According to the Centers for Disease and Control and Prevention (CDC), people over age 65, those who have cancer, HIV or AIDS, or diabetes are all considered at a higher risk of complications due to influenza, and people who fall into these categories should get an annual flu vaccine. Despite this recommendation, researchers from Texas Tech University found low rates of flu vaccinations among high-risk groups, including people over age 50, nursing home residents, and those with HIV or AIDS. The team also found that getting a flu vaccine significantly reduced high-risk patients’ probability for heart attack, cardiac arrest, transient ischemic attack (TIA) — also called a ministroke — and death due to flu complications. The research team determined that in high-risk patients over 50, getting the flu vaccine was associated with a nearly 30 percent reduced risk of heart attack, nearly 50 percent reduced risk of TIA, an 85 percent lower risk of cardiac arrest, and an almost 75 percent reduced risk of death within a year of being vaccinated. “This reduction in death is particularly substantial given that these are patients who are already at a greater risk of severe complications due to having a weakened immune system to begin with,” says Roshni Mandania, an MD candidate at the Texas Tech University Paul L. Foster School of Medicine in El Paso, who led the new research. According to Mandania, the flu usually does not cause complications in people with no existing conditions, and those individuals recover within roughly a week. “However, those who have a weak immune system whether it is because of diabetes, heart or lung disease, or have cancer or AIDS, suffer from worse complications due to physiological changes that produce a plethora of harmful effects. These vulnerable populations are at a higher risk of suffering from heart attacks and cardiac arrest because their bodies become overwhelmed with everything else that is going on,” she adds.
Preventing Complications of Flu and Underlying Disease
According to Mandania, the immune system becomes weaker with age, and older adults — particularly those living in nursing homes or long-term care facilities — are more likely to become infected and have a prolonged and severe illness as a result. She says that older adults are also more likely to have chronic conditions like chronic obstructive pulmonary disease (COPD), heart disease, and kidney disease that increase their susceptibility to infections such as the flu. In addition, Mandania says the flu can be more difficult to diagnose in older adults, as classic symptoms such as fever, cough, and general aches may not present so clearly in the elderly. According to Mandania, because of this, patients who fall into a high-risk category should have among the highest flu vaccination rates, as opposed to the extremely low rates her team identified. Mandania adds that several factors likely contribute to the low number of high-risk patients getting the flu vaccine, including access and attitude towards the vaccine. “Sometimes there is a disregard for the importance of the vaccine when someone happens to either not get sick that year, or someone does get sick and mistakenly attributes it to getting the vaccine,” says Mandania. According to Eduardo Sanchez, MD, MPH, chief medical officer for prevention at the American Heart Association, the most at-risk group are those over age 65 who have one or more underlying medical conditions that increase the risk of complications from influenza — the CDC reports that nearly one-half of all patients hospitalized for the flu had an existing heart condition — and that one solution may be to vaccinate hospitalized patients who are high-risk. He also notes that the flu vaccine will be critically important this year due to the fact that patients will face both influenza and COVID-19, as well as potentially overburdened hospitals. “The flu vaccine can help protect high-risk patients from influenza and reduce the burden of serious complications that must be cared for in hospitals,” he says.
