Influenza Vaccination: Protecting Older Adults & Reducing Costs
Because influenza infection is associated with an increased risk of heart attack and stroke in older adults, influenza vaccination…
preventing both influenza and its indirect consequences, Marco del Riccio, MD, of the University of Florence in italy, told The American Journal of Managed Care® in part 3 of an interview.
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Influenza and Cardiovascular Risk: An underestimated Economic Burden
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Influenza infection is associated with a significantly increased risk of acute cardiovascular events, such as heart attack and stroke, in the weeks following the acute respiratory illness, contributing to healthcare costs that are often not directly attributed to influenza.
While the direct costs of influenza hospitalization are quantifiable, the indirect costs related to subsequent cardiovascular complications are substantially underestimated in economic analyses. Influenza triggers systemic inflammation and can destabilize existing atherosclerotic plaques,leading to these events. The link between influenza and these longer-term consequences is difficult to establish definitively in claims data, resulting in incomplete cost calculations.
For example, a study published in the Circulation journal found that the risk of myocardial infarction (heart attack) increased by approximately 3.7 times and stroke risk increased by 2.4 times within the first week after influenza infection.This increased risk persisted, though diminished, for up to two weeks. These risks are adjusted for a range of confounding factors, but the full economic impact remains obscured.
Cardiovascular Event Risk Following Influenza Infection
The increased risk of cardiovascular events following influenza infection is a well-documented phenomenon, though its full extent is still being researched.
Influenza infection induces a pro-inflammatory state,which can exacerbate underlying cardiovascular disease. This is notably dangerous for individuals with pre-existing conditions like atherosclerosis. The inflammatory response can lead to plaque rupture and subsequent thrombosis (blood clot formation),triggering heart attacks or strokes. The Centers for Disease control and Prevention (CDC) recognizes influenza as a risk factor for worsening chronic medical conditions, including cardiovascular disease.
A 2018 study by Kwong et al., published in The BMJ, analyzed data from the UK and found a six-fold increased risk of myocardial infarction in the week following confirmed influenza infection. The study included over 36,000 patients with confirmed influenza.
Economic Implications of Influenza Prevention
Preventing influenza through vaccination can lead to both direct healthcare cost savings and indirect savings by reducing the incidence of subsequent cardiovascular events.
The economic benefits of influenza vaccination extend beyond preventing the illness itself. By reducing the number of influenza cases, vaccination can also lower the number of associated cardiovascular complications, thereby reducing overall healthcare expenditures. Cost-effectiveness analyses often focus solely on the direct costs of influenza, neglecting these indirect benefits. The CDC estimates that influenza vaccination prevents millions of illnesses and tens of thousands of hospitalizations annually, leading to considerable cost savings.
A 2023 report by the IQVIA estimated that widespread influenza vaccination in the US could prevent approximately 2.3 million medical visits and 100,000 hospitalizations, resulting in cost savings of over $3 billion annually.This estimate *does not* fully incorporate the potential savings from reduced cardiovascular events, suggesting the true economic benefit is likely higher.
Current Vaccination Rates and Public Health Initiatives
Despite the demonstrated benefits, influenza vaccination rates remain suboptimal, particularly among high-risk populations.
The CDC recommends annual influenza vaccination for everyone 6 months and older. Though, vaccination coverage varies significantly by age, race/ethnicity, and insurance status. As of December 2023, the CDC reported that approximately 48% of the US population had received an influenza vaccine. CDC flu Vaccination Coverage. Public health initiatives are ongoing to increase vaccination rates, including targeted outreach to vulnerable populations and partnerships with healthcare providers.