People 65 or older accounted for 70 to 85 percent of seasonal, flu-related deaths and between 54 and 70 percent of seasonal, flu-related hospitalizations in recent years, according to the Centers for Disease Control and Prevention.
Dr. William Schaffner, professor of preventive medicine and health policy at Vanderbilt University Medical Center’s Division of Infectious Diseases, in an interview agreed that the risks are greater for seniors who don’t get the vaccine. “Influenza strikes people across the age spectrum, but it’s clear that those 65 and older are more likely to get pneumonia, pay a visit to a hospital emergency room, be admitted to the hospital or wind up in an intensive care unit. They are more likely to die as a result of an influenza infection.”
The flu and older adultsThe main reason influenza affects older adults disproportionately is straightforward. “Simply stated, as we get older, we become more frail physically,” Schaffner said. “Our immune systems become less responsive and less robust, so we aren’t able to fight off infections with the efficiency that younger people do.”
Influenza viruses can reproduce and mutate rapidly, giving rise to new strains that are resistant to previous years’ vaccines. A variety of influenza viruses emerge and circulate every year during flu season in both the Northern and Southern hemispheres. Typically, one manages to spread faster and wider than the others and it’s deemed the dominant strain as a result.
“Last year, the H3N2 strain became notorious because it was more apt to cause serious complications. It hit those [aged] 50 to 65, and those with chronic, underlying illnesses, particularly hard,” Schaffner explained. Getting a flu shot is the single best preventive measure people of all ages can take. Equally important, getting a flu vaccine reduces the risk of serious complications arising as a result of a flu infection. A flu vaccination also minimizes the risk that infections will spread widely.
New flu strains, new vaccinationsThe FDA and CDC have developed two flu vaccines specifically formulated to help prevent and reduce the effects of the flu for people 65 and older. One, administered the most frequently, is a high-dose flu vaccine that is four-times as strong as the standard flu vaccine. The second is what’s known as an adjuvanated flu vaccine that boosts an older person’s immune system so that it can respond more effectively to an infection.
“The high-dose vaccine packs a bigger punch, which is valuable to someone with an immune system that isn’t as responsive or robust. The adjuvanated flu vaccine kickstarts the immune system so that a person will respond better to vaccine,” Schaffner says.
The mother of all flu epidemics
“One of the major reasons we vaccinate people is to ameliorate or prevent complications. That’s not reflected in the statistics regarding effectiveness, which are focused on complete prevention. The flu vaccine doesn’t completely eliminate the chance that you’ll get the flu, but you’re less likely to catch pneumonia, be admitted to the hospital or die. The vaccine reduces the severity of the illness, and that’s a significant benefit that we need to hold on to,” Schaffner explained.
When it comes to the flu and getting a flu shot, Schaffner warns people against being complacent or underestimating the risks. “1917-1918 was the mother of all flu epidemics—the worst in history—but last year proved to be a very severe flu season,” he points out.
For older adults considering the flu vaccine, Schaffner paraphrases the 18th century French Enlightenment author and philosopher Voltaire: “Perfection is the greatest enemy of the current good. We shouldn’t wait for the perfect vaccine, rather use what we have that has proved to be safe and effective.”