Immunise4Life calls for elderly to be vaccinated for influenza

In celebration of Malaysia’s 65^th Independence Day, Immunise4Life (IFL) launched its campaign, titled “Preventing the Flu at 65 and Beyond” with the theme “Flu Prevention, I Get It Done.”

The event was presided over by the Deputy Minister of Health 1, Dato’ Dr Noor Azmi Ghazali. Here, he unveiled the “7 Keys to Happy & Healthy Aging,” which included influenza prevention as one of the recommended lifestyle habits for older individuals in order to preserve their health, independence, and quality of life.

Older individuals should strive to live long, fulfilling lives by pursuing their passions, contributing to their communities, and spending time with loved ones. However, this is only possible if one maintains good health. Here, Noor Azmi iterated the importance of eating a healthy diet, staying physically active, getting adequate rest and sleep, going for regular health check-ups, learning new skills, and socializing with loved ones and friends. 

Additionally, he urged senior citizens to prevent influenza by receiving an annual vaccination. Influenza is a respiratory illness that can quickly and severely affect the elderly. According to the US Centers for Disease Control and Prevention (CDC), up to 70 percent of influenza-related hospitalizations and up to 85 percent of influenza-related deaths occur in individuals aged 65 and older. [Available at https://www.cdc.gov/flu/highrisk/65over.htm. Accessed on 12 September 2022.]

In line with recommendations by the World Health Organization, Noor Azmi said that vaccination against influenza is one of the most effective ways to reduce the risk of severe illness, hospitalization, and death. [Available at https://www.who.int/teams/global-influenza-programme/vaccines. Accessed on 12 September 2022.] He also reminded the public to continue following the MOH standard operating procedures such as wearing face masks, washing hands frequently, and maintaining a safe distance from those exhibiting respiratory symptoms.

Professor Datuk Dr Zulkifli Ismail, chairman of the IFL Technical Committee, said: "As we age, our immune system tends to weaken, and our lung function also declines. The flu may cause dizziness leading to falls, respiratory distress, and complications.” These complications include pneumonia, inflammation of the brain, multi-organ failure or sepsis. [Available at https://www.cdc.gov/flu/symptoms/symptoms.htm. Accessed on 12 September 2022.]  

Zulkifli added that older people with comorbidities are particularly vulnerable to influenza. He said: “People with diabetes are six times more likely to be hospitalized and three times more likely to die due to influenza-related complications, compared with people without diabetes. Influenza can also worsen one’s diabetes and even trigger diabetic emergencies.” [Available at https://www.nfid.org/2019/11/07/facts-about-diabetes-and-flu. Accessed on 12 September 2022.]

Due to the body’s inflammatory response to influenza infection, blood clots may form, together with elevated blood pressure and inflammation of the heart. This situation is potentially deadly for those with heart conditions. It’s been found that influenza infection is associated with increased stroke and myocardial infarction rates in the days to weeks after the infection. [Eur Respir J 2018;51(3):1701794]

Here, Zulkifli alluded to the importance of influenza vaccination, in particular for the elderly. “In older persons, annual influenza vaccination has been shown to reduce the risk of influenza-related hospitalization and death by over 40 percent. The yearly shot also benefits those living with diabetes by reducing their risk of stroke by 30 percent, heart failure by 22 percent, and heart attack by 19 percent. As for cardiac patients, influenza vaccination reduces the likelihood of major cardiovascular events by 36 percent. Chances of dying goes down by 18 percent among those with heart failure. Individuals who had a recent acute coronary syndrome may lower the risk of a poor outcome by 45 percent.” [Clin Interv Aging 2012;7:55–64, CMAJ 2016;188(14): E342–E351, Eur Respir J 2018;51(3):1701794, Circulation 2019;139:575–586, JAMA Netw Open 2022;5(4):e228873]

As influenza can be particularly debilitating to older persons, those who are confined to prolonged bed rest may quickly lose muscle and strength, while potentially being exposed to other infections, if they are hospitalized. They may also develop irreversible functional decline and be unable to perform simple daily tasks without help. Consequently, this loss of independence and sense of purpose may lead to depression.

Zulkifli cautioned against waiting for an outbreak before rushing to get vaccinated, citing the situation in 2020 just before the lockdown due to COVID-19 pandemic, where clinics ran out of vaccines due to the sudden surge in demand. Ideally, Zulkifli added, Malaysia should offer free influenza vaccinations to high-risk groups, including the elderly. There will be a significant reduction in influenza-related hospitalizations and deaths, as well as an increase in life expectancy.

While NGOs and stakeholders are lobbying the MOH to provide influenza vaccines free of charge, Zulkifli said in the interim, we should take a society-wide approach to preventing influenza among the elderly. He called for everyone to remind their elderly parents and relatives to get annual influenza vaccination. “Healthcare professionals, please get vaccinated and encourage your patients to do the same.”