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The Importance of Flu Shots

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Now’s the time to start thinking about getting the influenza vaccine. And this year it’s more imperative than usual because health experts are warning about the possibility of a “double threat” — twin epidemics of both the flu and the COVID-19 virus. According to Mark Thompson, PhD, an epidemiologist in the Influenza Division at the Centers for Disease Control and Prevention (CDC), “No year is a good year to get the flu, but this year — with COVID-19 also raging — it’s especially bad.”

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Although the flu usually peaks around December, the CDC advises that September and October are the ideal times to get the vaccine because then you’re protected for the whole flu season. The U.S. Food and Drug Administration (FDA) has already released several flu vaccine lots that are available for distribution by the manufacturers, and major drugstore chains are urging customers to get shots early because of the anticipated high demand — perhaps twice as many inoculations as in 2019.

But if you’re dragging your feet about getting a flu shot, here’s one more reason to do it. A new study from Denmark indicates that for adults with diabetes, influenza vaccination is significantly associated with reduced risks for:

· Death from all causes

· Cardiovascular death

· Death from heart attack (acute myocardial infarction, or MI) or stroke

The study was published in the medical journal Diabetes Care. A team of researchers led by Daniel Modin, MB, a research associate at Gentofte University Hospital in Copenhagen, used a Danish national register to identify nearly a quarter of a million adults with diabetes during nine consecutive flu seasons (2007 to 2016). The researchers excluded subjects who had heart disease, heart failure, lung disease, cancer or cerebrovascular disease. The investigators determined which of the selected patients had received a flu vaccine before each flu season. Then the researchers monitored the patients for four months (December 1 to April 1) to find out the number of deaths from all causes, from cardiovascular causes, and from stroke or heart attack.

Modin and his team discovered that during the follow-up periods about 8,200 patients had died of all causes. Of these, about 4,100 died of cardiovascular causes and 1,400 of heart attack or stroke. However, the patients who had received a flu vaccination were less likely to die of any of these causes. Compared to those who were not vaccinated, the risk in the vaccinated patients of cardiovascular death was 16% lower, of fatal stroke or heart attack was 15% lower, and of death from all causes was 17% lower. The vaccinated patients were also less likely to be hospitalized for acute diabetes complications (high blood sugar, ketoacidosis or coma). The researchers also looked into whether the patients’ use of insulin made any difference. They found that death rates were lower both in vaccinated patients who were prescribed insulin therapy and in those who weren’t. Their findings were not affected by the patients’ age, sex, education, income, medications or other illnesses, the researchers said.

The researchers concluded, “In this nationwide register-based study… we have shown that influenza vaccination is significantly associated with a reduced risk of all-cause, cardiovascular and stroke/acute MI death despite rigorous control for confounding factors. We have also shown that vaccination is significantly associated with a reduced incidence of acute diabetes complications. To our knowledge, this is the largest study to date examining the association between influenza vaccination and outcome in patients with diabetes… Our study significantly adds to the growing body of evidence indicating beneficial effects of influenza vaccination in patients with diabetes.”

Interestingly, this new information about the benefits of the flu vaccine comes a year after a similar report from the same team of researchers was presented at the European Society of Cardiology (ESC) Congress 2019. Modin and his colleagues released a study that showed influenza vaccination in patients with high blood pressure was associated with an 18% lower risk of death during the flu season. At the time, Modin said, “Given these results, it is my belief that all patients with high blood pressure should have an annual flu vaccination. Vaccination is safe, cheap, readily available and decreases influenza infection. On top of that, our study suggests that it could also protect against fatal heart attacks and strokes and deaths from other causes.

Want to learn more about diabetes and the flu? Read “Planning Ahead for Sick Days With Diabetes” and “Fight the Flu With Food.”



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