s Immune Aging Network, said preventing and better management of infections in older people had huge potential to enable people to enjoy a better quality of life for longer and ease pressure on health and social care systems.

“We welcome the focus of the Chief Medical Officer’s report on infections in older people and hope it will catalyze a renewed focus on research into how we can prevent disease and improve health outcomes linked to infections in this age group,” he said.

The report doesn’t just focus on older people. Among other areas, it warns that the near elimination of cervical cancer could be at risk if HPV vaccination rates are not maintained.

The report also highlights a decline in vaccination rates among pregnant women and a decline in routine vaccination coverage among children, the latter of which is particularly pronounced in London and more deprived areas.

“Some people keen to spread misinformation like to give the impression that the UK is becoming a vaccine-skeptical nation. That is absolutely not true,” Whitty said, adding that much of the decline in childhood vaccinations was due to the convenience of getting a vaccine.

The report also reveals a rise in imported infections such as malaria over the past decade, which Whitty says highlights the importance of maintaining the UK’s expertise in these areas. And he looks to the future, noting that situations like pandemics are “entirely predictable,” even if their timing is not.

“We must maintain our ability to prevent and respond to infections between events rather than wring our hands and hope we have it done when they arise,” Whitty wrote.