What is Flu and its symptoms?
Question:
Discuss about the Evaluation of Annual Influenza Vaccination Being Recommended.
Flu or influenza affects immunity system of older adults and young children easily. Due to weak immunity response of older adults, infants, young children, they are more susceptible from the attack to the virus. Older adults over 65 years of age receiving medical treatment at the community hospital are at greater risks of getting infected from the disease. Community nurses handle a wide variety of patients, facing multiple medical conditions; flu is the most common type of virus that affects majority of patients receiving treatment at the community hospital. Community nurses having to treat so many patients have risks of bearing the disease virus themselves. Mc Elhaney (2011) in his paper explores that older adults face risks from getting infected from the disease easily when in contact with older community nurses. The scope of this analysis identifies recommendations that are given to adults over 65 years of age to get vaccinated in case they are treated by older community nurses.
Flu: Influenza is commonly known as flu, is caused by a virus that causes respiratory illness. The flu virus is highly contagious in nature that spreads through infected persons cough or sneezes (Holland et. al., 2008). Flu is not a life threatening disease and adults are highly contagious for 1 to 2 days prior to getting symptoms, which might continue till 7 days of becoming ill. Symptoms associated with influenza are runny nose, high fever, muscle pain, sore throat, coughing, headache and feeling tired. The symptoms might last over a week and can include gastrointestinal symptoms as vomiting, diarrhea and nausea. The flu is usually treated by antibiotics unless the flu symptoms have aggravated into another illness that is caused by bacteria. During flu season from 71% to 85% of the older population above 65 years have experienced death and 54% to 70% had to be admitted to hospitals due to flu. Influenza is a serious issue for older adults hence they need to be vaccinated (Song, et. al., 2010). Worldwide treatment for flu is antibiotics such as antivirals oseltamivir and zanamivir. Though majority of flu cases are not considered serious but in older adults above 65 years, it can cause serious complications. Complications that are caused by influenza are dehydration, bacterial pneumonia, congestive heart failure or even asthma. There is an increasing worldwide trend in hospitalization of older adults diagnosed with flu symptoms; therefore it is better to adopt preventive measures (Medlock & Galvani, 2009). Prevalence of healthcare policy that makes essential for the elderly to get vaccinated can be an effective mechanism for prevention against influenza. A healthcare policy aimed at vaccinating elderly can emerge to be an effective to overcome barriers facing primary health care professionals. In absence of policy aimed at immunization, efforts of professionals in primary healthcare along with public health agencies will remain unattended. Immunization in influenza has to remain a government prerogative for enhancing impact on the national average rate in winter especially. Non-compliance factors to immunization schedules remains to be a major challenge arising from factors such as fear from side effects, fear from vaccinating needles, lack of confidence of immunization effectiveness and other factors conies to be barriers. Apart from immunization currently there is no other effective alternate mechanism available to protect elderly from the deadly attack of the disease that can enhance chances of comorbidity.
Prevalence and Risks of flu in Older Adults
Type of flu vaccine and requirement for annual boosters: due to the wide spread influence of influenza vaccination, it has been considered best to take vaccination of the viruses. The viruses are influenza H3N2 virus, H1N2 virus and one B virus. Post taking of the vaccination, protection begins from 2 weeks. Season based vaccination needs to begin by September and kept continued through January. Outbreak of influenza might change and be at peak during October or January month. Falsey et.al., (2009) in his article states that some individuals should not opt for the vaccination as those having allergy to chicken eggs, or who have had reaction to flu vaccination in the past, or people who had Guillain-Barre Syndrome after 3 weeks of receiving vaccine (Falsey et. al., 2009). In case an older adult had moderate fever, they need to wait prior to getting vaccinated.
Older adults 65 years or more are at more risks with complications from flu symptoms, as compared to younger healthy adults. Older adults have weakened defense immune response that further weakens with age. The best tactics to deal with flu for older adults is to take a flu shot. Centers for Disease Control and Prevention suggest that people 65 years or older have to get vaccinated each season for ensuring possible immunity wanes over a year. DiazGrandoz et al. (2014) evaluated that older adults can get injectable vaccines or flu shot that are cell-based injectable vaccine flu shots (DiazGranados et.al. 2014). The high dosage vaccine is for adults over 65 years of age and it contains 4 times the amount of antigen compared to regular flu shots. It has stronger immune response post vaccination. Older adults should not get nasal spray flu vaccine, jet injector flu vaccine or the intradermal flu shot. Adjuvant flu vaccine Fluad that is produced from MF59 adjuvant can help create a better immune response in adult population. The vaccinations come with some side effects which can happen with standard-dosage of seasonal shots. Other effects include redness or swelling where injection is administered, muscle ache, headache and malaise (McElhaney, 2011). It is advisable that older adults get vaccinated with pneumococcal vaccines for prevention against pneumococcal diseases.
