Flu & People 65 Years And Older
On June 30, 2022, CDC announced that Director Rochelle P. Walensky adopted the Decision memo approving the ACIP vote for a preferential recommendation for the use of higher dose or adjuvanted flu vaccines over standard-dose unadjuvanted flu vaccines for adults 65 years and older. CDCs full recommendations for the use of flu vaccines during 2022-2023 will appear in a forthcoming Morbidity and Mortality Weekly Report. Edits to this page are also forthcoming. More information can be found online: CDC Director Adopts Preference for Specific Flu Vaccines for Seniors
People 65 years and older are at higher risk of developing serious flu complications compared with young, healthy adults. This increased risk is due in part to changes in immune defenses with increasing age. While flu seasons vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu disease. In recent years, for example, its estimated that between 70 percent and 85 percent of seasonal flu-related deaths have occurred in people 65 years and older, and between 50 percent and 70 percent of seasonal flu-related hospitalizations have occurred among people in this age group.
People At High Risk For Developing Flu
Most people who get the flu will have mild illness, will not need medical care or antiviral drugs, and will recover in less than two weeks. Some people, however, are more likely to get flu complications that result in being hospitalized and occasionally result in death. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. The flu also can make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may experience a worsening of this condition that is triggered by the flu. The list below includes the groups of people more likely to get flu-related complications if they get sick from influenza.
What Are The Symptoms Of Influenza
Flu symptoms often appear suddenly. People at higher risk of complications, such as those with chronic lung disease, should seek prompt medical attention. Treatment may include antiviral medicine which can reduce symptoms if started within a day or two of getting sick.
Symptoms of influenza can include:
- Sudden onset of high fever
- Headache, muscle aches and joint pain
- Nasal congestion and runny nose
- Stomach symptoms such as nausea, vomiting or diarrhea may occur but are more common in children than adults.
Most people recover from the flu within one or two weeks, but others, especially the elderly, may feel weak for a long time even after other symptoms go away.
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What About Influenza Complications
In some cases of the flu, severe illness and complications can develop. This can result in hospitalisation and even death.
The flu can also make some existing medical conditions worse.
In Victoria, flu vaccination is free for people with a higher risk of severe complications associated with the flu:
- children aged 6 months to less than 5 years
- Aboriginal and Torres Strait Islander people from 6 months and over
- pregnant women at any stage of pregnancy
- people 65 years and over
- people aged 6 months and older with medical conditions putting them at higher risk of severe flu and its complications:
- cardiac disease
- children aged 6 months to 10 years on long term aspirin therapy.
Pregnant And Postpartum Women
Those who are pregnant or have given birth in the past two weeks are more at risk of flu complications and hospitalization due to the virus than women who are not pregnant. This is because pregnancy brings changes to the immune system, heart, and lungs. As well, fever can cause negative outcomes for a developing fetus.
The CDC recommends flu vaccination during pregnancy to protect both women and their babies during the first few months of life.
A study in 2018 analyzed the effectiveness of the flu vaccine in pregnancy. It found that the vaccine reduced the risk of hospitalization for flu during pregnancy by 40%.
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Flu Vaccines For People With Diabetes
- Injectable influenza vaccines are recommended for use in people with diabetes and certain other health conditions. Flu shots have a long, established safety record in people with diabetes.
- The live attenuated influenza vaccine , also known as the nasal spray vaccine, is recommended as an option for use in people 2 through 49 years old who are not pregnant. But people with some chronic medical conditions should generally not received LAIV. Your doctor or other health care professional can answer any questions you might have about flu vaccine.
Get pneumococcal vaccines.
- Having flu increases your risk of getting pneumococcal disease. Pneumonia is an example of a serious complication that can cause death.
- People who have diabetes also should be up to date with pneumococcal vaccination to help protect against pneumococcal disease. Pneumococcal vaccination should be part of a diabetes management plan. Talk to your health care provider to find out which pneumococcal vaccines are recommended for you.
Who Is Most At Risk This Flu Season
PINEVILLE, WV The 2019-2020 flu season is upon us and pharmacies are seeing an increase in flu cases this season. Gena Carter, with the Wyoming County Health Department, said there are several things for you to do to make sure you do not get the flu.
Stay away from anybody that is sick, Carter said. If you get the flu you need to stay home from work or school for at least 24 hours after the fever has ended, without any Tylenol or Motrin that would alter your temperature.
Carter said there are age groups that are most at risk to get the flu including young children, adults 65-years-old and older, and pregnant women. Carter warns it is very important to get the flu shot to protect yourself and others who can not protect themselves.
