WHEN YOU CONNECT THE CLUES...

A threat

to older adults EMERGES

don't let influenza affect what you've done to help manage patients with chronic conditions, including those with diabetes and cardiovascular disease

for older adults, influenza can be much more than just another illness1-5

It can result in dangerous, even deadly, complications that send millions to their doctors, hundreds of thousands to the hospital, and some to an early death.4,5 When you look at the evidence, you’ll uncover a pattern.

More importantly, you’ll see it’s time to reconsider how you can help protect older adults from this dangerous illness—and learn what more can be done to help stop it.

 

compared with younger adults, older adults have a higher prevalence of chronic medical conditions1,2

Many of these conditions are associated with an increased risk of influenza-related complications and severe outcomes.1,2

Influenza brings risk for patients with chronic conditions1

Among adults 50-64 years of age

~70% have ≥1 chronic condition3

~50% have 2 or more4

AMONG ADULTS 65+ years of age

~86% have ≥1 chronic condition6

80% have 2 or more4

influenza can threaten adults
with chronic conditions

helping prevent influenza is linked to lower mortality risk for adults, regardless
of health status
2

a 1 minus the hazard ratio.

Additionally, after adjusting for age, sex, and risk status, influenza vaccination was associated with a 44% reduction in all-cause mortality.2

Influenza infection may trigger cardiovascular events by causing an acute and severe inflammatory state that can lead to destabilization and rupture of atherosclerotic plaques.13

About twice as many people die of cardiac causes as opposed to influenza-induced pneumonia during influenza epidemics.13

In a study of autopsy-proven coronary heart disease in adults, influenza was associated with significantly higher risk for AMI and ischemic heart disease (IHD)13:

  • 30% greater risk of AMI
  • 10% greater risk of IHD

influenza steals $11.2 billion annually14

influenza causes devastating economic and productivity losses14

  • Influenza-related direct medical costs topped $3.2 billion in 2015
  • Lost earnings and productivity for US adults reached $8 billion

 

Economic pain hits older adults the hardest14

Older adults:

  • Took >60% of the hit for direct medical costs
  • Absorbed 40% of total indirect costs

The 4 most costly vaccine-preventable diseases for older adults16

In 2013, annual costs among older adults for all 4 diseases: $26.5 billion

in 2015, influenza cost adults15:

  • 3X more than pneumococcal disease
  • 7X more than herpes zoster
  • 11X more than the remaining vaccine-preventable diseases combineda

 

a HPV, hepatitis B, and other.15

DESPITE CONSISTENT VACCINATION RATES,
in
FLUenza REMAINS A THREAT TO older ADULTS

Flu-related illnesses are the leading cause of death for senior citizens

During the 2016-2017 flu season, approximately 55% of older adults were vaccinated against influenza.5

Yet, in that same flu season, roughly 86% of all influenza-related hospitalizations were of older adults, and adults 65 years of age and older went to the hospital twice as often as all other age groups combined.5 Historically, older adults have borne the brunt of influenza-related deaths, with 90% of influenza-related deaths occurring in adults 65 years of age and older.17

influenza vaccine effectiveness declines with age18

low Vaccine effectiveness

Age-related weakening of the immune system results in an increased risk of infection and a decreased response to vaccination.18,19

Two recent flu seasons show low vaccine effectiveness in both adults 50-64 years of age and adults 65 years of age and older, indicating that older adults need better protection.20,21

2015-2016

Dr. Irving Herling, Cardiologist

“The occurrence of an infectious illness, such as influenza, in a patient with cardiovascular disease can be devastating. Influenza can cause arterial wall inflammation that can destabilize plaque and result in an acute cardiovascular event.13

Because of this connection between influenza and cardiovascular events, as well as other mounting evidence, physicians may want to consider influenza as a potential trigger, even among young seniors who are healthy and active."22,23

Dr. Marvin Bittner, Infectious Disease Specialist

“Flu is frequently associated with an increase in secondary bacterial pneumonia. In patients 65 years of age and older, flu may result in a predisposition to these secondary bacterial infections.24

When a patient with flu is stricken with a secondary infection, symptoms can be prolonged and more serious than those observed with flu alone.24 In some cases, this can lead to hospitalization and even death."1

THERE ARE EFFECTIVE AGE-SPECIFIC VACCINE OPTIONS

learn how to more Rigorously help PROTECT YOUR older adult patients against influenza

The Experts

To better understand the nature of this virulent threat, medical experts have been consulted. Here is just some of what they had to say:

2016-2017

could we be doing more to help stop this threat?