Immunization rationale for 65 years and over population group: Influenza infection has been found associated with severe morbidity and serious outcomes. Adult population vaccination has been considered to be most effective strategy for prevention of the disease by World Health Organization. Though certain scholars argue regarding the exact magnitude of benefits from vaccination. Older adults above 65 years of age have weakened immune response system that is susceptible to the association of influenza virus response. Prevention from increased incidence of the infection can reduce morbidity and mortality significantly. Osterholm et. al. (2012), states that the flu can cause several complications with prevailing symptoms of the disease for a prolonged period (Osterholm et. al., 2012). Complications can arise in case older adults are being exposed to other older adults or older community nurses, who are bearer of the virus.
Types of Flu Vaccine and Annual Boosters
Requirement to be immunized against influenza as a community nurse: Older community nurses are at greater risks of carrying the influenza virus. Older community nurses have weakened immune response system. They are exposed to multiple types of patients, which increase their risks of becoming potential virus bearers. During seasonal outbreak of the disease, community nurses need to provide professional healthcare to patients suffering from serious influenza infections. This further increase their risks of bearing the virus that have capability to get transferred to other patients in the ward. Haq and McElhaney (2014) stated importance in cases older community nurses get vaccinated, there would be a reduced incidence of influenza amongst older adults, who were not facing the disease (Haq & McElhaney, 2014). This article clearly states that annual influenza vaccination of community nursing staffs greatly reduces mortality and morbidity in vulnerable patients.
Older community nurses providing healthcare facilities to older adults above the age of 65 years did not visualize influenza as being a threat to their health or wellbeing. They did not perceive vaccination for influenza to be necessary and viewed it to be harming their health in a negative manner or having side effects, weakening their immunity system. Research studies conducted to evaluate threat of transmission of influenza reflected unawareness amongst older community nurses being a high-risk population as they had never fallen ill with the disease. Several researches are connected with understanding related to ways in which mortality rates or treatment of adult population, only a few researches are connected towards understanding ways in which older community nurses could reduce epidemic (Vajo, et. al.,2010). Older community nurses have often declined vaccination on the motif that they have healthy body for maintaining their decisional autonomy. Community nurses are faced with untrustworthy ambience that opposes them to maintain healthy body. Nurses rely on conventional health beliefs compared to evidence medication. Impact from relying on conventional health beliefs makes them decline to influenza vaccination. Community healthcare centers as well as hospitals have to design specific intervention mechanisms tailored for nurses.
Older community nurses feared for side effects of vaccination, as some nurses already felt ill post taking of the vaccine. Talbot, et. al., (2011) analyses the negative effects arising from influenza vaccination made nurses feel the procedure to be unnecessary (Talbot, et. al., 2011). The negative side effects led to community nurse reluctance in getting vaccinated. Older Community Nurses felt that in case they felt ill, they had all possible right to stay back at home as they did so much work. Moreover taking influenza vaccination meant to some nurses that they had to undertake restrictive measures that could curb their autonomy. They did not trust influenza vaccination as having much effect on the virus widespread. As the vaccine’s composition is based on the assumption of season’s influenza virus look alike, effectiveness of the vaccination is less supposed to be less likely.
Response to older adult in the community, who argued that the flu vaccine results in catching the flu: Influenza vaccine is prepared on the basis of virus type that was present in the last year. However, viruses like any other living organisms are undergoing constant genetic mutation that makes them more complex and complicated (Izurieta, et.al., 2015). Mutation of virus causes inertness to vaccination present that in turn leads to immunity from the vaccine. Meaning that probability of vaccinations effectiveness has limited potential. Moreover influenza vaccine has several side effects associated with it that ranges from fever, to headaches, flu itself and many others.
