Seniors’ Getting Mixed Messages About Flu Vaccines

Six years ago, Ava Carter got her first flu shot after a bout with pneumonia.

She follows up without hesitation every fall with another dose of the seasonal flu vaccine. Carter, 73, knows seniors are the group most susceptible to the respiratory infection responsible for 36,000 American deaths a year.

But despite understanding the seasonal influenza’s threat, Carter’s not so sure about this year’s more high-profile illness: swine flu. There’s been a barrage of media reports saying people 64 and older aren’t at serious risk, so Carter isn’t completely convinced she needs a vaccine for the similar but separate strain.

“If my doctor thinks it’s necessary, then I’ll get it,“ said Carter, who regularly attends exercise classes at the Town ‘N Country Senior Center. “But if she doesn’t mention it, I’m not volunteering.“

Carter and 36 million other older Americans seem to be getting mixed messages: Health officials are begging them to get vaccinated and watch out for seasonal flu, which is particularly deadly to the elderly. They’re also being told to get a vaccine for swine flu, but to let other groups – such as children and pregnant women - get vaccinated first.

There are two reasons behind the differing recommendations: Swine flu is attacking younger people at far higher rates, and scientists say older Americans are mostly immune to the swine flu thanks to exposure of an identical strain in 1957.

Magnifying the uncertainty is the fact that public health officials are literally revising plans to fight swine flu on a daily basis as they receive new research.

National and state public health officials are concerned that the varied recommendations will result in fewer seniors getting seasonal flu vaccines. Traditionally, this demographic has been the most active participant in flu prevention.

“It’s not just seniors, we’re all concerned and we’re confused,“ said Cora Christian, a Virgin Islands physician and member of the AARP board of directors following the swine flu pandemic.

In 2007, an estimated 65 percent of Floridians age 65 and older got a seasonal flu shot, according to Department of Health survey data. Residents, ages 18 to 44, and 45 to 64, participated at far lower rates, 18 percent and 31 percent respectively, state numbers showed.

A recent Associated Press poll showed that participation rates likely will stay high. In the national survey, conducted last month, four of five seniors planned on getting the regular winter flu vaccine. By comparison, just half of adults of all ages said they would get the seasonal flu vaccine.

According to the Associated Press survey, 82 percent of seniors want the vaccine for swine flu, which is characterized by a fever of 100 degrees or higher, sore throat, and body aches. Most of the more than 1 million cases in the United States are mild; however, 91 Floridians have died from swine flu complications.

Tampa resident Jan Rahman, 61, said her friends are definitely worried about swine flu. They want to know if they can get vaccinated for swine flu or seasonal flu in one shot, when vaccinations will happen, and who will pay for it, she said.

“Everyone you talk to is either upset because they think they can’t get it and they need it, or they think they’ll be getting the flu from the shot,“ said Rahman, whose maternal grandparents died in a 1918 flu epidemic.

Christian said all people 2 years and older, and especially seniors, should get vaccinated for seasonal flu immediately. The cost of the annual flu shot is covered for seniors on Medicare, because the illness is particularly dangerous to their age group.

“One should not delay getting seasonal flu shots because of the confusion,“ she said.

Seniors who are relatively healthy are the ones who are being asked to wait for the swine flu vaccine, which should arrive at health clinics early nest month. Vaccines will first be given to priority groups, which include pregnant women, children older than 6 months, persons up to age 24, and those with “severe health conditions associated with higher risk of medical complications from influenza,“ said the Centers for Disease Control and Prevention.

A vast majority of the state and national swine flue deaths have affected people within these priority groups.

Specifics for the distribution of the swine flu vaccine are evolving and it is not clear what illnesses will qualify as a priority.

However, in 2004, 26 percent of all Americans, and 90 percent of seniors, were diagnosed with at least one chronic condition, according to a study by the Johns Hopkins Bloomberg School of Public Health.

Seniors with a chronic disease, such as diabetes, pulmonary disease, congestive heart failure and coronary heart disease, may be among those in the priority group, said Carmella Sebastian, Humana’s market medical officer for central and north Florida. She suggests seniors speak directly with their health care provider to know for sure.

“I know very few seniors who do not have at least one chronic illness,“ she said.

As swine flu is a global pandemic, most of the costs associated with its vaccine are being covered by government agencies, including Medicare. Some insurance carriers, such as Humana and Blue Cross Blue Shield, also will pay their clients’ cost for the swine flu vaccine.

That doesn’t mean all seniors are jumping on board for vaccinations. Several people working out at the Town ‘N Country Senior Center last week dismissed the need for a seasonal flu vaccine or a swine flu shot. Some said they prefer regular exercise or vitamin supplements to chemical prevention.

Tampa resident Sylvia Covington, 63, said there’s another issue to consider: convenience. She said a friend once waited five hours at a clinic for a seasonal flu vaccine. Prevention isn’t worth that much of her day, she said.

“I will get (the shot), unless it’s time consuming or expensive.“