Influenza Vaccine on the Elderly
Introduction
Based on current evidence, there is an overwhelming response with respect to the clinical efficacy, safety, and feasibility of influenza vaccine in the elderly. The impact of the vaccine is observed in elderly patients with chronic diseases with an influence on reduced mortality and hospital admissions. Based on a recent publication, the influence of the vaccine is also observed among health elderly population around the globe. Researchers and healthcare providers state that the declining age is associated with poor antibody response coupled with various confounding factors. However, these factors have not been clearly stated in literature. On the contrary, researchers also claim that given the fact of aging and confounding factors, the influence of the vaccine in mortality reduction, improved readmission, and low morbidity clearly depicts the importance of the vaccine. Many researchers promote the use of influenza vaccine even in patients with compromised health conditions (high risk individuals) in order to reduce the burden of influenza on a global scale (Oshansky, & Thomas 2012).
Based on a recent report on vaccination and antibody response, clinical researchers state that vaccination of elderly population is bound to have low impacts but it does not necessarily mean that the vaccine would have no impact on the entire elderly population (Noh & Kim, 2013). It is assumed that a fraction of the elderly population would respond to the vaccine which may have significant impact on a global scale. Furthermore, there is limited side-effects of vaccination which may be rare and limited to mild to moderate effects. As per the National Health Services, the implementation of the influenza vaccine would result in healthcare costs savings and a significant reduction in hospitalizations. The most significant impact would be on the mortality and morbidity. Researchers are also in the assumption that the implementation of the influenza vaccine is correlated to the health status of the elderly population and lowers the risk for preventable disease (Noh & Kim, 2013). This paper provides an overview on the key benefits of the influenza vaccine in the elderly population.
Impact of influenza vaccination in elderly: Mortality and Hospitalization
One of the most influential segments based on the implementation of influenza vaccination in the elderly is the reduction in mortality and hospitalization rates. In a recent publication, the influenza vaccination was observed to have a significant impact from community-based settings to national level prevention (Jefferson, et al. 2010). There has been a wide scale appreciation of the inactivated influenza vaccine which is considered to be safe and effective. Most healthcare providers claim that the influenza vaccine reduces the hospitalization rates. Influenza-associated healthcare complications and all-cause mortality is known to have reduced post-implementation of the vaccination. Based on a recent study in a nursing home, researchers observed a positive trend in reduction of influenza and rapid management of the elderly population. Some of the most significant findings is based on the benefits among elderly population with comorbid conditions (Jefferson, et al. 2010).
The Centre for disease control and prevention (CDC), recommends the use of seasonal influenza vaccine for the elderly as a preventive healthcare strategy. The WHO has also recently adapted and implemented the use of the influenza vaccine among elderly population in order to stratify risk and ensure public safety (Trucchi, et al. 2015). Based on a recent publication, the seasonal influenza strategy for the elderly has had an impact on risk reduction and risk mitigation. Healthcare workers clearly state the use of influenza vaccine as a strategy to mitigate harm-benefit balance. The concept is based on the use of the vaccine in order to reduce harm and benefit in case of actual diagnosis of the disease. It also helps in preventing complications among elderly patients (Trucchi, et al. 2015). Based on a risk-benefit analysis, the influenza vaccine has shown benefit in terms of safety and prevention among the elderly population (Trucchi, et al. 2015).
Literature Review
In a population-based study in Taiwan, a team of researchers analysed the influence and impact of influenza vaccine among elderly population with disabilities. The study was based on a retrospective analysis of the target population from National Disability Registration System and National Health Insurance program dataset (Chang, et al. 2016). It was observed that only 37% of the elderly population with disabilities in Taiwan had received seasonal influenza vaccine. The researchers utilized multivariate logistic regression analysis to confirm the results of the study. Researchers claim that the lack of awareness, patient education, and poor healthcare policies may have influenced the low rate of seasonal vaccination among the target population (Chang, et al. 2016). A systematic review on the evidence of the feasibility, safety, and effectiveness of vaccines in individuals aged 65 years and above was conducted (Rivetti, et al. 2006). A review of 64 studies revealed that the influenza vaccine had promising impacts on the healthcare system but lacked the support and implementation on a large scale. The vaccine was also associated with a reduction in the all-cause mortality (Rivetti, et al. 2006). In a systematic review of observation studies on the influence of influenza vaccination on seasonal mortality among elderly patients (65 to 75 years) suggested no major impact. Furthermore, researchers claimed that most observational studies overestimated the efficacy and safety of influenza vaccine among the elderly population (Simonsen, et al. 2005). In a cohort study wherein a total of 83 nursing homes were assessed, researchers claimed that the influenza vaccine was found to prevent only 33% of patients. The researchers recommend to continue current healthcare policies and recommend the use of influenza vaccine (Monto, et al. 2001). In an age-structured compartmental model study in Canada, a team of researchers estimated that health impact and cost-effectiveness of the influenza vaccine. They concluded that influenza vaccine was associated with positive health impacts and cost-effectiveness but lacked a substantial implementation strategy for the elderly population (Fisman DN & Tuite. 2011).
