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Flu Shot Protects Elderly from Death by Many Causes
Nov. 3, 2004 – Missing an annual flu shot by an
elderly person can put their lives at jeopardy from more than just
influenza, according a new research. The study from the Netherlands says
senior citizens who have a yearly flu vaccination have reduced risk of
death from all causes.
"Influenza-associated morbidity and mortality
increase with age, especially for individuals with high-risk
conditions," the authors provide as background information in the
article in the current issue of JAMA. "The effectiveness of vaccination
has been reported to decrease in high-risk persons. Annual influenza
revaccination has been proposed as a strategy to increase vaccination
effectiveness."
In this study, A.C.G. Voordouw, M.D., from Erasmus
Medical Center, Rotterdam, The Netherlands, and colleagues, analyzed
data from 1996 through 2002 from electronic patient records that were
part of the Integrated Primary Care Information Project of Medical
Informatics at the Erasmus Medical Center.
The study included 26,071 persons aged 65 years or
older. During the total study period, the population studied received
62,476 influenza vaccinations. The annual vaccination coverage ranged
from 64 percent in 1996 to 74 percent in 1999. Influenza epidemics
during the study period were of mild to moderate severity with the 2000
– 2001 season showing no clear epidemic activity.
During the study followup period, 3,485 patients
died. "Overall, a first vaccination was associated with a nonsignificant
annual reduction of mortality (death) risk of 10 percent, while
revaccination was associated with a reduced mortality risk of 24
percent," the authors report. "Compared with a first vaccination,
revaccination was associated with a reduced annual mortality risk of 15
percent.
During the epidemic periods this reduction was 28
percent." The authors also found that an interruption of the annual
vaccinations series was associated with a 25 percent increase in
mortality risk, whereas restarting vaccination after an interruption
resulted in a mortality risk reduction similar to that observed
following revaccination. The authors note that "in the total population
one death was prevented for every 302 vaccinations, or 1 for every 195
revaccinations."
"In summary, our study shows that annual
revaccination against influenza in a population of community-dwelling
elderly persons is associated with a reduction of mortality risk. This
study supports the recommendation for yearly influenza vaccination for
elderly individuals, with or without multiple diseases and in patients
80 years or older. Because influenza vaccination is inexpensive and
safe, clinicians should recommend annual influenza revaccination for
such patients."
Editor's Note: This
study was supported by an unconditional grant from the Netherlands
Organisation for Health Research and Development. The grant was obtained
following review of a submitted protocol to evaluate the effectiveness
of the influenza vaccination program in Dutch elderly citizens.
[Co-author] Dr. D. J. Smith was supported by a European Union grant.
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