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People with cardiovascular disease and older adults should get a flu shot every year

  • High value
  • Evidence A
  • Buys life
  • Disputed
  • Costs a little
  • Takes minutes
  • No willpower

In plain words

In the trial of flu vaccine after a heart attack, deaths within a year fell from 4.9% to 2.9%. For people with cardiovascular disease and for older adults, a shot each fall costs 50 to 150 CNY.

Cost

One shot costs 50 to 150 CNY. Once a year, in the fall.

What you get

One trial was done after myocardial infarction, with 2571 people randomized. Neither doctors nor patients knew which shot was given. In people who got the flu vaccine, total mortality over 12 months was 2.9%. With placebo it was 4.9% (HR 0.59; 95% CI 0.39 to 0.89, the plausible range). A placebo is a control shot with no active ingredient. The HR for cardiovascular death was 0.59. Another study pooled several studies. Major cardiovascular events were 3.6% in people who got the flu vaccine and 5.4% in controls (RR 0.66; 95% CI 0.53 to 0.83). For cardiovascular death, RR was 0.74 (95% CI 0.42 to 1.30; this difference is still within the margin of error and not statistically significant).

Notes

Disputed. Grade A applies only to people with cardiovascular disease. For otherwise healthy older adults, the Cochrane review gives just one result: illness from flu in a season fell from 6% to 2.4%. It rates the certainty of that evidence as “low” and the evidence on death rate as “very low.” The review cited is Demicheli V et al., 2018.

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. Fröbert O 等 (2021). Influenza Vaccination After Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.121.057042
  2. Behrouzi B 等 (2022). Association of Influenza Vaccination With Cardiovascular Risk: A Meta-analysis. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2022.8873
  3. Demicheli V 等 (2018). Vaccines for preventing influenza in the elderly. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD004876.pub4（备注里说的那份 Cochrane 汇总）

Mentioned in

Translated from the Chinese original. Original book, section 1, tip 20. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer