# 4358
The value of influenza vaccines in the elderly has been a subject of great debate for a number of years, and it is pretty much accepted that flu shots provide a less robust immune response the older a person gets.
You’ll find that this blog has covered this topic more than a few times in the past, including:
Why Vaccines Matter
Vaccines: Sometimes You Just Need A Bigger Hammer
Another Study: Flu Vaccines Do Not Reduce Mortality Rates In The Elderly
Study: Flu Vaccines And The Elderly
Today, the Cochrane group has come forth with an update to their review of the efficacy of flu vaccines for the elderly, and they state that they find no hard evidence that they provide much value.
That isn’t to say that they’ve found enough evidence to conclude that flu shots aren’t beneficial for the elderly . . . just that they find the existing studies to be lacking, or of dubious value.
As with a lot of things in medicine, we don’t always have the rigidly constructed, double-blind, placebo controlled studies we’d like to have. That, however, doesn’t invalidate their usefulness.
That said, better studies with conclusive results would be a welcome addition to our medical knowledgebase.
If all this sounds vaguely familiar, we trod similar territory last December when the Cochrane group came out and declared that Tamiflu was unproven to have much benefit for healthy adults with uncomplicated seasonal flu.
MEDPAGE Today has a pretty good overview of the Cochrane review, which I’ve only excerpted. You’ll find a link to the Cochrane review and their summary below that.
Scant Support for Flu Vaccines in Older Patients
By Charles Bankhead, Staff Writer, MedPage Today
Published: February 17, 2010
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.Action Points
- Explain to patients that a review of the medical literature found only modest evidence to support vaccination of older people against influenza.
- Note that the review does not prove that vaccinatiion of older patients is not worthwhile.
The practice of targeting influenza vaccine to older people has only poor-quality supporting evidence that fails to show a clear benefit or harm, authors of a systematic review concluded.
The only randomized, controlled trial of acceptable quality "seemed" to show a beneficial effect of vaccination against influenza symptoms but lacked statistical power to examine the effect on complications.
"The available evidence is of poor quality and provides no guidance regarding the safety, efficacy, or effectiveness of influenza vaccines for people ages 65 years or older," Tom Jefferson, MD, of the Cochrane Collaboration in Rome, and colleagues wrote in an article published in The Cochrane Library.
"To resolve the uncertainty, an adequately powered publicly funded randomized, placebo-controlled trial run over several seasons should be undertaken."
Vaccines for preventing seasonal influenza and its complications in people aged 65 or older
Influenza vaccination of elderly individuals is recommended worldwide as people aged 65 and older are at a higher risk of complications, hospitalisations and deaths from influenza. This review looked at evidence from experimental and non-experimental studies carried out over 40 years of influenza vaccination. We included 75 studies. These were grouped first according to study design and then the setting (community or long-term care facilities).
The results are mostly based on non-experimental (observational) studies, which are at greater risk of bias, as not many good quality trials were available. Trivalent inactivated vaccines are the most commonly used influenza vaccines.
Due to the poor quality of the available evidence, any conclusions regarding the effects of influenza vaccines for people aged 65 years or older cannot be drawn. The public health safety profile of the vaccines appears to be acceptable.
