Flu Shots: An Ounce of Prevention Is Especially Vital for the Elderly

When it comes to keeping elderly Americans safe and healthy at home and in the community, disease prevention is the coin of the realm. It keeps chronic conditions from getting worse, saving countless dollars in avoided emergency room visits and expensive treatments — and often people’s lives as well.

With that in mind, what if I told you there was a simple shot that prevents thousands of deaths each year among older, frail Americans, a vaccination that valiantly fights an illness whose victims, when it is fatal or leads to a hospital visit, are overwhelmingly — up to 85% — elderly? And what if you learned that this shot costs seniors no money out of pocket, has negligible side-effects, and is available virtually everywhere — including most doctor’s offices, centers where seniors gather, and everyone’s neighborhood pharmacy.

I’m talking, of course about, a flu shot — something that the Centers for Disease Control recommends every year for most Americans over the age of 6, and especially for people 65+. This year’s flu season is proving more virulent than usual, and doctors are being especially vehement in their calls for people to get vaccinated. During just one week in mid-January, more than 1,600 New Yorkers were hospitalized with the flu — the highest weekly total since 2004, according to the New York State Department of Health. As of January 13, 17,362 cases of the illness had been reported across New York and more than 5,000 people had been hospitalized. With flu season expected to continue until April and the spread of the disease rampant, it’s not too late to get the flu shot if you (or an elderly loved one) haven’t already done so.

Those 65 and older are especially vulnerable if they skip vaccination, because invasive diseases like flu can worsen the chronic conditions that the majority of seniors are already coping with (surveys show that 80% in this age group have at least one chronic illness and 77% have at least two). In addition, our immune system tends to weaken as we age, and it responds more slowly to infectious diseases. “The purpose of the vaccine is not only to prevent disease but also, if people do get the flu, to prevent complications, so that the chronic conditions they’ve been living with don’t become life-threatening,” says Lisa George, MD, an infectious-disease physician and Senior Medical Director for VNSNY CHOICE Health Plans, where I work.

In addition to the flu shot — which you must get each year in order to fight that season’s specific strains of the virus — the CDC also recommends that seniors also stay updated on these vaccines:

· Pneumococcal vaccine, a series of two vaccines to protect against pneumonia, including infections in the lungs and bloodstream, which can be particularly devastating for elders. For more details, see CDC recommendations here.

· Shingles vaccine, whether or not you recall having chicken pox as a child, is recommended to prevent this painful, blistering skin rash caused by the chicken pox virus. For more details, go here.

Vaccines: Myth vs. Reality

Our RN care coordinators are often asked why, if vaccines have such a proven track record of success, do people still resist getting vaccinated? Often, the following common misperceptions stand in the way:

Myth: “I can’t afford it.”

Reality: Under Medicare, there is no out-of-pocket cost for flu or pneumonia vaccinations when they’re administered in accordance to CDC guidelines. Shingles vaccines are also covered by most plans, though co-payments vary.

Myth: “I don’t want to get the flu, or other side effects, from the flu shot.”

Reality: While some people may experience mild side effects from the flu vaccine, including pain or redness at the injection site and/or mild headache or muscle ache, those minor discomforts do not compare to the potential for complications if you don’t get the shot. “Even if you do feel a little ill from the vaccine, it’s momentary and very mild compared to what can happen if you get the full-on flu, especially for people like our health plan members, who have a lot of comorbidities,” says Corrissa Sanford-Faber, Director of Quality for VNSNY CHOICE.

Myth: “I hear this year’s vaccine doesn’t work.”

Reality: Every year, it seems, rumors circulate about the relative effectiveness of that season’s batch of vaccines, and this year has been no different. But health officials repeatedly point out that even a less-than-perfect flu vaccine is much better than nothing. “Even in an ineffective year, the benefits greatly outweigh the harms,” healthcare expert Aaron E. Carroll writes in The New York Times.

4. “I’m healthy; I’ll take my chances.”

Vaccines are not only a private concern — they are public health’s greatest success story, building a firewall that helps contain viruses from spreading rapidly through vulnerable populations.

The Power of Prevention

“When it comes to managing care for elderly New Yorkers, prevention is the key word,” Dr. George emphasizes. The idea extends well beyond vaccines, to providing a plan of care that takes into account physical, behavioral and social health factors, and that covers chronic conditions, patient education and eliminating barriers to access.

Recently, for example, hundreds of older New Yorkers gathered at senior centers across the New York City metro area to learn more about preventing the painful condition known as shingles, whose incidence increases with age. The VNSNY workshops, funded by the New York Foundation for Eldercare with support from the NYC Department for the Aging and local pharmacies, were conducted in multiple languages and offered shingles vaccinations on site at no cost to the seniors who requested them.

Robust care management and healthcare education are particularly important during flu season. That’s why we send every member of our CHOICE Health Plans information on how to prevent the illness, including the importance of getting the annual vaccine, along with hand-washing and other measures. Our care managers work with home health aides — who are the front line of day-to-day care — so they can educate and inform their clients about flu prevention. We even have our transportation vendors, who drive elderly members to and from doctor’s appointments, distribute fliers on flu prevention at the end of each trip. “We remind our members every chance we get that they are protecting themselves, as well as keeping others safe, by getting a flu shot,” says Corrissa.

President of VNSNY CHOICE Health Plans at Visiting Nurse Service of NY, and a leading healthcare expert focused on elder independence.