A majority of young adults with cardiovascular disease (CVD) are not receiving the annual influenza (flu) vaccine despite their heightened risk of secondary infections, according to a presentation at the American Heart Association (AHA)'s Scientific Sessions 2020.

For those with CVD, the vaccine can prevent the flu and its potential complications, which is important for this population as they are more susceptible to the flu than those without a chronic health condition.

"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," said lead author of the study Tarang Parekh, MBBS, MS, PhD candidate and assistant researcher at George Mason University College of Health and Human Services, in a press release.

In this study, researchers analyzed data on both CVD and flu vaccination from the 2018 Behavioral Risk Factor Surveillance System. They then surveyed participants on whether they received a flu shot in the past 12 months and have a history of heart attack, angina (chest pain), congestive heart failure, or stroke.

With data from 100,000 adults between the ages of 18 and 44 years, the researchers were able to place participants into groups of those aged 18 to 34 years and those aged 35 to 44 years. The rates of vaccination within each group was then assessed with a focus toward those who had CVD.

Based on the results of the survey, the researchers found that approximately 20% of participants aged 18 to 34 years with a history of heart attack received an annual flu shot, whereas approximately 25% of those who did not have a history of heart attack were vaccinated. Among the participants aged 35 to 44 years, approximately 22% who had a history of heart attack got the flu shot, whereas 28% of those without a history of heart attack did.

Additionally, the flu vaccination rate among older adults with any CVD history (26.7%) was lower than among younger adults (28%). However, stroke survivors aged 18 to 34 years were more likely to be vaccinated at a rate of 27% than those of the same age who had never had a stroke, who were vaccinated at a rate of 24%.

Overall, the rate of flu vaccination in 2018 was found to be higher among adults aged 35 to 44 years than among younger adults aged 18 to 34 years, although the rates were similar among younger adults whether or not they had a history of CVD.

"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 noted during the presentation that they hope these findings will increase awareness among cardiologists and the public regarding the importance of the flu vaccine each year.

"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," Parekh said.

Additionally, the AHA noted the relevance of this study to their ongoing collaboration with the American Lung Association and the American Diabetes Association to promote the importance of the flu vaccine.

“All adults and all children, by and large, should be getting influenza vaccinations year after year,” said AHA’s chief medical officer for prevention Eduardo Sanchez, MD, MPH, FAAFP, in a press release. “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."

REFERENCE
Flu vaccine rate less than 25% in young adults with heart disease, despite increased risk. Dallas, TX: American Heart Association; November 9, 2020. eurekalert.org/pub_releases/2020-11/aha-fvr110220.php. Accessed November 12, 2020.