This blog was based on the paper written by: Palache, Abraham. (2018). Internal Medicine Review. Global Seasonal Influenza Disease and Vaccination: A Paradox with Substantial Public Health Implications. To learn more, click here.
To the average person, the flu (also known as influenza), is no more than a severe form of the cold that causes inconvenience for a week or so. However, many are not aware that influenza has a serious socio-economic burden due to absence from work and loss of productivity,1 and can lead to complications or worsen existing illnesses, particularly for high-risk groups such as:
Thankfully, a vaccine is available. The influenza virus is unique as there are different strains that circulate, and new strains of the virus are constantly emerging, meaning the flu vaccine must be taken every year in order to be protected.
The World Health Organization recommends that those from high-risk groups receive their seasonal flu shot,3 however the process of annual re-vaccination is an obstacle to achieving high coverage rates. Additional factors that negatively impact vaccination rates include:
Local studies are significantly impacted by many circumstances, such as the extent of the circulating virus, the immune status of the population before vaccination and how accurate the strains in the vaccine match the circulating influenza strains. If these conditions are not accounted for, then the results will not be accurate or generalizable.
Health authorities usually rely on national data to implement healthy public policy. Since many countries do not have sufficient influenza surveillance systems, this can impede prevention policies from being implemented.
As author Dr. Abraham Palache stated in his research publication, “This poses a huge public health dilemma, since national borders offer no defence to the threat of influenza. Should vaccination be offered based on the global evidence and experience or not because of insufficient national surveillance infrastructure and therefore insufficient national data?”
Evidence for the global benefit of seasonal influenza vaccination has been collected over the past 50 years, demonstrating that influenza-related disease, hospitalization and deaths impact all populations globally. Therefore, it is rational to assume that countries without an influenza monitoring system have a similar disease burden as countries in the same geographic region where more established monitoring exists.
It is therefore recommended to use the existing “global file on influenza vaccines” as the foundation for vaccination policies across the world, rather than relying on better local evidence. The benefits would be immediate and every 3-5 years, updated global research could be used to inform any need for adaptation of the current global or national policies.
When global evidence supports the benefit of influenza vaccinations, failing to vaccinate risk groups, including older adults, would be against ethical and evidence-based medical practice. In older persons, an influenza infection may result in loss of independence, aggravate underlying conditions and lead to complications such as pneumonia.
For the health and well-being of at-risk populations and the community at large, it is worth a shot. Pun intended.
 Gasparini R, Amicizia D, Lai PL, Panatto D. Clinical and socioeconomic impact of seasonal and pandemic influenza in adults and the elderly. Human Vaccines & Immunotherapeutics 2012; 8(1): 21-28.
 Monto AS, Ansaldi F, Aspinall R, McElhaney JE, Montaño LF, Nichol KL, Puig-Barberà J, Schmitt J, Stephenson I. Influenza control in the 21st century: Optimizing protection of older adults. Vaccine 2009; 27(37):5043-53. doi: 10.1016/j.vaccine.2009.06.032.
 WHO. Vaccines against influenza – WHO position paper – November 2012. Wkly Epidemiol Rec 2012 Nov 23; 87(47):461-76.
IFA GUEST BLOGGER: Ruby Clarkson is a freelance writer with a passion for helping others. She specializes in elderly care and loves sharing her writing with the world.
There are many benefits to living in a rural community but as residents get older, life can become a lot more difficult. For many older people – and their relatives – isolation can be a big problem, both affecting factors like quality of life, as well as overall general health. Dementia is not uncommon amongst older people, and it seems that isolation can be a factor in its progress, especially amongst older people. Whether you are farmer or a resident in a rural community, tackling isolation can be trickier than for those who live in urban areas.
People who live in rural areas are fiercely independent by nature, but also somewhat remote. This can make caring for them particularly tricky and often it is the families who take responsibility for their care. According to Helping Hands, who organise carers for people with dementia, “though there are chances for people requiring care to engage with others in a residential home or hospice, having the flexibility to choose their activities and when they want to visit other loved ones can make a huge difference to wellbeing.”
Dementia is a set of symptoms which effect the brain. It can reduce a persons ability to think, problem solve, remember and communicate, and unfortunately makes these functions of the brain deteriorate over time. Alzheimer’s is the UK’s most common cause of dementia – although there are others.
For all families, the onset of dementia is very concerning, but this can be especially concerning for those who own farms. Just as for any other family, dementia can be distressing and difficult, but for farmers who rely on the farm for their financial survival, looking after someone who is suffering from dementia can add extra pressure. According to a study carried out by Plymouth University which looked at the experience of dementia in farming (including for farming families), there are four main areas of concern:
There are a few options for those who are suffering with dementia in terms of receiving outside care. It is important for families to be aware that there are options available – on a spectrum of one-off care worker visits, to regular visits or even a live-in carer, or going to a nursing home where there is 24-hour care available.
There is plenty of evidence to suggest that keeping people who are suffering from dementia in familiar surroundings is important to both reduce the distress of an illness which can be very frightening to those suffering from it, as well as to help to slow the illness’s progress down.
Having a carer who is experienced in dementia care can make a massive difference to both the sufferer’s quality of life, helping with anything that is needed – house-keeping, going out, helping with medication, helping with mobility, assisting with activities and hobbies – or just a friendly face for a chat.
In rural communities this company and specialist knowledge can be especially valuable, and families can choose whether they want a carer who comes over one or a few days a week, or as a live-in carer.
It is important for bother sufferers of dementia and family members to remember that you are not alone. Regardless of where you are living, there is help available.
In the winter of 2017, Germany saw 82,000 cases of influenza, with a vaccination rate below 50% recorded in recent years. Influenza vaccination is a critical yet underthought element of a life course approach to healthy ageing, as older people have a higher chance of developing influenza-related complications that can result in premature morbidity or mortality and severely limit functional ability.
On 30-31 January 2019, the International Federation on Ageing (IFA) convened the “Fighting the Flu through Targeted Awareness Campaigns” expert meeting in Berlin, Germany comprising some 30 experts in social media, digital health, knowledge mobilization and risk analysis alongside experts in vaccination, public health and ageing to deepen understanding of good communication practices that aim to raise vaccination public awareness.
The expert meeting featured presentations from organizations and projects including but not limited to the Vaccine Confidence Project, Vaccination60+, Vaccines Today, eHealth Digital Media, Age UK, Qatar Computing Research, and Four Communications. Meeting delegates discussed the need for innovative communication strategies to address barriers and improve public understanding on the risk of influenza and positive health and socioeconomic impacts of vaccination.
Several important next steps resulted from the meeting, with delegates in agreement that there is a need to form strategies from a multi-stakeholder approach; tailor communication strategies on influenza to specific at-risk groups including older adults; include older people in the formation, research and evaluation process of campaigns; and concert efforts to increase eHealth literacy of people at-risk to influenza, particularly around those who are vaccine hesitant.
In the next coming weeks, a Consensus Statement resulting from the meeting will be released together with a White Paper arguing that evidence-based communication strategies should be utilized and expanded upon to increase influenza vaccination uptake rates for adults, therein to encourage healthy ageing and prevent functional decline.
Haas, J, et al. “Burden of Influenza in Germany: A Retrospective Claims Database Analysis for the Influenza Season 2012/2013.” The European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care., U.S. National Library of Medicine, July 2016, www.ncbi.nlm.nih.gov/pubmed/26143025.