• Angela Tufvesson - Hong Kong

1Q5A: Spreading the word on influenza vaccination

The link between influenza vaccination and heart health is clear. Annual vaccines, tailored formulations for older adults, and collaboration between government and industry can vastly improve health outcomes, explains France-based Thomas Triomphe, executive vice-president vaccines, Sanofi.

(PART 1 of 5) Re:solve Global Health’s latest Q&A series examines the positive association between influenza vaccination and cardiovascular health. We asked five experts in diverse locations, and from varied backgrounds, including cardiology, pharmaceuticals, and health economics, to answer this crucial question: How can we make best use of influenza vaccination to improve cardiovascular health?

Why is it important to vaccinate those diagnosed with cardiovascular disease (CVD) against influenza?

CVD is the world’s number one killer and influenza increases the risk for cardiovascular complications. The risk of having a heart attack or stroke is elevated by up to 10 and 8 times, respectively, in the 10 days following infection.

For people who already have a CVD diagnosis, a recent study concluded that influenza vaccination reduces cardiovascular deaths after a heart attack and should be considered as part of in-hospital care following a heart attack.

How does the influenza vaccine reduce the risk of cardiovascular problems?

Flu vaccination is on par with smoking cessation and statins in preventing heart attacks. But influenza vaccines differ by the level of protection they provide; and there is clear evidence that using high-dose, tailored flu vaccines, which have been developed specifically to address waning immunity of older adults, can lead to better health outcomes.

Over a period of 10 years, the use of a high-dose versus standard-dose flu vaccine in the US resulted in an 18% reduction in cardiorespiratory hospitalisations. In terms of public health benefits, this means avoiding over 750,000 influenza medical visits and over 500,000 cardiorespiratory hospitalisations, and US$4.6 billion in savings.

How important is it to have an annual influenza vaccine to realise these benefits?

It’s key. The flu virus is sneaky—it has animal reservoirs, which means it’s permanently reassorting in nature, so we cannot let our guard down. The World Health Organization (WHO) has a permanent system of surveillance in place across the world, and, twice a year, a group of experts advises on which viruses pose the greatest risk in the northern and southern hemispheres.

As manufacturers, we stay in close contact with these experts, and we adapt our vaccines to these recommendations. We are also pushing the boundaries by seeing how artificial intelligence can help through collaborations on machine learning with public institutions.

Getting an annual flu shot remains the best solution for all people at risk of complications. We encourage cardiologists to look at the data and talk about flu shots with their patients. We also welcome the discussions in the cardiology community on how to implement influenza vaccination as a routine secondary preventive measure for cardiovascular events.

What can be done to enhance cooperation and lift influenza vaccination rates globally?

Everyone deserves to be protected from the complications of flu by receiving the right vaccine, regardless of age, ethnicity, socioeconomic status, and healthcare risk factors. Therefore, government recommendations for vaccination need to be evidence-based and take into account the broad clinical value demonstrated for certain influenza vaccines through randomised controlled trials, including end points like cardiovascular and pneumonia hospitalisations.

Nothing is more beneficial to public health than an empowered population, with information and understanding about their own health. That’s why we and governments around the world spend a lot of time communicating about the importance of influenza vaccination, and we must continue that work to ensure people don’t become complacent about influenza vaccination, especially when they are at risk.