Cardiovascular-targeted patient education and uptake of influenza vaccination in elderly patients.

Abstract

Elderly patients are especially vulnerable to influenza and its complications but their vaccination coverage remains unsatisfactory. Prospective study of hospitalized or ambulatory patients ≥65 years of age. A questionnaire on influenza vaccination was followed by short physician-administered verbal instruction on risk of 'heart-attack and stroke' following influenza, ameliorated by vaccination. Most patients (n = 100) had cardiovascular risk-factors, many had prior vascular disease. In 2018, 53 % did not intend to be vaccinated. None were aware of the association between influenza and risk of vascular events but when asked again ≤7 days after the intervention 34/53 (64 %) stated they will shortly get vaccinated. Charts of 27/34 recorded actual influenza vaccination when examined six weeks later (51 % of 'unwilling' patients). Together with the patients already planning to be vaccinated (47 + 27/100) the current target of 70 % vaccinated can be surpassed. Pending confirmation by a larger RCT, informing elderly patients of the substantial risk of vascular events following influenza and its modification by vaccination may constitute a simple, effective, costless and time-frugal method of changing many patients' often-negative attitudes towards seasonal influenza vaccination. The resulting increased vaccine uptake in vulnerable elderly patients, may improve their influenza-associated morbidity and mortality. Providers discussing seasonal influenza vaccination with their patients could inform them of the substantially increased risk of myocardial infarction and ischemic stroke associated with acute influenza to overcome vaccine hesitancy.