Few clinicians would disagree that influenza (flu) vaccine has generally recognized benefits in all age groups, with senior citizens deriving the greatest risk reduction in flu-related mortality. Nonetheless, it is easy to overlook the fact that flu vaccination has important impact on other downstream clinical consequences besides upper respiratory symptoms, including otitis media and — as this report details — cardiovascular (CV) health.

The death toll from flu disproportionately affects seniors, and is recorded during the annual flu epidemic as “pneumonia and influenza” deaths. Although flu is credited as the culprit, many of the pneumonia deaths are actually due to bacterial superinfection, often with staphylococci.

In a review of data beginning as early as 1946, the authors scrutinized more than 2000 reports on flu outcomes, ultimately defining 12 randomized, clinical trials (n = 6735) within their selection criteria of flu vaccine vs placebo in midlife adults (mean age = 67) considered to be at high CV risk.

The primary outcome of interest was a composite of fatal and nonfatal myocardial infarction and stroke as well as unstable angina, heart failure, and coronary revascularization. The data indicated that flu vaccine was associated with a 36% lower risk for this primary outcome. Clinician endorsement of vaccines has a powerful impact on patient concordance. Such data as these should stimulate intensified vigor for ensuring that our highest risk citizens enjoy the opportunity for CV risk reduction afforded through the flu vaccine.

Source: Udell JA, et al. Association between influenza vaccination and cardiovascular outcomes in high-risk patients: A meta-analysis. JAMA 2013;310:1711-1720.