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Flu News for Senior Citizens
Flu Shots Encouraged for Heart Patients in New
Advisory as Flu Season Nears
American Heart Association reminds seniors its
time for flu shots
 September
29, 2006 - The American Heart Association and the American College of
Cardiology are asking heart doctors to do something they may not
normally do give flu shots to their patients. However, patients with
cardiovascular disease should not get the nasal-spray flu vaccine. This
is a significant new recommendation for this flu season, with senior
citizens and other high risk individuals.
Patients with cardiovascular disease are more
likely to die from influenza than patients with any other chronic
condition, according to the new AHA/ACC scientific advisory.
Studies have found that annual flu vaccinations can
prevent death in adults and children with chronic conditions of the
cardiovascular system. But only one in three adults with
cardiovascular disease was vaccinated against flu in 2005.
If we vaccinated at least 60 percent of the 13.2
million people with coronary heart disease in the United States against
influenza, we could prevent hundreds of deaths and thousands of cases of
flu each year, said Matthew M. Davis, M.D., lead author of the advisory
and associate professor of pediatrics, internal medicine, and public
policy at the University of Michigan in Ann Arbor.
The target goal set by the U.S. Department of
Health and Human Services is to vaccinate 60 percent of people with
heart disease under age 65, and 90 percent of everyone 65 and over, many
of whom have heart disease, Davis said.
Overall, influenza is responsible for 36,000 deaths
and 225,000 hospitalizations in the United States each year. People
with cardiovascular disease are particularly vulnerable, because the flu
can exacerbate heart disease symptoms directly, and can also lead to
conditions like viral or bacterial pneumonia that cause flare-ups of
cardiovascular disease, he said.
A case of influenza tends to make people with
heart disease even sicker than others who are healthy, and increases the
chance of having to go to the hospital, he said.
Immunization against seasonal influenza has a
critical, but underappreciated, role in preventing death among
cardiovascular disease patients. In May 2006, new American Heart
Association/American College of Cardiology joint guidelines on
preventing recurrent cardiovascular events recommended an annual flu
shot for all people with cardiovascular disease.
Influenza vaccination is now recommended with the
same enthusiasm as cholesterol and blood pressure control and other
modifiable risk factors for cardiovascular disease, the advisory noted.
The strongest evidence of a protective effect comes
from the FLUVACS trial. In that trial, 301 people hospitalized for
either a heart attack or an angioplasty and stent procedure to open
clogged arteries were randomly assigned to receive flu vaccine or remain
unvaccinated. Over the next year, among those who did not get
vaccinated 23 percent had died of heart disease, had a nonfatal heart
attack or developed severe ischemia (insufficient blood supply to the
heart tissue), compared with only 11 percent of their vaccinated
counterparts.
A visit to the cardiologist presents a good, but
often missed, opportunity to get vaccinated, Davis said. Most people
with heart disease visit their cardiologists during the time when they
should get the flu shot, but only about half of cardiologists in the
United States stock the vaccine in their clinics.
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Get Flu Shots Beginning in October |
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October or November is the best time to get a flu
shot, but getting a shot in January or even later can still be
beneficial. Flu season can start as early as October and last as
late as May. In the U.S., the peak of flu season can occur
anywhere from late December through March.
The American Heart Association has released new
guidelines for the 2007-08 flu season with includes a new
recommendation that all heart disease patients get flu shots.
Patients with cardiovascular disease should only
receive the flu vaccine by injection, not the live, attenuated
vaccine given as a nasal spray, which can cause influenza in
this high-risk population.
Every year in the U.S., about 36,000 people die
from influenza (flu) and over 200,000 are hospitalized due to
complications from it. These complications can include bacterial
pneumonia, dehydration and worsening of chronic medical
conditions, such as congestive heart failure, asthma or
diabetes. Children may get sinus problems and ear infections.
According to the Centers for Disease Control and Prevention
(CDC), these high-risk individuals include:
● People 50 years and older
● People who live in nursing homes and other long-term care
facilities that house those with long-term illnesses
● Adults and children 6 months and older with chronic heart or
lung conditions, including asthma
● Adults and children 6 months and older who needed regular
medical care or were in a hospital during the prior year because
of a metabolic disease (like diabetes), chronic kidney disease,
or weakened immune system (including immune system problems
caused by medicines or by infection with human immunodeficiency
virus [HIV/AIDS])
● Children 6 months to 18 years old who are on long-term
aspirin therapy. (Children given aspirin while they have
influenza are at risk of Reye syndrome.)
● Women who will be pregnant during the influenza season
● All children 6 to 59 months of age |
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The advisory authors said immunization isnt
perceived as part of a typical cardiology practice. But the most
effective way to increase the number of cardiovascular patients
vaccinated is to have flu vaccine available in all cardiology practices
and to have physicians strongly recommend the vaccine to their patients.
Most insurance plans cover flu vaccinations.
The advisory urges:
● Cardiologists to stock flu vaccine for
their patients in their clinics and strongly encourage influenza
immunization.
● Patients with cardiovascular disease to
get a flu vaccination (given by injection) every year by the end of
November. Receiving a shot in January or even later should still
protect from flu, as the flu season in the United States typically peaks
in January, February or March.
● Patients with cardiovascular disease not
receive the live, attenuated vaccine given as a nasal spray. The live
vaccine can cause influenza in this high-risk population.
Last years shot wont offer protection this year,
because the dominant strains of influenza virus change each year. The
vaccine, which takes about two weeks to become effective, is
reformulated each year to respond to these changes as best we can,
Davis said.
The Centers for Disease Control and Prevention also
recommends annual influenza vaccination for people age 50 and older;
children ages 6 months to 59 months; women who will be pregnant during
flu season; and adults and children with other chronic conditions.
The advisory is endorsed by the American
Association of Cardiovascular and Pulmonary Rehabilitation, the American
Association of Critical Care Nurses, the American Association of Heart
Failure Nurses, the American Diabetes Association, the Association of
Black Cardiologists, Inc., the Heart Failure Society of America, and the
Preventive Cardiovascular Nurses Association.
The American Academy of Nurse Practitioners
supports the recommendations of this scientific advisory. This science
advisory is consistent with the recommendations of the Centers for
Disease Control and Prevention and the Advisory Committee on
Immunization Practices.
Read the scientific
advisory about flu and heart disease
Notes:
Co-authors are Kathryn Taubert, Ph.D.; Andrea L. Benin,
M.D.; David W. Brown, M.S.P.H., M.Sc.; George A. Mensah, M.D.; Larry M.
Baddour, M.D.; Sandra Dunbar, R.N., D.S.N., and Harlan M. Krumholz, M.D.
The advisory is available online at
www.americanheart.org and
www.acc.org; and will be published in Circulation: Journal of the
American Heart Association and Journal of the American College of
Cardiology.
Editors note: For more information on influenza visit
www.americanheart.org/flu.
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