Calling on ACIP to address disparities in flu vaccinations


Calling on ACIP to address disparities in flu vaccinations

Brandpoint (BPT)

(BPT) – By Thomas Triomphe, Executive Vice President of Vaccines at Sanofi

While flu seasons can vary in severity, one thing is clear: older adults bear the greatest burden from severe complications of seasonal flu. Year over year, about 90% of flu-related deaths and 50-70% of influenza-related hospitalizations occur in adults aged 65 and older. The higher risk for severe flu-related complications in older adults can be attributed to weakened immune systems and the presence of underlying chronic health conditions. Although what’s not apparent within these data is the disproportionate impact of severe complications from seasonal flu on older adults from racial and ethnic minority groups. This month, the CDC’s Advisory Committee on Immunization Practices (ACIP) is evaluating data so that it can provide clearer guidance for flu vaccines for these populations.

Black and Hispanic older adults (65-74) with the flu are more likely to be hospitalized and admitted to an intensive care unit, compared with White adults of the same age. Additionally, minority communities may have higher susceptibility to flu infection caused by a higher likelihood of living in multi-generational housing, a greater reliance on public transportation and a reduced ability to work from home.

Compounding the higher rates of hospitalization and susceptibility to exposure is the disparity in flu vaccination rates: among individuals from racial and ethnic minority communities, the rates of flu vaccination are lower than that of Whites. Additionally, there’s lower uptake of flu vaccines in older adults receiving low-income subsidies or living in rural areas.

What’s more, while everyone can get a flu vaccine with low (or no) out-of-pocket cost, not all vaccines offer the same protection, especially for older adults. A study published in NEJM showed that the only available high-dose vaccine specifically designed for people 65 years and older was 24% more effective in preventing flu in adults over age 65 compared with a standard-dose vaccine. A separate study published in the Lancet found that adults over 65 who received that same high-dose vaccine had a lower risk of hospital admission versus adults over 65 who received a standard-dose vaccine, especially those living in long-term care facilities. Yet despite this, flu vaccine recommendations do not distinguish between flu vaccines available for adults 65 years and older.

When it comes to older adults from minority populations, an article published in The Lancet showed that among adults over 65 who received a flu vaccine, those from racial and ethnic minority groups were 26-32% less likely to receive the high-dose vaccine. The same study also showed that older adults with chronic diseases were less likely to receive a high-dose vaccine than those without a chronic disease diagnosis. Guidance designating a preferred flu vaccine for older adults could avoid unnecessarily compromising the health of these older adults who are already at higher risk for severe flu-related complications.

Frequent doctor’s visits are associated with a higher uptake of flu vaccination in older adults, although they are not associated with a higher chance that the patient receives a high-dose flu vaccine.

Perhaps some pharmacies or doctor’s offices don’t stock the high-dose vaccine, or perhaps they don’t know there’s one high-dose vaccine that offers greater protection for an older population. Without a clear recommendation by ACIP, some communities, especially those with higher minority populations or those in rural areas, may not purchase or stock enough high-dose flu vaccines, thus missing the potential to lower the burden of disease for older adults in these settings.

Flu vaccination is one of the most important tools we have for protecting the public’s health, especially for older adults from racial and ethnic minority groups who may suffer the greatest burden. ACIP has the ability to make a distinction between influenza vaccines by supporting a recommendation for the use of high-dose influenza vaccine in this vulnerable population to help address this disparity. The data is clear: older adults, especially those from minority communities, may be at a disadvantage when it comes to flu vaccination. We need to make sure this disadvantage is addressed before the individual goes to their doctor or enters the pharmacy to receive their flu shot — following the science that shows flu vaccines aren’t all the same would be a meaningful step.

Thomas Triomphe is the Executive Vice President of Vaccines at Sanofi. Thomas leads the company’s vaccines research and development, industrial and commercial operations and drives the teams’ commitment to prevention against infectious diseases, with a portfolio encompassing seasonal influenza vaccines, pediatric combinations, adolescents & adults boosters, meningitis and travel/endemic vaccines, as well as the development of the first preventive intervention against respiratory syncytial virus for all infants and vaccines against COVID-19.