Flu vaccine rate less than 25% in young adults with heart disease, despite increased risk

Despite clear evidence of the health benefits, the vast majority of young adults with cardiovascular disease are not getting the recommended annual influenza vaccine, according to preliminary research to be presented at the American Heart Association's Scientific Sessions 2020.

For people with cardiovascular disease, getting the flu vaccine helps prevent the flu and its serious complications.

"Individuals with cardiovascular disease are more likely to have flu than among those without any chronic health conditions," said study lead author Tarang Parekh, M.B.B.S, M.S., Ph.D. candidate and assistant researcher at George Mason University College of Health and Human Services in Fairfax, Virginia. "Having a flu infection can exacerbate cardiovascular diseases like heart attack and stroke and can also lead to secondary infections such as pneumonia. You are putting yourself at increased risk when you don't get the flu vaccine."

For the study, researchers analyzed information on flu vaccination and cardiovascular disease from the 2018 Behavioral Risk Factor Surveillance System. For the survey, participants were asked whether they had a flu shot within the past 12 months and have a history of heart attack, angina (chest pain), congestive heart failure or stroke.

Using data from more than 100,000 adults, ages 18 to 44 years old, researchers categorized participants into two groups: 18- to 34-year-olds and 35- to 44-year-olds. The analysis looked at the vaccination rates between the two groups, focusing on those who had any cardiovascular disease.

The study revealed that:

• Only about 20% of 18- to 34-year-olds who had a history of heart attack received an annual influenza vaccination, versus about one-fourth of those free from heart attack.
• Only about 22% of 35- to 44-year-olds who had a heart attack got the flu vaccine, compared to about 28% of those with no history of heart attack.
• Compared to younger adults, the flu vaccination rate in those with any cardiovascular disease was lower in older adults, 28% versus 26.7%, respectively.
• Surprisingly, younger stroke survivors were more likely to be vaccinated: 27% of 18- to 34-year-olds who had a history of stroke received the flu vaccine, compared to 24% who never had a stroke.
• Overall, the 2018 flu vaccine rate was higher among older adults (aged 35 to 44) than younger adults (aged 18 to 34), yet it was similar among younger adults, with or without a history of cardiovascular disease.

"If we look at our Healthy People 2020 goals, one major goal is to reach 70% of the population receiving the annual flu vaccine. However, we are not even at the halfway mark, especially when you consider that the vaccine rate among those with cardiovascular disease is significantly lower," Parekh said. "It's essential that young adults with cardiovascular disease receive the flu vaccine. We need to place greater focus on patients who are not being vaccinated and push a targeted intervention to close that gap."

The authors hope their study will increase awareness among cardiologists and the public. "The next step would be for the cardiovascular community to routinely recommend the flu vaccine to their patients. Putting the current recommendations into action has the potential to prevent serious heart complications and save lives," he said.

According to the American Heart Association's Chief Medical Officer for Prevention Eduardo Sanchez, M.D., M.P.H., FAAFP, this study provides additional merit for the American Heart Association's ongoing collaboration with American Lung Association and the American Diabetes Association:

"We have partnered with the American Lung Association and the American Diabetes Association to collectively deliver a message to physicians and other health care professionals and to the general public that all adults and all children, by and large, should be getting influenza vaccinations year after year. In particular, for patients who have chronic diseases like high blood pressure, diabetes or emphysema, it is critically important to get the annual flu vaccine. The potentially serious complications of the flu are far, far greater for those with chronic diseases," said Sanchez.