Influenza Vaccination in Older Adults Could Save Lives, Reduce Costs: Marco del Riccio, MD

Because influenza infection is associated with an increased risk of heart attack and stroke in older adults, influenza vaccination may prevent wintertime cardiovascular events, saving lives and reducing costs by preventing both influenza and its indirect consequences, Marco del Riccio, MD, of the University of Florence in Italy, told The American Journal of Managed Care® in part 3 of an interview.

Watch parts 1 and 2 to learn about the inspiration behind the Flunomics report, published by Sanofi in collaboration with del Riccio, and the factors that contributed to the disproportionate impact of influenza on older US populations during the 2024-2025 season.

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

You also found that older adults generated most influenza-related hospital costs due to higher hospitalization rates rather than higher per-stay costs. How should this inform health system planning?

I think we have to take this information and consider it in terms of different levels. The first one is in terms of understanding that [older adults] bear the most important burden of disease. In terms of the health of our population, we want our population to stay healthy and to age healthily. This is important to know, because it means that if you had to prioritize a population for preventive tools, this is one of the key things that you might want to take into consideration. This is the population that bears the most disproportionate burden, part 1.

Part 2 is that it's an expense for public health, especially in countries where you have a public system and everything is funded. But as you look at it, it is an expense, and it is an expense that can be prevented, which is not always the case for everything. When you estimate and do calculations, and you want to reduce the burden, you want to reduce expenses, it's also important to understand that you have tools to prevent a disease that can bear and that can bring disproportionate expenses to your population. Again, this is the key risk group that bears the highest burden, also in economic terms.

I'm not 100% aware of the out-of-pocket costs of the influenza vaccine in the US, but if I'm not wrong, the out-of-pocket cost is around $100 for the high dose, thinking of the older adults; this is to be checked. But if you think that the average calculated cost for hospitalization for older adults is about $35,000 for a stay, comparison is quite important. I mean, of course, not every vaccine will prevent a hospitalization. Of course, you have to vaccinate quite a lot of people to prevent a hospitalization, yet the burden will be in favor of vaccinating, of course. So, this is rather important.

The other very important thing to consider is that it's probably to be taken into consideration that these numbers, these figures, are underrepresented. What we can calculate are the direct costs and part of the indirect costs of hospitalizations for influenza, but what we cannot, or at least it's very, very hard, is the link to the acute respiratory infection, influenza, in this case, and the long-term consequences of having had an acute event. We know that, for instance, the chance, or the probability, of having a heart attack or [stroke] rises 5 times in the first week or first 2 weeks after having an acute respiratory infection such as influenza, and slightly less for [stroke].

Still, it's hardly calculated because it’s something that you do not link directly to your influenza event, and so it's not being linked to the calculation of the costs that you have because you're having probably a heart attack, which the probability is made higher by having had an acute respiratory infection, so this extra part of the cost of the heart attack is not calculated within the consequences of an influenza infection. Yet, it's there.

So, the question is, on the other side of the coin, is there a chance to prevent even a little part of the heart attacks you have during the winter by vaccinating people, by preventing influenza? The answer is yes. So, you would save lives and money by preventing influenza and also by saving the indirect consequences of an influenza infection.