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'Fighting talk' on community hospital pay

A new study has turned expectations on their head by finding healthy elderly people benefit more than those with comorbidities from influenza vaccination.

But further research suggests the healthy elderly remain unconvinced they need the vaccine amid warnings that many may be slipping through the net.

The vaccine can cut mortality by up to 34 per cent in healthy elderly people compared with 25 per cent in those with respiratory illness or other comorbidity, Dutch researchers found.

Mortality fell with each successive year that people were vaccinated, but a year's gap sent the risk of dying soaring ­ to even higher levels than in unvaccinated patients.

Lead author Professor Bruno Stricker, professor of pharmacoepidemiology at the Erasmus Medical Centre in Rotterdam, stressed the importance of vaccinating patients every single year, saying a year's interruption caused a 'strong and significant increase' in mortality. 'Fortunately if you restart vaccination, protection comes back again,' he added.

The study, published in JAMA earlier this month, used a large primary care data- base of over 26,000 patients to assess the effect of successive annual flu vaccinations.

But GPs may have their work cut out convincing healthy elderly people of the merits of flu vaccination, according to research presented at the Five Nations Health Protection Conference in Manchester this month.

Many healthy elderly didn't believe they needed the vaccine and didn't regard age as a risk factor for flu, researchers at the University of Wales College of Medicine found.

Dr Douglas Fleming, director of the RCGP Birmingham research unit, said there was a hard core of healthy patients who refused to be vaccinated at any cost.

But he disputed the results of the Dutch study, saying GPs should continue to focus on patients with comorbidity. 'I've always believed we should be focusing on people with comorbidities whatever their age,' he said.

By Emma Wilkinson

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