Influenza Vaccination and Mortality From Bronchopneumonia in the Elderly

Acute upper respiratory tract viral illness and influenza immunization in homes for the elderly

“…Although we failed to demonstrate a protective effect of influenza vaccine or a reduction in complications associated with influenza, several vaccine trials in the elderly have shown such benefits. In a 3-year study in Glamorgan, South Wales, Howells and colleagues [22] noted a reduction of over 80 % in the incidence of bronchopneumonia and mortality in immunized patients. Serie and co-workers [23] in France similarly found that complications and mortality were reduced by 90-95%, and Gross and co-workers [24] noted a reduction in mortality of almost 60%.…”

“…None of the patients died, but 2 of those infected with RSV developed pneumonia. Morales and co-workers [16] reported 12 RSV infections with 2 deaths among 159 respiratory episodes during a 6-month study of respiratory infections in geriatric wards in Edinburgh, and Sorvillo and colleagues [17] describe an outbreak in a Los Angeles County nursing home in which 40 out of 101 (40%) residents were affected, 22 (55%) of whom had pneumonia and 8 (20%) died. In the current study RSV infections were proven in 9 residents in 3 homes.…”

Influenza deaths in Leicestershire during the 1989–90 epidemic: implications for prevention

“…Twenty-two were admitted to hospital at least once in the preceding 5 [14], analysis of the medical records of residents of 11 homes for the elderly in Leicestershire [15], and immunization rates of the elderly population in the Trent Region [10]. Table 1.…”

“…Previous studies have found a decreased incidence of complications of influenza or influenza-like illness, including bronchopneumonia, hospital admission, and death in people receiving influenza vaccine compared to non-vaccinees [5][6][7][8]. None of these studies were truly randomized and since doctors are likely to vaccinate active medically-stable patients with chronic ill-health rather than inactive.…”

“…Influenza vaccine offers 60-80 % protection to healthy adults when vaccine and epidemic strains are closely related, but studies in elderly care homes reveal a mean protection of only 27 % against influenza-like illness for influenza A (H3N2) vaccines, and 21 % for influenza B vaccines [4]. Despite these poor results considerable reductions in the incidence of complications, including bronchopneumonia, hospital admission, and death, have been associated with the use of influenza vaccine in the elderly when vaccine and epidemic strains are closely related [5][6][7][8]. The Department of Health, the Welsh Office, and the Scottish Home and Health Department suggest that influenza vaccination be considered for elderly persons living in residential homes and long-stay hospitals, and for patients, especially the elderly, suffering with chronic pulmonary disease, chronic heart disease, chronic renal disease, diabetes and other less common endocrine disorders, and conditions involving immunosuppressive therapy [9].…”