Alzheimer’s Dementia and Flu: Little Known Running Mates

Autumn brings beautiful leaves, contentious elections and……vaccination proddings to avoid influenza. While there are few who aren’t moved by scenes of beautiful orange, crimson and gold leaves on a hillside, few want to discuss the upcoming election between Clinton and Trump. But when we do, we learn there is no changing the minds of those deeply entrenched in one camp or the other and that there are few who haven’t decided.

Similarly, when you sit in a physician’s office, there are few who are neutral on influenza vaccines, also commonly called “flu shots.” You either believe in them or you don’t. I offer them to all, touting their importance and effectiveness, especially for those with Alzheimer’s disease and related dementias and those who partner in their care.

So…while not everyone may be convinced to follow my advice, you may want to check out the CDC website for frequently asked questions about influenza vaccination at  http://www.cdc.gov/flu/about/season/flu-season-2016-2017.htm.

And I will give you less commonly advertised information pertinent to those with Alzheimer’s disease or related dementias and those who care for them.

• Dementia is a risk factor for developing influenza—making flu immunization particularly important in this group.
• High-dose vaccination is 22% more effective in preventing flu-related hospitalizations than typical-dose vaccination in adults older than 65^1,2. That is a substantial reduction! Studies are currently ongoing in individuals in skilled nursing facilities.
• Risk of heart attack (or myocardial infarction) is linked to recent flu infection. In individuals with or at high risk of heart disease (eg, those with a family history of heart disease, high cholesterol levels, or high blood pressure), the effectiveness of vaccination in preventing heart attacks is reported between 15% and 45%. This is similar to the effectiveness of stopping smoking (32%-43%) or treatment to lower cholesterol (19%-30%) or high blood pressure (17%-25%)^3,4.

Consider this

• Influenza may be prevented or severity of the illness lessened with immunization.
• You don’t need to go to the doctor’s office to be vaccinated. Pharmacists are an integral part of the healthcare team and can inform you about and administer the vaccine⁵. Going to a local pharmacy is so convenient, and usually an appointment isn’t even needed.
• The impact of flu infection—higher rates of heart attack for example—are lessened with immunization.
• There is no evidence that getting immunized gives you the flu. A bit of a sore arm, yes. But if you develop a respiratory infection soon after being immunized, it is because you’ve been exposed to the host of viruses common during autumn and winter, not the vaccine.
• Remember to wash your hands often to prevent the spread of infection.

 

REFERENCES

1. DiazGranados CA, Dunning AJ, Kimmel M, et al. Efficacy of high-dose versus standard-dose influenza vaccine in older adults. N Engl J Med. 2014;371:635–645.
2. Izurieta HS, Thadani N, Shay DK, et al. Comparative effectiveness of high-dose versus standard-dose influenza vaccines in US residents aged 65 years and older from 2012 to 2013 using Medicare data: a retrospective cohort analysis. Lancet Infect Dis. 2015;15:293–300.
3. Barnes M, Heywood AE, Mahimbo A, et al. Acute myocardial infarction and influenza: a meta-analysis of case-control studies. Heart. 2015;101(21):1738–1747.
4. MacIntyre CR, Mahimbo A, Moa AM, et al. Influenza vaccine as a coronary intervention for prevention of myocardial infarction. Heart. 2016 Sep 29. pii: heartjnl-2016-309983.
5. Isenor JE, Edwards NT, Alia TA, et al. Impact of pharmacists as immunizers on vaccination rates: A systematic review and meta-analysis. Vaccine. 2016;34(47):5708–5723.