Influenza and older people

The World Health Organization and the Ministry of Health recommend annual influenza vaccination for all adults aged 65 years or older. Annual influenza vaccination is funded for all eligible adults aged 65 years or older.

Aging and the serious impact of influenza infection

The natural decline in immune function associated with aging can increase an older person’s vulnerability to both the risk of infectious disease and serious complications.

Disease complications in older people with influenza include pneumonia, secondary bacterial infection, acute coronary syndrome (including AMI), heart failure, ischaemic stroke, haemorrhagic stroke, exacerbation of asthma and increased frailty. Influenza may also exacerbate chronic underlying conditions, including cardiovascular disease, ischaemic heart disease (IHD), heart failure, and chronic obstructive pulmonary disease (COPD).

Influenza increases the risk of mortality

Mortality is significantly higher in older people with influenza than younger healthy adults with influenza. The risk of influenza- related death increases with advancing age, the presence of chronic conditions, or increasing levels of frailty.

Influenza increases the risk of hospitalisation

The risk of influenza-related hospitalisation is greater for older people compared with healthy adults aged under 65 years. Increasing levels of frailty and the presence of chronic conditions such as diabetes or heart, kidney, neurological or respiratory diseases add to the risk of influenza-related hospitalisation.

Influenza increases the risks of disability and frailty

Older people have lower physiological reserves to aid a return to pre-illness function. Periods of restricted activity or hospitalisation related to illness or injury in older people living in the community are significant causes of ongoing disability completing activities of daily living (ADLs).

Following hospitalisation of older people living in the community with an illness such as influenza, disability completing ADLs was substantially higher in those who required admission to an intensive care unit (ICU) than those who did not. In a review, 10–63% of older people admitted to an ICU experienced new or worsened disability with ADLs during the year after discharge. The disability persisted beyond the first year in of these people.

Admission of older adults to an ICU is related to a two-fold increase in outcomes such as polypharmacy, urinary incontinence, depression, immobility, faecal incontinence and cognitive impairment in the subsequent 12 months. The survival rate of older people has also been shown to be reduced following discharge from an ICU, ranging from two-thirds at 6 months to around half at 12 months (66% and 49%).

Influenza vaccination supports healthy aging and maintenance of independence for older people

Discuss influenza vaccination with older people and their whānau:

1. Explain:

a. Annual influenza vaccination supports healthy aging, independence and quality of life.

b. They are more likely to catch influenza and get very ill or die, even if they are fit and healthy.

c. Influenza vaccination can protect them from getting influenza or if they get influenza, they are less likely to get very ill.

d. Influenza vaccination cannot give them influenza as it does not contain live viruses.

e. Being immunised can stop them giving flu to their family and friends.

2. Make a clear recommendation that they receive an influenza vaccination.

3. Suggest that family and friends in regular contact also get vaccinated against influenza.

Further information