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Protecting Older, Vulnerable Patients From the Flu

Author Information (click to view)

Merle C. Turner, DO

Founder and Medical Director
Family Practice Physician
Warner Family Practice

Merle C. Turner, DO, has indicated to Physician’s Weekly that he has, in the past, served as a paid speaker for Atherotech, CardioDX, and Sanofi Pasteur.

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Merle C. Turner, DO (click to view)

Merle C. Turner, DO

Founder and Medical Director
Family Practice Physician
Warner Family Practice

Merle C. Turner, DO, has indicated to Physician’s Weekly that he has, in the past, served as a paid speaker for Atherotech, CardioDX, and Sanofi Pasteur.

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When considering influenza vaccine resources for the season, it’s important to offer a variety of vaccine options and newer delivery systems.
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People aged 65 and older account for more than 60% of the estimated 226,000 flu-related hospitalizations and 90% of the 3,000 to 49,000 flu-related deaths in the United States each year. This age group is at highest risk for contracting influenza and developing its potentially serious complications, including pneumonia, bronchitis, sinus and ear infections, and coronary problems. Flu symptoms can even exacerbate other comorbid conditions. This puts patients at greater risk for complications and reduces quality of life. Collectively, these health issues can result in hospitalization and even death in older patients.

Be Vigilant of Those at Higher Risk for Flu

As the 2012-2013 influenza season continues and we look ahead to the next, it’s important to improve community-wide vaccination rates so that we can protect public health, especially when treating adults aged 65 and up. Seniors are at higher risk for influenza because the immune system weakens with age. In turn, the body’s ability to produce a sufficient amount of protective antibodies is reduced.

When considering influenza vaccine resources for the season, it’s important to offer a variety of vaccine options and newer delivery systems.

Merle C. Turner, DO

A few years ago, the healthcare world received good news when a higher dose of the influenza vaccine was approved by the FDA for older patients. Designed for those aged 65 and older, the vaccine generates a stronger immune response because it contains four times the amount of antigen as the standard dose. While the high-dose vaccine has shown a higher risk for side effects at the injection site, there is no greater risk of a systemic reaction than from that of a standard-dose flu vaccination.

Slow Adoption of Higher-Dose Flu Vaccine

The higher-dose vaccine has yet to become a standard option among healthcare practitioners. Some providers may be unaware that the higher-dose vaccine is covered by insurance. Others feel it’s more prudent to wait for real-world efficacy studies before using the higher-dose vaccine, but unfortunately, these analyses are years away from emerging. Physicians need to become more proactive in offering the higher-dose vaccine. The higher-dose vaccine is among the influenza vaccinations included in the CDC’s recommendations for preventing and controlling influenza; it’s also covered by Medicare Part B.

Think Ahead During Flu Season

In today’s healthcare climate, physicians are forced to consider the business aspects of treating the flu. When considering influenza vaccine resources for the season, it’s important to offer a variety of vaccine options and newer delivery systems. Being prepared with these options can increase the reach of medical practices by attracting a diverse patient base with varying needs. This kind of forward-thinking can benefit practitioners and simultaneously improve efforts to increase immunization rates, thereby reducing flu-related hospitalizations and deaths.

In practices nationwide, it’s critical to review the patient population and be armed with different influenza vaccine options, especially for adults aged 65 and older. Only then can we maximize our ability to protect patients from the flu and make the disease an annual priority that is addressed the best way possible.

Readings & Resources (click to view)

U.S. Department of Health & Human Services. Seniors. Available at: http://www.flu.gov/at-risk/seniors/index.html.

Rothberg, MB, Haessler, SD, Brown, RB. Complications of viral influenza. Am J Med. 2008;121:258-264. Available at: http://download.thelancet.com/flatcontentassets/H1N1-flu/pathogenesis/pathogenesis-8.pdf.

CDC. What You Should Know and Do this Flu Season If You Are 65 Years and Older. Available at: http://www.cdc.gov/flu/about/disease/65over.htm.

CDC. Estimates of deaths associated with seasonal influenza – United States, 1976-2007. MMWR. 2010;59:1057-1062.

CDC. Fluzone High-Dose Seasonal Influenza Vaccine. Available at: http://www.cdc.gov/flu/protect/vaccine/qa_fluzone.htm.

U.S. Food and Drug Administration. December 23, 2009 Approval Letter. Fluzone High-Dose. Available at: http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm195481.htm.

Centers for Medicare & Medicaid Services. Medicare Learning Network. Influenza vaccine payment allowances: annual update for 2010-2011 season. Available at: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM7120.pdf.

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