Did the Influenza Vaccine Work Better Than Expected Last Year?

Did the Influenza Vaccine Work Better Than Expected Last Year?

Plus, is there a link between anticholinergic medication and dementia?

Q: I heard the flu vaccine only worked 20 to 25 percent of the time last year. Is it even worth getting this year? —  Lolly G., Stamford, CT

A: It’s always worth getting the flu shot and that 20 to 25 percent effectiveness number was a very early estimate. The Centers for Disease Control and Prevention says the effectiveness rate ended up around 36 percent, across several different flu strains, but primarily against H3N2. However, even a 20 percent effectiveness rate —as was the case in 2014-2015—prevents an estimated 144,000 flu-related hospitalizations and 4,000 deaths. And this year the vaccine almost doubled that prevention/death rate.

So yes, get your flu shot as soon as it’s available this fall. And don’t forget, there’s also a cumulative benefit. We can’t put an exact number on it, but we do know people who receive the vaccination year after year, and who still end up getting sick, tend to have less severe symptoms for a shorter period of time than unvaccinated folks. And getting the flu shot 10 years in a row from age 50 to 60 decreases all causes of death, including from stroke and heart attack, by more than 25 percent.

Plus, there’s the benefit—especially for 30- to 50-year-olds—that comes from creating “herd immunity.” When you’re inoculated against the flu, you’re not putting vulnerable young kids and seniors who may not have been inoculated at risk of coming down with it and suffering serious complications.

Clearly, there’s no downside to getting the flu shot. (Compared to the chance of preventing serious illness and death, the chance of a serious side effect is 1 in 40,000.) As Health and Human Services Secretary Alex Azar put it, it’s “the same kind of sensible precaution as buckling your seatbelt.”

So protect yourself and your family and get vaccinated—there’s a schedule for all of your vaccinations on the CDC website—when the time is right.

Q: My dad is 91, in an assisted care facility, and he’s recently started taking an anticholinergic medication for a bladder problem and depression. It seems to be dulling him down and I read that anticholinergic meds are linked with dementia. Should we get him off these pronto? — Quentin, H., Sacramento, CA

A: First off, these are a powerful class of drugs and never, ever stop taking a medication without a doctor’s supervision. Even aspirin or a statin requires careful consideration before stopping. You need to get off slowly. Second, there are alternatives to anticholinergics that may make sense, depending on how your Dad handles the side effects. The Golden Rule is that a medication’s benefits need to clearly outweigh any harm it may cause. So, let’s take a look at the study you mentioned.

Published in BMJ, the study looked at the records of more than 40,000 patients with dementia and more than 280,000 without dementia and analyzed over 27 million prescriptions. The researchers didn’t find a direct relationship between the prescriptions and dementia, and there was no link between people taking inhaled anticholinergics for lung problems and dementia. But they did find that folks who took the most oral anticholinergic meds had higher rates of dementia. Now we’re not sure which came first, the dementia or the meds, but as far as your dad is concerned, there are a couple of takeaways.

We do know that some anticholinergic drugs can cause temporary, short-term cognitive impairment to attention and reaction time. That’s why current guidelines say frail older people should avoid anticholinergic drugs. If you talk to his doctor about alternative medications, try to remember that he may have to switch to two medications, which can be a concern, but they may have less serious side effects. On the positive side, the side effects you think he is experiencing may be temporary, but it’s always important to let his doctor know about your concerns.

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