Influenza can be fatal in the elderly

• 10% of all elderly influenza cases lead to the patient being unable to independently perform daily tasks after recovery, forcing them to rely on others.
• Influenza affects elderly patients more seriously than other groups, with their risk of stroke 8 times greater than the general population and their risk of developing coronary artery disease 10 times greater than the general population.
• The elderly influenza vaccine offers patients up to 24.2% greater protection against the influenza virus compared with traditional 4-strain influenza vaccines.

Influenza is a common infectious respiratory condition that is generally more prevalent during the monsoon season. The most common symptoms of an infection are fever, cough, aches and pains, although these tend to disappear within 3–5 days in less severe cases.
However, for elderly patients, or those with underlying health conditions such as chronic obstructive pulmonary disease, asthma, heart disease, cerebrovascular disease, chronic kidney disease, or diabetes, the risk of a serious infection requiring hospital treatment are higher. Based on data related to hospital stays resulting from influenza infections in Thailand, it has been found that infants and the elderly are the groups most at risk.

1. Immunosenescence
   The elderly are more at risk of contracting infections than the general population, including bacterial, fungal, or viral infections. The aging process, as well as the physical imbalances that such infections can cause, are factors behind severe inflammation, which is an immune system response that can be difficult to prevent and which can result in potentially life-threatening symptoms.
2. Underlying diseases
   The elderly, and groups with underlying diseases such as kidney disease, diabetes, and cancer, are at greater risk of developing more serious symptoms and complications from an influenza infection, including sinusitis, bronchitis and pneumonia, with some cases being fatal as a result.
3. Frailty
   Frailty is not technically a disease, but it is something that can affect people who are otherwise in good health. It is also a very common issue among the elderly. Indeed, 10% of all elderly influenza cases experience symptoms that inhibit their ability to perform daily tasks, meaning they must rely on others. Additionally, 1 in 3 elderly patients who require an overnight hospital stay end up incapable of independent tasks within 12 months of receiving treatment.

Influenza infections impact the bodies of elderly patients in more ways than in other groups, resulting in the following potential complications:

• A stroke risk that is 8 times greater than in the general population, and a risk of developing coronary artery disease that is 10 times greater than in the general population due to the inflammation caused by the influenza’s impact on heart and coronary function. This inflammation is a result of the fight between white blood cells and the virus, which is the cause of sore throat, headaches, aches and pains, blocked nose, and fatigue, for instance. Additionally, the increased white blood cell production resulting from the body’s fight against viruses or bacteria can lead to thrombosis which is capable of elevating blood pressure and inhibiting circulation, both of which can restrict blood flow to the brain and heart.
• 75% of diabetics who contract influenza experience blood glucose regulation issues. Hyperglycemia impedes white blood cell function, which also inhibits the body’s ability to fight off the infection. Diabetics are therefore more at risk of contracting the virus and experiencing complications, such as pneumonia, ear infections, and other potentially life-threatening symptoms, than the general population.
• Elderly patients with weakened immune systems have a heightened risk of complications arising from pneumonia. This includes blood stream infections and respiratory failure, which are responsible for 50% of all elderly deaths attributed to influenza, and is why pneumonia is such a feared condition for elderly patients.
• 23% of elderly patients who contract influenza are no longer able to independently perform tasks, even after recovering from the disease.

It is possible to prevent influenza with annual vaccinations, which are necessary due to the yearly transformations that the virus undergoes, as well as to combat various strains of the disease.

The influenza vaccine can be administered at any time throughout the year, although the most suitable times are just prior to the rainy season (May) and before winter (October) as these times are when the disease is most prevalent.

There is now a specially designed elderly influenza vaccine available that can offer greater protection for this group. Additionally, this vaccine can reduce hospital stays owing to various other complications, such as influenza-related pneumonia, respiratory complications, and influenza symptoms themselves.

The elderly influenza vaccine contains 4 times as many antigens compared to traditional influenza vaccines, and is most suited to patients age 65 and above.
(Ref: Quadrivalent Influenza Vaccine (Split Virion, Inactivated), 60 mcg HA/strain SMPC. Internal data)

A study undertaken in the U.S.A. and Canada from 2011 – 2013 on a sample group of 31,989 patients aged 65 and over involved comparing efficacy between the traditional 4-strain influenza vaccine and the newly developed elderly influenza vaccine. Researchers found that the elderly influenza vaccine increased protection by up to 24.2% more than the traditional 4-strain influenza vaccine.

The study also found that in addition to the protection it offered against influenza, the elderly influenza vaccine reduced hospitalization and mortality rates resulting from various other complications more than the traditional influenza vaccine.

• A 64.4% reduction in hospitalization from influenza or pneumonia.
• A 48.9% decrease in the mortality rate.

As of today, more than 202 million doses of this vaccine have been administered worldwide and elderly patients have been closely monitored afterward. Based on more than 10 years of data, it has been found that there are no safety concerns related to its use and there have been no reports of unwanted serious side effects.
In terms of systemic reactions to the vaccine, the occurrence risks are no different to those associated with the traditional 4-strain influenza vaccine.