Introduction

Flu and pneumonia are major causes of illness and death in older people, especially for those with some sort of chronic illness. Vaccines against flu and pneumonia have been shown to be quite effective in general. In many countries, however, vaccination hasn't been very popular partly because the results of vaccination programs are uncertain. There has been no in-depth study of the health benefits of flu and pneumonia vaccinations for older people.

The medical scientists who wrote the article we summarize here investigated the effectiveness of flu and pneumonia vaccinations in helping older people avoid serious illness and even death.

A 3-year study in Sweden

The population of Sweden, about nine million people, of whom almost two million live in the capital Stockholm, has a low rate of flu and pneumonia vaccination. This is probably because vaccinations were recommended for only those people with chronic respiratory and heart conditions. Also the costs of vaccination were not reimbursed in Sweden until recently, although now the Swedish National Board of Health and Welfare recommends flu shots for everybody over 65 years old.

The Swedish scientists who wrote this article carried out a planned study that ended in 1999. The study was undertaken in Stockholm County and had as its goal to investigate the health and financial effects of flu and pneumonia vaccinations on older people.

100,242 people over 65 were vaccinated against the flu and pneumonia during an 8-week campaign. The scientists closely followed the health of these people and compared it with that of other individuals over 65 years old in Stockholm. Using Sweden's excellent personal health identification system, the scientists entered all the health details in a database. They compared hospital admissions and death rates for the two groups.

Results of the study

The investigation showed that the vaccinations greatly reduced hospital admissions and mortality for those people who were vaccinated. Flu vaccinations reduced hospital treatment by 46%, serious influenza by 29% and pneumonia by 36%. Pneumonia vaccinations reduced the incidence of invasive pneumonia, the worst kind, by 52%. And the mortality of the vaccinated group was 57% lower than the unvaccinated group. Since hospital treatment is expensive, health costs were also reduced.

The scientists pointed out that there was a possibility that the vaccinated group was initially healthier, since they cared enough about their health to be vaccinated. Another study, however, has shown that older people with health problems are more likely to be vaccinated. The scientists said they plan a more complete analysis to see if these factors could have any influence on the results. But they pointed out that other, smaller case studies have produced similar results.

Conclusions

The scientists concluded that this large study clearly showed that flu and pneumonia vaccinations for older people have substantial health benefits and should be seriously considered by all older people. Flu and pneumonia "shots" are clearly cost-effective measures that should be widely available for older persons, whatever health-provider systems are in place.