Abstract
BackgroundOlder adults are at high risk for influenza-related complications including worsening frailty and function. We surveyed older Canadians to explore the impact of influenza and determine how influenza knowledge influences vaccination decision-making.MethodsWe disseminated an online survey through a national polling panel. The survey included questions about the respondents’ influenza vaccination practices and knowledge about influenza. Using validated measures, they reported their frailty and functional status prior to the 2016/17 influenza season, during illness (if applicable), and following the season. Regression analyses were used to examine predictors of poor functional outcomes.ResultsFive thousand and fourteen adults aged 65 and older completed the survey; mean age was 71.3 ± 5.17 years, 42.6% had one or more chronic conditions, 7.8% were vulnerable and 1.8% were frail. 67.9% reported receiving last season’s influenza vaccine. Those who rarely/never receive the influenza vaccine were significantly less likely to correctly answer questions about influenza’s impact than those who receive the vaccine more consistently. Of the 1035 (21.5%) who reported experiencing influenza or influenza-like illness last season, 40% indicated a recovery longer than 2 weeks, and one-fifth had health and function declines during this time. Additionally, 3.1% of those afflicted “never fully recovered”. Older age, significant trouble with memory and having influenza/ILI were among the independent predictors of persistent declines in health and function.ConclusionsGiven that frailty and function are important considerations for older adults’ well-being and independence, healthcare decision-makers must understand the potential for significant temporary and long-term impacts of influenza to make informed vaccine-related policies and recommendations.
Highlights
Older adults are at high risk for influenza-related complications including worsening frailty and function
The influenza vaccine is typically available in all provinces beginning in early-middle October, and residents can be vaccinated at any time before the end of the season but are encouraged to receive the vaccine as early as possible; the majority of individuals who opt to be vaccinated receive the vaccine by the end of December [8]
This is likely partially due to vaccine hesitancy created by reports that vaccine effectiveness (VE) is lower in older adults compared to younger populations [11,12,13,14,15]
Summary
Older adults are at high risk for influenza-related complications including worsening frailty and function. Half of influenza infections are asymptomatic or mild [2] and most who experience “influenza-like illness” (ILI; upper respiratory illness of sufficient severity to affect activities of daily living) will recover within 10 days [3] Others, those 65 years of age and older, are at greater risk for a more detrimental impact. To protect the health of older adults, Canada’s National Advisory Committee on Immunization (NACI) has set a national target immunization rate of 80% [9] and yet vaccine uptake in seniors remains sub-optimal at 64–67% [10] This is likely partially due to vaccine hesitancy created by reports that vaccine effectiveness (VE) is lower in older adults compared to younger populations [11,12,13,14,15]. This variability in VE is a source of debate [12] with recent research demonstrating that VE might be significantly confounded by frailty, a measure of vulnerability to adverse health outcomes based on accumulation of health, mobility and functional deficits [16]
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