REFERENCES  |  Terms & Conditions  |  Privacy Policy

1. Centers for Disease Control and Prevention (CDC). Influenza (flu): people at high risk of developing flu-related complications. http://www.cdc.gov/flu/about/disease/high_risk.htm. Accessed April 11, 2018. 2. Wang C-S, Wang S-T, Lai C-T, Lin L-J, Chou P. Impact of influenza vaccination on major cause-specific mortality. Vaccine. 2007;25:1196-1203. 3. CDC, AARP, American Medical Association. Promoting Preventive Services for Adults 50-64: Community and Clinical Partnerships. Atlanta, GA: National Association of Chronic Disease Directors; 2009. 4. Gerteis J, Izrael D, Deitz D, et al. Multiple Chronic Conditions Chartbook. Rockville, MD: Agency for Healthcare Research and Quality; 2014. AHRQ publication Q14-0038. 5. CDC. Influenza (flu): estimated influenza illnesses, medical visits, hospitalizations, and deaths averted by vaccination in the United States. http://www.cdc.gov/flu/about/disease/2016-17.htm. Accessed April 16, 2018. 6. Ward BW, Schiller JS, Goodman RA. Multiple chronic conditions among US adults: a 2012 update. Prev Chronic Dis. 2014;11:E62. 7. Minchole E, Figueredo AL, Omeñaca M, et al. Seasonal influenza A H1N1pdm09 virus and severe outcomes: a reason for broader vaccination in non-elderly, at-risk people. PLoS ONE. 2016;11:e0165711. 8. Hulme KD, Gallo LA, Short KR. Influenza virus and glycemic variability in diabetes: a killer combination? Front Microbiol. 2017;8:861. 9. Vamos EP, Pape UJ, Curcin V, et al. Effectiveness of the influenza vaccine in preventing admission to hospital and death in people with type 2 diabetes. CMAJ. 2016;188:E342-E351. 10. Warren-Gash C, Blackburn R, Whitaker H, McMenamin J, Hayward AC. Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: a self-controlled case series analysis of national linked datasets from Scotland. Eur Respir J. 2018;51. doi:10.1183/13993003.01794-2017. 11. Ludwig A, Lucero-Obusan C, Schirmer P,  Winston C, Holodniy M. Acute cardiac injury events ≤30 days after laboratory-confirmed influenza virus infection among U.S. veterans, 2010-2012. BMC Cardiovasc Disord. 2015;15:1-9. 12. MacIntyre CR, Mahimbo A, Moa AM, Barnes M. Influenza vaccine as a coronary intervention for prevention of myocardial infarction. Heart. 2016;102:1953-1956. 13. Madjid M, Miller CC, Zarubaev VV, et al. Influenza epidemics and acute respiratory disease activity are associated with a surge in autopsy-confirmed coronary heart disease death: results from 8 years of autopsies in 34,892 subjects. Eur Heart J. 2007;28:1205-1210. 14. Putri WCWS, Muscatello DJ, Stockwell MS, Newall AT. Economic burden of seasonal influenza in the United States. Vaccine. 2018;36:3960-3966. 15. Ozawa S, Portnoy A, Getaneh H, et al. Modeling the economic burden of adult vaccine-preventable diseases in the United States. Health Aff (Millwood). 2016;35:2124-2132. 16. McLaughlin JM, McGinnis JJ, Tan L, Mercatante A, Fortuna J. Estimated human and economic burden of four major adult vaccine-preventable diseases in the United States, 2013. J Prim Prev. 2015;36:259-273. 17. CDC. Estimates of deaths associated with seasonal influenza—United States, 1976-2007. MMWR. 2010;59(33):1057-1062. 18. Monto AS, Ansaldi F, Aspinall R, et al. Influenza control in the 21st century: optimizing protection of older adults. Vaccine. 2009;27:5043-5053. 19. Aging changes in immunity. MedLinePlus website. http://www.nlm.nih.gov/medlineplus/ency/article/004008.htm. Accessed June 13, 2018. 20. Jackson ML, Chung JR, Jackson LA, et al. Influenza vaccine effectiveness in the United States during the 2015–2016 season. N Engl J Med. 2017;377:534-543. 21. Ferdinands J. Influenza vaccine effectiveness, 2016-17. Presented at: Meeting of the Advisory Committee on Immunization Practices (ACIP); June 21, 2017; Atlanta, GA. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2017-06/flu-03-ferdinands.pdf. Accessed February 15, 2018. 22. Warren-Gash C, Smeeth L, Hayward AC. Influenza as a trigger for acute myocardial infarction or death from cardiovascular disease: a systematic review. Lancet Infect Dis. 2009;9:601-610. 23. Siriwardena AN. Increasing evidence that influenza is a trigger for cardiovascular disease. J Infect Dis. 2012;206:1636-1638. 24. Beadling C, Slifka MK. How do viral infections predispose patients to bacterial infections? Curr Opin Infect Dis. 2004;17:185-191. 25. CDC. Influenza (flu): what you should know and do this flu season if you are 65 years and older. http://www.cdc.gov/flu/about/disease/65over.htm. Accessed March 6, 2018.

SAUS.IFLU.18.07.4155

WHEN YOU CONNECT THE CLUES...

A threat

to older adults EMERGES

influenza can threaten adults with chronic conditions

Flu-related illnesses are the leading cause of death for senior citizens

The Experts

Senior citizens weakened immune systems make them more susceptible to the flu-related complications

influenza can threaten adults with chronic conditions

Economic pain hits older adults
the hardest14

Older adults:

  • Took >60% of the hit for direct medical costs
  • Absorbed 40% of total indirect costs

During the 2016-2017 flu season, approximately 55% of older adults were vaccinated against influenza.5

Yet, in that same flu season, roughly 86% of all influenza-related hospitalizations were of older adults, and adults 65 years of age and older went to the hospital twice as often as all other age groups combined.5 Historically, older adults have borne the brunt of influenza-related deaths, with 90% of influenza-related deaths occurring in adults 65 years of age and older.17

low Vaccine effectiveness

The Experts

WHEN YOU CONNECT THE CLUES...

A THREAT

to older adults EMERGES

don't let influenza affect what you've done to help manage patients with chronic conditions, including those with diabetes and cardiovascular disease

influenza can threaten adults with chronic conditions

helping prevent influenza is linked to lower mortality risk for adults, regardless of health status2

influenza steals
$11.2 billion annually
14

DESPITE CONSISTENT VACCINATION RATES,
in
FLUenza REMAINS A THREAT TO older ADULTS

THERE ARE EFFECTIVE AGE-SPECIFIC VACCINE OPTIONS

The Experts