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Protecting the Elderly Against Influenza: When and How is Vaccination Made Most Effective?

D'Arcy L. Little, MD, CCFP
Director of Medical Education
York Community Services, Toronto, ON

Introduction
Influenza, an acute respiratory illness, causes more adults to seek medical attention than any other respiratory infection. In Canada, influenza is a seasonal disease, causing annual epidemics that affect 10-20 percent of the population and result in approximately 4,000 deaths, 70,000 hospitalizations, and 1.5 million days of lost work.1 The elderly (people aged 65 years and older), and those with chronic cardiopulmonary disorders, diabetes and other metabolic diseases, have an increased risk of developing influenza complications. Hospitalization rates among elderly patients increase markedly during major influenza epidemics, and 90% of the deaths attributed to influenza and pneumonia are observed in this population.2

Vaccination remains the most reliable means of preventing an influenza infection and the resultant morbidity and mortality. Despite the significance of influenza, efforts to vaccinate the elderly remain suboptimal. A large study conducted in the Netherlands revealed that healthy elderly people avoid influenza vaccination because they fear the side effects, and because they believe that their general health is good and that the benefits of vaccination are, therefore, minimal.