CDC Says Immunizations Are Critical for Older Americans

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Flu Deaths Doubled in Last Decade

As the 2003-04 flu season approaches, service providers in aging should be aware of a dramatic rise in deaths from influenza among elders, many of them preventable, in recent years. According to the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, the number of deaths from influenza complications nearly doubled during the last decade from about 20,000 per year throughout the 19705 and '80s to 36,000 deaths a year. Nine in 10 of those who succumb are older adults. During the 1970s through mid-1990s, about 114,000 people were hospitalized each year from influenza-related causes; about 43% were people age 65 or older.

In addition, 1998 data from CDC show that 3,400 older adults die from pneumonia, meningitis and other possible effects of invasive pneumococcal disease each year. Taken together, pneumonia and influenza are a leading cause of death among older adults, CDC's National Center for Health Statistics reports. The societal cost for a typical influenza epidemic alone has been estimated to exceed $10 billion, and CDC notes that more people die of influenza and invasive pneumococcal disease in the United States annually than die of AIDS, which took 15,600 lives in 2001.


CDC epidemiologist Keiji Fukuda said the new estimates on influenza deaths are actually more conservative than those for previous decades. CDC researchers believe the increase in influenza-related deaths is due in part to the aging of the U.S. population and the fact that more virulent strains of influenza viruses have been circulating during the last decade.

The number of deaths and the cost to society are likely to increase as the nation's population ages. The U.S. Census Bureau projects the number of adults age 65 or older will double from 35 million (or 13% of the population) in 2000 to 70 million (20% of the population) by 2030. The new estimates also indicate adults 85 and older-a population that doubled between 1976 and 1999-may be 32 times more likely to die of influenza complications than people ages 65 to 69.

According to CDC, one-third of elders in the United States do not get influenza shots and nearly half have never been vaccinated against pneumococcal disease. This information-and the fact that Medicare pays for the shots-highlights the need for continued public and physician education and incentives.

"People don't realize how serious the flu is," commented Alison Johnson, deputy director of the Immunization Services Division of CDC's National Immunization Program. The classic symptoms of the influenza virus are well known-fever and chills, dry cough, runny nose, body aches, headache and sore throat. Pneumonia begins with high fever, cough and chest pain. Although anyone can get influenza, older adults have a higher risk for complications, pneumonia, hospitalization or death. Serious illness and death are also a greater threat among those with medical conditions such as asthma and diabetes.

One reason people don't get vaccinated, say CDC scientists, is the prevalence of a myth that people can get the flu from a vaccination, even though the vaccine is made from a dead virus that cannot cause influenza. During fall months, however, when influenza vaccines are typically given, people often coincidentally experience a cold or another respiratory infection from a different organism soon after receiving an influenza shot. Thus, they may associate the vaccination with what they think may be a case of the flu. The most frequent side effect of immunization is soreness at the vaccination site that lasts less than two days.

Influenza vaccines must be updated annually to match the viruses expected to circulate in the coming year. Federal health officials and vaccine manufacturers start almost a year in advance to determine which strains of influenza to vaccinate against, CDC authorities explain. Delays in influenza vaccine availability can occur in years when scientists have difficulty determining which influenza strains are circulating worldwide, when a particular strain does not grow well, or when manufacturers need additional time to implement prescribed quality-control procedures. …