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  health > seniors > story page AIDSAlternative MedicineCancerDiet & FitnessHeartMenSeniorsWomen

Physicians call for change in flu vaccine recommendations

October 4, 1999
Web posted at: 12:51 PM EDT (1651 GMT)

In this story:

Serious condition

Caregivers not exempt


By John A. Cutter

(WebMD) -- As another flu season approaches, a leading physicians' organization is recommending everyone 50 years and older receive a vaccination against influenza.

That represents a much lower age than the previous recommendation, which called for people 65 years and older to get flu shots, as well as people of all ages with special health conditions. Officials at the American Academy of Family Physicians called for the change during a September meeting in Orlando, Florida, because the rate of flu-related deaths rises once people pass age 50.

"We're not talking about a small public health problem; we're talking about a major problem," said Dr. Richard Zimmerman of the University of Pittsburgh and a member of the academy's Commission on Clinical Policies and Research.

The new recommendation grows out of an expanding body of research suggesting the age should be lower. Officials at the U.S. National Center for Health Statistics say people ages 45 to 64 are about five times more likely to die from influenza and its complications than people who are ages 25 to 44. Once a person passes age 65, the chances of dying from influenza or a related illness such as pneumonia rise to about 100 times that of people ages 25 to 44.

Serious condition

Each year, influenza and influenza-related pneumonia kill an estimated 20,000 to 40,000 people in the United States, according to the academy. The best time to get a flu shot is between October 15 and November 15, before the winter-long flu season starts. Medicare and many private insurance plans will cover the cost.

"Elderly people really are at significantly higher risk of serious complications of the flu and of dying from those flu complications," says Dr. Carolyn Buxton Bridges, a medical epidemiologist with the influenza branch of the U.S. Centers for Disease Control and Prevention in Atlanta. "The flu shot is not 100 percent effective, but you want to do whatever you can to help lower the risk for yourself or someone in your care," like a frail older parent or a partner with a chronic lung, heart, kidney or diabetic illness.

Influenza can threaten people of all ages, but at the moment, the CDC has not joined the academy in recommending routine flu shots for everyone 50 and older. The idea, however, is under study by the federal Advisory Committee on Immunization Practices.

Caregivers not exempt

However, what Bridges does emphasize is that people who are around frail older persons should get the flu shot to reduce the seniors' risk of infection. The virus is spread easily when an infected person coughs or sneezes. It also can be picked up on surfaces that an infected person touches.

Many caregivers who forget about getting flu shots for themselves figure if they get the flu, they will not infect their parents. But such thinking can be dangerous. The shot is less effective in older persons and those with chronic illnesses because the vaccine does not result in as high an immunity in them as it does in younger persons. So a caregiver with the flu still can infect a parent who has received the vaccine.

In healthy people, the flu shot is about 70 to 90 percent effective, Bridges says. In adults past age 65, it is about 30 to 70 percent effective in preventing a bout with the flu, she adds.

"The flu, even as a mild case, usually makes healthy people very sick. They may end up in bed for two weeks and feel as if they were hit by a Mack truck," she explains. "It can be worse for someone who is frail or has a chronic illness."

The immunity from the shot usually lasts for the typical flu season, which runs from November through the early spring. Bridges says older people also should consider getting the pneumonia vaccine, which can last for up to 10 years.

This year's flu shot contains inactivated viruses to boost people's immunity against the three strains of influenza that are expected to circulate this winter in America. There are many strains of flu, and different ones can be active in different years.

Because the viruses in the shots are not active, they cannot cause influenza, health experts agree. Some people experience soreness in the arm after the shot, and others might have a slight fever. However, people who are allergic to eggs should not receive flu shots because they can experience an allergic reaction.

Copyright 1999 WebMD, Inc. All rights reserved.

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