Methodology: The study is based on a systematic review of literature based on the influence of health impacts and socioeconomic influence of influenza vaccine. Only papers between 2000 and 2010 were selected for the review. A literature search and analysis was conducted from Pubmed, CINHAL, and Cochrane library. A systematic review provides a non-biased and comprehensive overview of a research objective. The inclusion criteria for the study is as follows (a) Patients above 65 years of age (b) Healthy patients above 65 years with comorbid conditions and disability (c) Patients with a history of influenza vaccination and (d) Patients currently enrolled for influenza vaccination. The total estimated sample size for the study would include 500 participants based on the review of literature. The exclusion criteria for the study would include (a) Patients below 65 years (b) Patients with a history of vaccine-associated side effects or adverse events and (c) Patients in end-of-life care or severe chronic health conditions such as cardiovascular disease and stroke. All data would be collected from published resources from international and peer-reviewed journals. Since this is a systematic review of study participants, there is no formal requirement of an informed consent process or application. The papers would be reviewed and analysed based on patient experiences, health outcomes, and socioeconomic factors that were influenced with influenza vaccine.
Data Analytics: The patient-centric information would be analysed using advanced statistical analysis which may include t-test, regression analysis, and pool-data analysis (Bates, et al. 2014). Cumulative statistical analysis using SPSS software would be used to assess the overall impact of influenza vaccine in the elderly population (Bates, et al. 2014). Furthermore, the impact on health outcomes from cumulative analysis would be assessed using SPSS software. In order to avoid bias, three authors would be included in the analysis for literature search and analysis. A fourth author would be involved in the review process in order to proofread and analyse the effect of confounding factors (Bates, et al. 2014).
Applicability to Nursing
Nursing professionals play a key role in the prevention, treatment, and management of influenza among the elderly population. Nursing professionals would act as an educator, mediator, influencer, healthcare provider, and manager. The major impact of nurses would include patient education and awareness on the implementation of influenza vaccine in the elderly population. Nurses from various healthcare settings including nursing homes, community healthcare centres, and home-based nursing. Nurses would also act as mediators between family members and the patient in order to influence the concept of influenza vaccination among elderly population (Toronto & Mullaney. 2010).
Conclusion
Although the influenza vaccine has received substantial acclaim and acceptance on a global scale, the implementation in the elderly population is poor due to the lack of sufficient scientific evidence. The implementation of influenza vaccine remains at low rates among the elderly population above 65 years in almost all countries. There is need form both governmental and private organizations to impose prevention and control of influenza among the elderly through influenza vaccination. However, based on the current evidence, the impact of influenza vaccine on the elderly population is known to have reduce mortality and morbidity. The implementation of an influenza vaccine will enable the community to become ready for the next pandemic attack while the vaccine delivery will enhance the progress towards this unmet goal.
References
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Chang, Y.-C., Tung, H.-J., Hsu, S.-W., Chen, L.-S., Kung, P.-T., Huang, K.-H., Tsai, W.-C. (2016). Use of Seasonal Influenza Vaccination and Its Associated Factors among Elderly People with Disabilities in Taiwan: A Population-Based Study. PLoS ONE, 11(6), e0158075. http://doi.org/10.1371/journal.pone.0158075
Fisman, D. N., & Tuite, A. R. (2011). Estimation of the Health Impact and Cost-Effectiveness of Influenza Vaccination with Enhanced Effectiveness in Canada. PLoS ONE, 6(11), e27420. http://doi.org/10.1371/journal.pone.0027420
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TRUCCHI, C., PAGANINO, C., ORSI, A., DE FLORENTIIS, D., & ANSALDI, F. (2015). Influenza vaccination in the elderly: why are the overall benefits still hotly debated? Journal of Preventive Medicine and Hygiene, 56(1), E37–E43.
