Published September 25, 2007
The life-saving benefits of giving elderly people the flu vaccine have been “vastly overstated,” according to the authors of a review published in October edition of The Lancet Infectious Diseases.
Just last week, the U.S. Centers for Disease Control and Prevention encouraged high-risk people, including those over the age of 65 and small children, to seek a flu shot.
But Dr. Lone Simonsen of George Washington University in Washington, D.C., and team concluded from their review that the evidence is currently “insufficient to indicate the magnitude of the mortality benefit, if any, that elderly people derive” from a vaccination program.
Although placebo-controlled randomized trials have demonstrated that the flu vaccine is effective in younger adults, a small number of trials never included the elderly, especially those older than 70, despite the fact that about 75 percent of influenza-related deaths occur in people older than 70, the authors said.
The trials that did include the elderly suggested that clinical gains and antibody responses from the vaccination fall in the years after the age of 70. And, even though vaccination coverage rose from 15 percent in 1980 to 65 percent today, there has been no confirmation of any influenza-related mortality improvement since 1980, said the authors.
The authors, however, encouraged the elderly to continue to be vaccinated against the flu.
“Influenza causes many deaths each year, and even a partly effective vaccine would be better than no vaccine at all,” they wrote. “But the evidence base concerning influenza vaccine benefits in elderly people does need to be strengthened."
The authors suggested that more clinical studies are needed, including randomized trials in the elderly.
“That suggestion, which seems to fly in the face of current policies, is in our opinion the only ethical and scientific way to have definitive answer to the question of whether or not current influenza vaccines protect elderly people," the authors wrote.