Immunization rationale for 65 years and over population group
Older adults often argue that flu vaccination might lead them to catch the flu itself. Influenza vaccine injected into adults helps boost their immunity defense mechanism by creation of antibodies. As earlier stated that older adults have already weaker defense immune system, getting injected from the virus antigen might lead to collapse of their defense mechanism altogether. In turn they might end up catching the flu itself. Older adults in contact with other older adults or older community nurses are at higher risk from catching infection at community health care centers. Inspite of all prevailing reasons, vaccinations remain the most effective mechanism (Lang, et. al., 2012). Older adults, who argue regarding effectiveness of the vaccination, need to provide education counseling for the vaccination. They need to be counseled regarding the various negative impacts and complexity that might arise in absence of vaccination. They need to be convinced related to their weakened immune defense systems with which they might easily catch the flu. When older adults are receiving their treatment at community health care centers or hospitals they likely have been affected from morbidity. Additional burden of morbidity might lead to complications as bacteria might mutate to create more complicated diseases. Therefore, it is advised by health practioner as well as by Health care centers to get vaccinated to reduce impacts.
Studies evaluating data pertaining to older adults facing risks from influenza while in contact with other older adults and older community nurses reflects varied evidence. All evidences support that health risks amongst older population is higher considered to other population segment. Influenza can create varied complications in older population above 65 years of age hence it becomes necessary to evaluate such outcomes and adopt measures that can prevent epidemic leading to mortality. Vaccination has been considered the most effective way in which complications can be avoided, other measures includes avoiding close contact with an infected person, covering of mouth and nose when infected, cleaning hands regularly, avoiding touching of nose, mouth or eyes and practicing overall good health habits. These habits have been shown to have a positive effect on curbing widespread of the disease.
Reference Lists
DiazGranados, C.A., Dunning, A.J., Kimmel, M., Kirby, D., Treanor, J., Collins, A., Pollak, R., Christoff, J., Earl, J., Landolfi, V. and Martin, E. (2014). Efficacy of high-dose versus standard-dose influenza vaccine in older adults. New England Journal of Medicine, 371(7), 635-645.
Falsey, A. R., Treanor, J. J., Tornieporth, N., Capellan, J., & Gorse, G. J. (2009). Randomized, double-blind controlled phase 3 trial comparing the immunogenicity of high-dose and standard-dose influenza vaccine in adults 65 years of age and older. The Journal of infectious diseases, 200(2), 172-180.
Haq, K., & McElhaney, J. E. (2014). Immunosenescence: influenza vaccination and the elderly. Current opinion in immunology, 29, 38-42.
Holland, D., Booy, R., De Looze, F., Eizenberg, P., McDonald, J., Karrasch, J., … & Weber, F. (2008). Intradermal influenza vaccine administered using a new microinjection system produces superior immunogenicity in elderly adults: a randomized controlled trial. The Journal of infectious diseases, 198(5), 650-658.
Izurieta, H. S., Thadani, N., Shay, D. K., Lu, Y., Maurer, A., Foppa, I. M., … & Worrall, C. (2015). Comparative effectiveness of high-dose versus standard-dose influenza vaccines in US residents aged 65 years and older from 2012 to 2013 using Medicare data: a retrospective cohort analysis. The Lancet Infectious diseases, 15(3), 293-300.
Lang, P. O., Mendes, A., Socquet, J., Assir, N., Govind, S., & Aspinall, R. (2012). Effectiveness of influenza vaccine in aging and older adults: comprehensive analysis of the evidence. Clinical interventions in aging, 7, 55.
McElhaney, J. E. (2011). Influenza vaccine responses in older adults. Ageing research reviews, 10(3), 379-388.
Medlock, J., & Galvani, A. P. (2009). Optimizing influenza vaccine distribution. Science, 325(5948), 1705-1708.
Osterholm, M. T., Kelley, N. S., Sommer, A., & Belongia, E. A. (2012). Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. The Lancet infectious diseases, 12(1), 36-44.
Song, J.Y., Cheong, H.J., Hwang, I.S., Choi, W.S., Jo, Y.M., Park, D.W., Cho, G.J., Hwang, T.G. and Kim, W.J.(2010). Long-term immunogenicity of influenza vaccine among the elderly: risk factors for poor immune response and persistence. Vaccine, 28(23), 3929-3935.
Talbot, H. K., Griffin, M. R., Chen, Q., Zhu, Y., Williams, J. V., & Edwards, K. M. (2011). Effectiveness of seasonal vaccine in preventing confirmed influenza-associated hospitalizations in community dwelling older adults. Journal of Infectious Diseases, 203(4), 500-508.
Vajo, Z., Tamas, F., Sinka, L., & Jankovics, I. (2010). Safety and immunogenicity of a 2009 pandemic influenza A H1N1 vaccine when administered alone or simultaneously with the seasonal influenza vaccine for the 2009–10 influenza season: a multicentre, randomised controlled trial. The Lancet, 375(9708), 49-55.
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