Dr. Jay Keystone
Professor of Medicine, University of Toronto
Athough you may think of the flu as nothing more than a short-lived fever, runny nose, and aches, the consequences can be grave for high-risk population groups like seniors. In fact, this common respiratory infection causes more than 12,000 hospitalizations in Canada each year.
Seniors hardest hit
Getting vaccinated with flu vaccine is crucial for seniors and those in close contact with seniors, given that older adults account for about 90% of influenza-related deaths and 70% of hospitalizations. As tropical and infectious disease expert Dr. Jay Keystone points out, one in 400 to 800 healthy Canadians over age 65 will be admitted to hospital with influenza-related illness. “People think it’s just the flu, I’ll be over it in a day or two; but with the elderly, it may be much longer and the consequences can be much more severe, including greater risk for heart attacks and strokes,” says Dr. Keystone, adding that flu increases the risk of heart attack by three to five times and stroke by two to three times.
Enhanced vaccines boost protection
Immunosenescence in the elderly — the gradual deterioration of the immune system brought on by aging — means that older adults have less immunity to influenza viruses. “Seniors tend to have more underlying co-morbidity, and diabetes, chronic lung, kidney or liver disease, or even obesity, all make it worse if you end up with influenza,” says Dr. Keystone, who is Director of the Medisys Travel Clinic in Toronto and a University of Toronto professor. As well, seniors may have a lower protective immune response after vaccination, meaning the standard flu shot may not provide enough protection.
Fortunately, special flu vaccines can improve the effectiveness of influenza vaccines in seniors by at least 30%, says Dr. Keystone. The enhanced vaccines — which includes a vaccine containing an adjuvant (to boost the immune response) and a high-dose vaccine — are covered by most insurance plans and are available where you would regularly get your flu shot.
It’s not just an all or nothing phenomenon — when you’re at risk, some protection is better than none.
Dr. Jay Keystone, infectious disease expert
Although no vaccine is 100% effective, all flu shots will, at the very least, reduce the severity of the illness and may reduce heart attacks and strokes by about 25%–30%. “It’s not just an all or nothing phenomenon — when you’re at risk, some protection is better than none,” says Dr. Keystone, who adds that mild and transient side effects are slightly higher with enhanced flu vaccines.
A little redness or swelling from a flu shot pales compared to the potential consequences of hospitalization, which sometimes leads to decreased ability to function and loss of independence in seniors. “Only 65% of seniors get immunized in Canada and the risks are pretty substantial, especially when you think about the increased risk for heart attack and stroke.”
If you’re under 65 don’t think you’re off the hook, especially if you are in close contact with older relatives. As Dr. Keystone points out, “It’s all about herd immunity — I really believe we need to immunize young people to protect old people and those at risk.”
