Friday, July 01, 2011

NFID: The Challenges Of Influenza In Older Adults



# 5665



NFID is the National Foundation for Infectious Diseases -- a non-profit organization founded in 1973 – that describes its mission as: “educating the public and healthcare professionals about the causes, treatment and prevention of infectious diseases.”


NFID is a resource rich website with information fact sheets on a variety of infectious diseases, continuing medical education (CME) links, information on conferences and courses, and publications.


While influenza can strike people of any age, it is the elderly who experience the greatest health burden from the illness. Those over 65 are more likely to be hospitalized, or die, as a result of the flu.



(Credit NFID)


The immune system of those over 65 is often  less robust than their younger counterparts, and they may be dealing with underlying chronic conditions such as heart disease, COPD, and diabetes that further increase their risks.


Complicating matters, the influenza vaccine may be less effective in the elderly as well (see Study: Flu Vaccines And The Elderly, Flu Shots For The Elderly May Have Limited Benefits).


Earlier this year NFID convened a panel of experts to address the issues of influenza and the elderly that included such familiar names in public health as Arnold Monto, MD; Kristin Nichol, MD, MPH; H. Keipp Talbot, MD, MPH; and William Schaffner, MD.


From that panel a 5-page brief has emerged, called: Understanding the Challenges and Opportunities in Protecting Older Adults from Influenza.



Although the elderly generally see less protection from the flu vaccine, older individuals may still mount a robust immune response. In populations 65 and older, the brief points out that:


  • Hospitalization rates for influenza and pneumonia are lower in community-dwelling adults who received the seasonal influenza vaccine.
  • Immunization is associated with reduced hospitalization of older patients for cardiac, respiratory, and cerebrovascular diseases.


While the goal of vaccinating the younger population is to prevent infection, the authors point out that:


. . . the goal in older adults is to prevent severe illness, including exacerbation of underlying conditions, hospitalization, and mortality.


In other words, even if the vaccine doesn’t always prevent infection in the elderly, studies suggest that the vaccine may blunt the seriousness of the illness in those over 65.


The authors also point out that new vaccine technologies are being tested including the new high-dose influenza vaccine (see MMWR On High Dose Flu Vaccine For Seniors, Vaccines: Sometimes You Just Need A Bigger Hammer),  Intradermally administered flu vaccines, and in Europe, the inclusion of adjuvants.


The authors write:

Health care providers should stay alert for the introduction of these new vaccines, learn their benefits for specific populations, and consider all options when planning ahead for the influenza season. In settings with large numbers of frail elderly, such as nursing homes, familiarity with the different options for preventing and managing influenza is especially important.


In addition to embracing universal vaccination for everyone over the age of 6 months and keeping up with the latest technology, the authors urge that health care providers:


Demonstrate a Personal Commitment to Influenza Vaccination

Health care providers can set a good example—and protect themselves and their patients— by receiving the influenza vaccine every year and by encouraging their colleagues and all members of their staff to do so too. Until the health care community as a whole attains a near universal influenza vaccination rate, there is room for much progress to be made in this area.



Although this brief is very brief, it is well footnoted for those who would like to follow up on the statements within.


The bottom line is pretty simple.  Quoting again from the brief:


The public must become aware that influenza is far more serious than the common cold, especially for older people, and that the vaccine is both safe and beneficial.


This brief, along with the other offerings on the NFID site, are well worth taking the time to peruse.

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