Influenza and the Elderly


Influenza attacks can affect the elderly to extreme degrees, often with fatal results. It is estimated that 90 percent of influenza related deaths occur among the 65 and over age group. As immune systems get older, they get weaker, and are more vulnerable to viruses and infections. These attack older people differently. They need to take extra precautions and steps to remain healthy during the flu season.

Studies have shown that geriatric populations have benefited more from a higher dose of the influenza vaccine than is generally administered to younger demographics. Although both the high and standard doses protect against the same three strains of the virus, the higher doses appear to induce a greater immunity among this section of the population.

A study was conducted involving subjects living in a long-term-care facilities (LTCFs) for the elderly. They were given the high-doses variant of the inactivated influenza vaccine, or HD IVV. They were shown to have acquired greater immunity to all strains of influenza when compared with those who received the standard-dose IVV.

Dr. David Nace of the University of Pittsburgh in Pennsylvania, and his team published the results of this randomized, controlled, single-blinded, trial on December 17 online in the Journal of Infectious Diseases. The study was completed on 187 elderly subjects from different LTCFs with an average age of 86.7 years over the last two seasons.

The researchers compared the efficacy of the HD IVV approved in 2009 with the efficacy of standard dose IVV. They measured immunity levels 30 and 80 days after vaccination. In addition to producing superior responses from the antibody, the investigators discovered that the titers of the antibodies remained elevated in response to HD IVV  between day 30 and day 180. The study did not include patients who had contracted influenza.

The advanced age and reduced immunity of the frail and elderly cause severe complications from an attack of influenza. There has been an urgent need for a stronger vaccine for them. The HD IVV seems to be the answer. It is necessary and appropriate to use them on this demographic stated Dr. Litjen Tan, PhD, of the Immunization Action Coalition in St. Paul, MN. Dr. Tan emphasized that Medicare covers the HD vaccine.

Carolyn B. Bridges, MD and Megan C. Lindley, MPH from the Centers for Disease Control and Prevention in Atlanta, Georgia, issued a cautionary editorial. They said the study needs additional research as it was limited to measure serum titers but not clinical outcomes.

Taking the influenza vaccine is a necessary precaution for the elderly. In addition, washing hands frequently can dramatically reduce the chances of getting flu many other deadly infections. Avoiding contact with people who exhibit symptoms of the flu is a wise move. Caregivers and health workers should take similar precautionary measures as well.

Each year, 15 to 60 million Americans succumb to seasonal influenza, the National Institute of Allergy and Infectious Diseases estimates. Hospitalization will be necessary for around 200,000 patients. CDC states 90 percent of flu-related deaths and over 50 percent of hospitalizations occur in people age 65 and older. About 23,000 older adults are at risk of death from flu-associated causes.

The elderly should check with their health care provider to discuss the two options of the vaccination. Health care providers should decide which one is appropriate on a case-by-case basis. Those who have symptoms should contact their doctors immediately. Some medical personnel may advise antiviral flu medications for their patients.

Influenza is dangerous and even deadly for the elderly. Studies conducted by the CDC indicate that vaccinations reduced hospitalizations due to flu in the over 65 age group. This reinforces CDC’s emphatic recommendations for annual vaccination of the elderly who are at high risk.

By Bina Joseph





Photo by Lance McCord – Flickr License

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