Age is not only criterion for flu vaccine

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7163.946 (Published 03 October 1998) Cite this as: BMJ 1998;317:946
  1. Jonathan S Nguyen-Van-Tam, Senior lecturer in public health medicine. (jon.vantam{at}nottingham.ac.uk)a,
  2. Moe H Kyaw, MPH student.,
  3. James C G Pearson, Senior lecturer in medical statistics.
  1. Division of Public Health Medicine and Epidemiology, School of Community Health Sciences, University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH

    EDITOR—The Department of Health has announced that influenza vaccine is to be recommended for all people aged 75 and over with effect from the 1998-9 winter season1 this represents an extension to the previous policy of targeting people of all ages with high risk conditions.2 We welcome universal targeting of very elderly people, which offers favourable cost benefit and simpler logistics for those involved in delivering the vaccine, but the attention of primary care professionals must also remain focused on people aged under 75 who have conditions that place them at risk of flu and its complications.

    We recently interviewed 232 patients admitted as medical emergencies (all causes) to a large teaching hospital in West Midlands between 2 April and 30 May this year, all of whom had one or more indications for flu vaccine.2 During the 1997-8 winter season in the same area a local policy existed to offer flu vaccine to all people aged 65 and over. The table shows the vaccine uptake by age group. It is noteworthy that uptake during the 1997-8 season was 61% among patients aged 75 and over with indications for the vaccine, compared with only 27% among those below this ageχ 2=25.3, 1 df, P<0.05).

    Uptake of influenza vaccine in 1997-8 winter season among 232 patients in hospital with one or more indications for vaccine

    View this table:

    Although based on a sample of patients in hospital, these data nevertheless show that uptake of flu vaccine was considerably lower in people with high risk conditions who were aged under 75. Therefore, although the risks of serious morbidity and mortality due to flu certainly increase with age, 34 the new age related guideline issued by the Department of Health must not be interpreted in isolation; primary care professionals must remain committed to active targeting of high risk patients aged under 75.


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