“So much more than just a flu”



Older adults suffer disproportionately from influenza, accounting for the most hospitalizations and deaths every season. The devastation from an influenza infection means more that just getting sick and feeling uncomfortable for a couple of days. Influenza is debilitating, life threatening, and can cause life long disability even after infection. Here is how an influenza infection can lead to disability in older adults.


1. Influenza the “heart attack virus”

Did you know that an influenza infection can trigger a heart attack? A large study was published showing a higher incidence of heart attack (6x) in the first week following an influenza infection. The mechanism for this is thought to be an “inflammatory response”. Essentially your body’s own defense systems against the virus end up taking on some collateral damage. This damage comes in the form of dislodging plaques in the arteries allowing them to travel to the heart. With limited blood supply, the heart muscle cells begin to die due to lack of oxygen – the basis of a heart attack.

2. Stroke what older adults “fear most”

Over the course of the lifespan, views on death vs disability change drastically. Studies have shown that older adults would rather prevent stroke than death. This higher emphasis on stroke prevention stems from the consequences of devastating disability and loss of independence following a stoke. The inflammatory response described earlier can also result in “dislodged” plaques in the artery travelling to the smaller blood vessels in the brain. With limited blood supply, brain cells begin the die due to lack of oxygen – the basis of a stoke.

3. Irreversible loss of muscle mass

An influenza infection in an older adult has a higher chance of leading to hospitalization. With being in the hospital leading to being “bedbound” or fixed to a hospital bed. Did you know that hospitalization is associated with a loss of up to 50% of lower limb strength? Being affixed to a hospital bed, with each passing day the body loses muscle mass. Furthermore, some studies have shown a possibility that influenza infection itself leads to muscle mass reduction.

Vaccination is your best defense against the devastating effects of influenza. Older adults are considered a “high risk group”, with many experiencing a decrease in independence after recovering
from an influenza infection. Vaccination is strongly recommended. Even for those who are younger, vaccination prevents the transmission of influenza to those at risk.

Wait…but your telling me there is more that just one “Flu Shot”

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Be mindful of “your options” this coming flu season! Many of us have the o so typical “flu shot experience”. When the fall comes around we roll up our sleeve at either our local pharmacy or doctors office to get our annual flu shot. Not much thought goes into it, we cross it off our to do list and trudge on into the winter. Do you ever stop to wonder what type of influenza vaccine you received? There are currently a multitude of options when it comes to influenza vaccination products for the 2020-2021 season. Contrary to popular belief the vaccine you receive each year is not labeled in a generic “flu shot” vial. There are many varieties in which this vaccine can come it.

Some vaccines contain protection against more circulating strains of the virus. There are some influenza vaccines which contain additional technologies to “boost” the immune response in older adults. There is an influenza vaccine made in a different environment, instead of the traditional egg based vaccine. Finally there is an influenza vaccine that is delivered through the nose, instead of injection into the muscle.

You are probably wondering, which vaccination is best for you? Certainly, a valid question given how important it is to protect yourself as best as possible this season. The best thing you can do this
influenza season is to ask your doctor or pharmacist about your options this season. Things will be hectic this influenza season, and your health care provider will be doing the best they can administer a vaccine to you. If you don’t ask or advocate about you’re your options, then you may be missing out on better protection against influenza disease.



Written by Ajit Johal RPh BSP BCPP CTH

About the author

Ajit has been providing immunizations and clinical education since 2012. As a community pharmacist, he is an accessible provider of immunizations to patients in the community. In 2018, he started an organization called immunize.io, with a mission statement of ”taking our best shot at immunizing the world”. Through ”immunize.io” he has worked with numerous organizations and communities to address “vaccine hesitancy” and improve access to vaccinations.  He champions community pharmacists as leaders of immunization services, in particular in the area of recommended but ”unfunded” vaccines.  Ajit is also a clinical instructor for the University of British Columbia Faculty of Pharmaceutical Sciences Program. At UBC he coordinates the elective course for UBC Pharmacy students in the area of travel health and immunizations