We have all been told over and over that influenza vaccination would reduce mortality risk in the elderly. New research from the University of Alberta published in the September issue of the American Journal of Respiratory and Critical Care Medicine by Dr. Eurich and colleagues is revealing that the facts are different. 700 elderly subjects were matched and half were given the Flu vaccine, the other half were not. The study was controlled and matched for a great number of variables to exclude the “healthy user artifact”, which many previous studies had suffered from. The authors critically analyzed previous similar studies and compared them with their findings. They found that there was no statistical difference between the two groups in terms of mortality or severity of any Flu that was observed. The previous studies had identified differences, but it was noted that this difference had been due to frailty factors among the non-vaccinated controls and a healthy-user artifact among the vaccinated subjects. Dean Eurich, Ph.D. who is a clinical epidemiologist and assistant professor at the School of Public Health at the University of Alberta, pointed out that vaccination rates in the US have increased from 15% to 65% in the last few years. However, he said that hospital admissions or all cause mortality rates have not decreased in a comparable fashion. In addition, he points out that only 10% of all winter time deaths in the United States are related to influenza. This would make the prediction of a cut of death rates from all causes to 50% very unlikely. In his study Dr. Eurich took health records from 6 hospitals in the Capital Health region in Alberta. 12% of patients had died overall and there had been a medium length of hospital stay of 8 days. When 704 patients with community-acquired pneumonia were analyzed who were 65 or older and who had been admitted during the Flu season, half were vaccinated, the other half was not. It depended now on which model was used to analyze the study: vaccinated subjects were about half as likely to die when compared to the unvaccinated patients, a result that was comparable to previous publications. However adjusting for smoking history, sex, functional lung status, severity of the disease, socioeconomic status, prior pneumococcal vaccinations etc. gave a completely different result. Now there was only a 19% relative risk of death in the vaccinated group, which was not statistically significant.
There are three consequences of this study according to Sumit Majumdar, M.D., M.P.H., associate professor in the Faculty of Medicine & Dentistry at the University of Alberta:
1. For patients: people who have chronic lung diseases such as emphysema (COPD), immune deficiencies, or chronic conditions that make them more susceptible to getting the Flu, should still be vaccinated. Also, health care workers, family and friends of elderly patients who are susceptible to get the Flu should get immunized against influenza. But everybody should also take simple steps like washing hands, avoiding hospitals and contact with sick children during the flu season. Antiviral agents for prevention may be something you should consider; discuss this with your doctor. Keep in mind that the flu vaccine is not as effective as it was made out to be.
2. For vaccine manufacturers: previously, claims of effectiveness have been overinflated. They should consider developing more effective vaccines for the elderly.
3. For policy makers and governments: what has been proven is that hygienic measures such as hand washing and isolation procedures are effective. Also, vaccination of children and health care workers will interrupt the infectious cycle.
Last edited December 4, 2012