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What is the burden of influenza for at-risk patients?

Some people may be at increased risk of influenza-related complications, including:1

Flu vaccination is an essential part of helping protect communities29

The Health Circle Podcast

Learn more about influenza vaccination in our podcast The Health Circle. In each episode, we explore a new topic related to flu vaccination.

Overview of the UK Influenza National Programme

Influenza Vaccination for Pregnant Women
 

Influenza Vaccination for Over 65s
 

Influenza Vaccination for At-risk Groups
 

What are the complications associated with the burden of Influenza?

Influenza may trigger other unwanted health complications for patients

Evidence indicates that influenza may trigger severe cardiovascular complications beyond respiratory infection.7

A self-controlled case series study conducted in Scotland showed that adults aged 40 years and older (median age 68), without a history of heart attack or stroke, were at a significantly increased risk of severe cardiovascular complications in the 1–3 days following a confirmed influenza infection.7

In the 1–3 days following a laboratory-confirmed influenza infection:a

Risk of having a heart attack7

Risk of having a stroke7

aIn a self-controlled case series study (based on a population in Scotland 2004-2014) conducted on a database of adults aged ≥ 40 years with ~90% of the study population aged 50 years and older. In the 1–3 days following a laboratory-confirmed influenza infection versus unexpected or baseline time periods.

CI, confidence interval; IR, incidence ratio.

Hospitalisations and economic burden of influenza

Influenza has an associated impact on healthcare costs and resources.

Influenza may have a considerable burden on secondary healthcare systems.30

Hospital admissions during the 2018/19 influenza season had associated medical costs of £99,565,310.1 The highest costs were found to be associated with patients aged 65+ years.30

Certain groups may create increased pressure as they are more likely to experience a longer and more severe illness. During the 2018/19 influenza season:30

<65 years

75+ years

Costs per hospitalisation: ~£1,900

Costs per hospitalisation: ~£3,700

Average length of stay: 4.74 days

Average length of stay: 12.55 days

Mortality: 1.83%

Mortality: 11.18%

References
  1. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1176378/UKHSA_12699_Flu_Vaccination_main_leaflet___Winter_2023-2024_04_WEB.pdfGreen book. Chapter 19. Influenza. (2020). https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/931139/Green_book_chapter_19_influenza_V7_OCT_2020.pdf (Accessed October 2023).
  2. Haralambieva IH, et alPLoS One. 2015;10:e0122282.
  3. NHS. The flu vaccination. Who should have it and why. Winter 2023 to 2024. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1176378/UKHSA_12699_Flu_Vaccination_main_leaflet___Winter_2023-2024_04_WEB.pdf (Accessed October 2023)
  4. NHS. Flu vaccinations and long term respiratory conditions. https://www.aspenmedicalpractice.nhs.uk/wp-content/uploads/2019/10/Respiratory-Conditions-and-Flu-Vaccine-Importance.pdf (Accessed October 2023)
  5. BHF. Flu and your heart condition. https://www.bhf.org.uk/informationsupport/support/practical-support/flu-and-your-heart-condition (Accessed October 2023)
  6. Fukuta H, et alHeart Fail Rev. 2019;24:109–14.
  7. Warren-Gash C, et alEur Respir J. 2018;29:1701794.
  8. CDC. Flu and people with chronic kidney disease. https://www.cdc.gov/flu/highrisk/chronic-kidney-disease.htm (Accessed October 2023).
  9. Grzegorzewska AE. Hum Vaccin Immunother. 2015;11:2599–605.
  10. Centers for Disease Control and Prevention. Flu & people with chronic kidney disease. https://www.cdc.gov/flu/highrisk/chronic-kidney-disease.htm (Accessed October 2023)
  11. British Liver Trust. Get the flu jab. https://britishlivertrust.org.uk/about-us/what-we-do/campaigns/get-the-jab/ (Accessed October 2023).
  12. Härmälä S, et alBMJ Open. 2019;9:e031070.
  13. NHS. flu vaccinations and chronic liver disease. https://www.aspenmedicalpractice.nhs.uk/wp-content/uploads/2019/10/Liver-Disease-and-Flu-Vaccine-Importance.pdf (Accessed October 2023)
  14. NHS. Flu vaccinations and chronic neurological disease. https://www.aspenmedicalpractice.nhs.uk/wp-content/uploads/2019/10/Neurological-Disease-and-Flu-Vaccine-Importance.pdf (Accessed October 2023)
  15. NHS. Flu vaccinations and diabetes. https://www.aspenmedicalpractice.nhs.uk/wp-content/uploads/2019/10/Diabetes-and-Flu-Vaccine-Importance.pdf (Accessed October 2023)
  16. Diabetes UK. Flu jab and diabetes. https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/flu-jab (Accessed October 2023).
  17. Sellers SA, et alInfluenza Other Respir Viruses. 2017;11:372–93.
  18. Bosaeed M and Kumar D. Hum Vaccin Immunother. 2018;14:1311–22.
  19. Kumar D, et alClin Infect Dis. 2018;67:1322–9.
  20. NHS England. Vaccination audit for asplenic patients. https://www.england.nhs.uk/atlas_case_study/vaccination-audit-for-asplenic-patients/ (Accessed October 2023).
  21. NHS. Spleen problems and spleen removal. https://www.nhs.uk/conditions/spleen-problems-and-spleen-removal/ (Accessed October 2023)
  22. CDC. People at High Risk For Flu Complications. https://www.cdc.gov/flu/highrisk/index.htm (Accessed October 2023).
  23. Honce R and Schultz-Cherry S. Front Immunol. 2019;10:1071.
  24. Rasmussen SA, et alEmerg Infect Dis. 2008;14:95–100.
  25. Pebody R, et alEurosurveillance. 2010;15:19571.
  26. Benowitz I, et alClin Infect Dis. 2010;51:1355–61.
  27. Omer SB, et alPLoS Med. 2011;8:e1000441.
  28. CDC. Flu and young children. https://www.cdc.gov/flu/highrisk/children.htm (Accessed October 2023).
  29. Franklin B and Hochlaf D (2018). An economic analysis of flu vaccination. https://ilcuk.org.uk/an-economic-analysis-of-flu-vaccination/ (Accessed October 2023).
  30. Moss JWE, et alBMC Public Health. 2020;20(1):1464.

MAT-XU-2301387 (v2.0) Date of preparation: October 2023