You not only protect yourself but you protect the people that cant be vaccinated, Carter said. The Immunol suppressed, people that are battling cancer. There are people that cant get the flu vaccine so your not only protecting yourself but your protecting others.
Cater said while the flu season is well underway, it is not to late to get the flu shot. You can get the shot at your local health department or any local pharmacies.
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Patients With Uncomplicated Seasonal Influenza:
Patients that are not from a high risk group should be managed with symptomatic treatment and are advised, if symptomatic, to stay home in order to minimize the risk of infecting others in the community. Treatment focuses on relievingsymptoms of influenza such as fever. Patients should monitor themselves to detect if their condition deteriorates and seek medical attention Patients that are known to be in a group at high risk for developing severe or complicated illness, should be treated with antivirals in addition to symptomatic treatment as soon as possible.
Patients with severe or progressive clinical illness associated with suspected or confirmed influenza virus infection should be treated withantiviral drug as soon as possible.
- Neuraminidase inhibitors should be prescribed as soon as possible to maximize therapeutic benefits. Administration of the drug should also be considered in patients presenting laterin the course of illness.
- Treatment is recommended for a minimum of 5 days, but can be extended until there is satisfactory clinical improvement.
- Corticosteroids should not be used routinely, unless indicated for other reasons as it has been associated with prolonged viral clearance, immunosuppression leading to bacterial or fungal superinfection.
- All currently circulating influenza viruses are resistant to adamantane antiviral drugs , and these are therefore not recommended for monotherapy.
The Types Of Flu Vaccine Available
There are several types of flu vaccine. You will be offered one that is most effective for you, depending upon your age, from the following:
- children aged 2 to 17 are offered a live vaccine as a nasal spray. The live viruses have been weakened so it cannot give you flu
- adults aged 18 to 64 are offered an injectable vaccine. It is an inactivated vaccine that does not contain any live viruses and cannot give you flu. There are different types available depending on how they were manufactured
- adults aged 65 and over are offered an injected vaccine. It is an inactivated vaccine that does not contain any live viruses and cannot give you flu. Usually, you will be offered one that contains an adjuvant that helps the immune system create a stronger response to the vaccine. It is offered to people in this age group because as people age their immune system responds less well to vaccines
If your child is aged between 6 months and 2 years old and is in a high-risk group for flu, they will be offered an injected flu vaccine as the nasal spray is not licensed for children under the age of 2. Some children over the age of 2 who are in a high-risk group will also need to have an injected vaccine if the nasal spray vaccine is not suitable for them.
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People With Certain Chronic Health Conditions
- Heart disease: Heart disease patients are six times more likely to have a heart attack within seven days of influenza infection. People with heart disease and those who have had a stroke are at higher risk for developing serious complications from flu, and even death. Increased inflammation caused by flu infection can make heart disease symptoms worse even weeks after flu symptoms have resolved, leaving people vulnerable to permanent loss of function and disability.
- Lung disease : People with asthma and/or Chronic Obstructive Pulmonary Disease have an increased risk of developing serious flu-related complications. Flu can have a direct effect by increasing inflammation in the lungs and airways, which can trigger asthma attacks and make COPD symptoms worse
- Diabetes: People with diabetes have a greater risk of flu-related complications. Diabetes can interfere with the bodys ability to fight flu, and flu infection can interfere with management of blood sugar levels
- Compromised immune system: People who have weakened immune systems such as current and former cancer patients and people living with HIV/AIDS are at higher risk of developing serious flu-related complications, including hospitalization and death
- Obesity: Individuals with a body mass index of 40+ have a higher rate of serious flu-related complications, including hospitalization
What To Expect With Influenza
Symptoms of the flu can hit very quickly and may last several weeks. A bout of the flu typically follows this pattern:
- Days 13: Sudden appearance of fever, headache, muscle pain and weakness, dry cough, sore throat and sometimes a stuffy nose.
- Day 4: Fever and muscle aches decrease. Hoarse, dry or sore throat, cough and possible mild chest discomfort become more noticeable. You may feel tired or flat.
- Day 8: Symptoms decrease. Cough and tiredness may last one to two weeks or more.
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When To See Your Doctor
For your yearly flu shot. Everyone 6 months and older should visit a healthcare provider every year to get a flu vaccine. The best time to go is soon after the vaccine becomes available in the fall.
If you develop flu symptoms. If you do get sick, it is important for you to call your doctor as soon as possible to receive prompt treatment with antiviralsespecially if you are at high risk for complications. Antivirals can be effective in reducing the severity of flu and the duration of the disease.
