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Mortality from pneumonia and risk conditions during influenza epidemics. High influenza morbidity during nonepidemic
Abstract:
Increases in mortality from pneumonia and high-risk chronic diseases have not occurred during recent influenza epidemics. Excess mortality during the past four influenza epidemics in the United States is attributable to influenza reported as a primary cause of death, and the average excess was only about 4,000 deaths per epidemic. Most clinical influenza severe enough to cause hundreds of millions of days of bed disability during nonepidemic as well as epidemic years is not caused by the influenza viruses. During the nonepidemic year of 1973 to 1974, there were 61,841,000 episodes of clinical influenza severe enough to put people to bed for an average of 3.6 days. In my judgment there is now no basis for recommending annual administration of influenza vaccines to so-called high-risk groups and persons over 64 years of age.
Insights
Annual influenza vaccination may not be recommended for high-risk groups and older adults. Most severe influenza cases causing significant bed disability are not caused by influenza viruses.
Area of Science:
- Epidemiology
- Public Health
- Virology
Background:
- Recent influenza epidemics have not shown increased mortality from pneumonia or chronic diseases.
- Excess mortality attributed to influenza as a primary cause of death averages only about 4,000 deaths per epidemic in the US.
- Significant bed disability from clinical influenza occurs annually, not just during epidemics.
Purpose of the Study:
- To evaluate the necessity of annual influenza vaccination for specific populations.
- To assess the actual impact of influenza viruses on mortality and morbidity.
Main Methods:
- Analysis of US mortality data during recent influenza epidemics.
- Review of clinical influenza episode data, including bed disability days.
- Assessment of the role of influenza viruses versus other causes of severe clinical influenza.
Main Results:
- No significant increase in mortality from pneumonia and high-risk chronic diseases observed during recent influenza epidemics.
- Average excess mortality directly attributed to influenza was approximately 4,000 deaths per epidemic.
- Millions of clinical influenza episodes causing substantial bed disability occur annually, independent of influenza virus activity.
Conclusions:
- The data does not support the routine annual administration of influenza vaccines to high-risk groups or individuals over 64.
- Most severe clinical influenza cases are not caused by influenza viruses, questioning the efficacy of widespread vaccination strategies.
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