Every year, millions of people become infected with the influenza virus. In the U.S., it is recommended that anyone over the age of six months be vaccinated against influenza (flu). The World Health Organization (WHO) has come up with “six priority groups” that are strongly encouraged to get vaccinated. These groups include pregnant women, health care workers, small children (ages six months to two years), people with chronic medical conditions, and the elderly.
According to WHO Europe, “90 percent of deaths related to seasonal influenza occur among those 65 and older.” Elderly who are infected with the influenza virus experience more severe symptoms, have a longer recovery time, and are hospitalized more often and longer. Compared to the U.S., there is an overall lack of support for the influenza vaccine in Europe. This is a result of missing data on the effectiveness and feasibility of the vaccine as well as lack of money.
In 2013, the flu vaccine was only 62 percent effective. For the elderly and frail, the vaccine is even less effective. The main reason for the ineffectiveness is that the influenza vaccine only responds to certain circulating viral strains. Also, the responsiveness of the vaccine depends on “the seroconversion in the individual” after vaccination. Anytime a vaccine (antigen) enters the blood, antibodies are created by the immune system to fight off the disease that a person is immunized for. A reduced seroconversion can lead to a reduced effectiveness of the vaccine.
Although the flu vaccine is less effective in the elderly, it is still recommended that older adults get vaccinated because “some protection is better than none,” and immunization can lead to decreased recovery time and severity of illness. In addition, hospital admissions and the death rate related to influenza are reduced, which lessen the burden of a health care system in any country. Therefore by 2014-2015, 94 percent of countries in the WHO European Region recommend that at least 75 percent of the elderly population should get vaccinated. However, only the Netherlands were able to reach this goal.
How can we increase the uptake levels of the influenza vaccine? Dr. Caroline Brown, Programme Manager for Influenza at WHO/Europe, highlights that we need to “estimate the burden of influenza, assess the costs and benefits of influenza vaccination programs,” and still maintain and improve the vaccination programs we have. Making a vaccine easy to access and afford is key as well. In Europe, vaccines can only be given by doctors and vaccine programs do not always exist, which causes a lack of accessibility to vaccines. Some countries offer free vaccines while other countries require residents to pay for them. It is important to improve the public’s perception of the influence of vaccines, which will happen once there is more data about the effectiveness of vaccines. Researchers are also eager to find a more effective vaccine; a vaccine that could possibly be effective for a longer period of time and be given in higher doses as a recent study shows. This could increase the protection for influenza especially among the elderly.
If the vaccine is not as effective among the elderly, we need to take another approach. In order to protect the elderly in nursing homes, let us reduce outbreaks and mortality rates as well as advising all health care workers to get vaccinated, which ultimately leads to herd immunity.
Martina Lesperance is a Health Educator and Screening Technician at Catapult Health.