For flu complications. Pneumonia can be caused by the flu virus or by bacteria that get into the lungs when the body’s defense system is weakened by the flu. See a doctor if you:
- Have difficulty breathing
- Experience chest pain as a result of coughing or
- Are coughing up yellow, green or bloody phlegm.
Other infections that may be associated with the flu include sinusitis, bronchitis and ear infections.
If your cough won’t go away. You may have a cough that lasts for weeks to months after flu symptoms go away and it may keep you up at night. This cough has been associated with asthma-like symptoms, and can be treated with asthma medications. Consult a healthcare provider if you have this kind of cough.
How Else Can I Protect Myself From Flu
Aside from receiving the flu vaccine, the best way to stay protected during flu season is to practise good hygiene.
The flu virus is spread via coughs and sneezes, since it is carried in infected droplets from the nose and mouth. A common route of transmission is to touch a contaminated surface and then touch your face, which is why its important to wash your hands regularly during flu season.
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Those At Increased Risk From The Effects Of Flu
Flu can affect anyone, but if you have a long-term health condition, the effects of flu can make it worse even if the condition is well managed and you normally feel well. You should have the free flu vaccine if you are:
or have a long-term condition such as:
- a heart problem
- a chest complaint or serious breathing difficulties, including bronchitis, emphysema or some people with asthma
- a kidney disease
- lowered immunity due to disease or treatment
- liver disease
- had a stroke or a transient ischaemic attack
- a neurological condition, such as multiple sclerosis or cerebral palsy
- a learning disability
- a problem with your spleen, such as sickle cell disease, or you have had your spleen removed
- you are seriously overweight
This list of conditions isnt definitive. Its always an issue of clinical judgement. Your GP can assess you to take into account the risk of flu making any underlying illness you may have worse, as well as your risk of serious illness from flu itself.
People With Chronic Health Problems Or Weakened Immune Systems
If you deal with a chronic health condition such as asthma, heart disease, COPD, diabetes, or blood, liver, or kidney disorders, youre at a higher risk of developing flu-related complications, according to the CDC. Complications can include things such as pneumonia, bronchitis, and sinus and ear infections, to name just a few.
When your body is coping with a chronic health issue, your immune system is already overloaded, explains Donna Casey, MD, an internal medicine physician at Texas Health Presbyterian Hospital Dallas. And because of that extra workload, it has fewer available resources to devote to fighting off infections like the flu. The same is true if you have an immune-lowering disease such as HIV/AIDS or leukemia, or if you receive drugs that compromise your immunity such as chemotherapy, radiation, or chronic corticosteroids.
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How Do People Die From The Flu
People often mistake the flu for a bad cold, since flu symptoms mimic a cold. When you catch the flu, you might experience coughing, sneezing, runny nose, hoarse voice, and a sore throat.
But flu can progress into conditions like pneumonia, or worsen other chronic issues like chronic obstructive pulmonary disease and congestive heart failure, which can quickly become life-threatening.
Flu can directly lead to death when the virus triggers severe inflammation in the lungs. When this happens, it can cause rapid respiratory failure because your lungs cant transport enough oxygen into the rest of your body.
The flu can also cause your brain, heart, or muscles to become inflamed. This can lead to , an emergency condition that can be fatal if not immediately treated.
If you develop a secondary infection while you have the flu, that can also cause your organs to fail. The bacteria from that infection can get into your bloodstream and cause sepsis, as well.
In adults, symptoms of life-threatening flu complications include:
- feeling short of breath
- difficulty waking up
People with compromised immune systems are at a higher risk of developing complications and possibly dying from the flu.
When your immune system is weakened, youre more likely to experience viruses and infections in a more severe form. And your body will have a harder time not only fighting those off, but also fighting any subsequent infections that could develop.
Children And The Flu Vaccination
If you have a child over 6 months of age who has one of the conditions listed above, they should have a flu vaccination. All these children are more likely to become severely ill if they catch flu, and it could make their existing condition worse.
Talk to your GP about your child having the flu vaccination before the flu season starts.
The flu vaccine does not work well in babies under 6 months of age so it is not recommended. This is why it is so important that pregnant women have the vaccination they will pass on some immunity to their baby that will protect them during the early months of their life.
Some other groups of children and young people are also being offered the flu vaccination. This is to help protect them against the disease and help reduce its spread both to other children, including their brothers or sisters, and, of course, their parents and grandparents. This will help you to avoid the need to take time off work because of flu or to look after your children with flu.
The children being offered the vaccine this year, are:
- all children aged 2 or 3 years old on 31 August 2021
- all primary school-aged children
- all year 7 to year 11 secondary school-aged children
- children with a health condition that puts them at greater risk from flu
For more information on children and flu vaccination, visit NHS.UK.
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