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Clinicians: For Older Adults with Dementia, Flu Vaccine is Critical During COVID-19

By | September 16th, 2020

While scientists are still developing a vaccine against COVID-19, there is a vaccine which can not only prevent the flu, but also reduce people’s chances of experiencing severe symptoms of the illness, and lower their risks of hospitalization and death.  

That is the common flu vaccine. For older adults with dementia, clinicians stress that this year, it is critical to be protected against the flu. 

“During this COVID lockdown period, a lot of medicine has been practiced via telemedicine, which has gone more successfully than most clinicians would have thought, myself included,” William Schaffner, the medical director of the National Foundation for Infectious Diseases, told Being Patient. “But one of the difficulties is that you can’t vaccinate via the computer.” 

Schaffner said the concern, particularly among older adults, is that they may forgo a flu shot this year out of an abundance of caution, not wanting to leave the house or go to their care provider’s office due to the pandemic.

 “One of the things that we recommend is they call in advance to see when they can get in and out to get their flu shot very, very quickly,” he said.

According to Vanessa Rodriguez, a geriatrics and palliative care physician at Martha Stewart Center for Living in New York City, the clinic will be scheduling appointments for the flu vaccine to avoid crowding and ensure physical distancing at waiting areas. 

Clinic staff have also instructed some patients to get their flu shots at the pharmacy during times that are less crowded. 

“We definitely strongly think that routine vaccination during the flu season will be essential in the care of older adults,” Rodriguez told Being Patient. 

“During this COVID lockdown period, a lot of
medicine has been practiced via telemedicine.
But one of the difficulties is that
you can’t vaccinate via the computer.”

Rodriguez said her patients with dementia often have underlying conditions that put them at higher risk for complications for the flu compared to older adults who are healthy. Those who have heart failure, and rely on water pills that help the kidneys flush out unneeded water and salt, may be even more dehydrated if they have the flu, she said. After all, it is common for people to lose their appetites, eating and drinking less when they are sick. 

She added that older adults with diabetes who have the flu and lose their appetite can experience an overly low blood sugar level, also known as hypoglycemia, which can be a serious complication. And, patients with respiratory illnesses like asthma or chronic obstructive pulmonary disease who contract flu are more susceptible to respiratory complications. They may experience problems with breathing, requiring treatment in the hospital. 

“Some of them can get so sick that they can get pneumonia on top of their influenza,” Rodriguez said. “That’s one of the worst complications.” 

Some older adults with dementia may be at higher risk of exposure to the flu than those living independently as they are cared for by home aids, she noted. Some of the home aides have families, other jobs or take public transportation, increasing their risk of exposure to the flu. 

“It’s good to encourage family members, caregivers of the person who is older and has dementia, to get vaccinated,” said Ronan Factora, a geriatrician at Cleveland Clinic in Ohio.  

According to the Centers for Disease Control and Prevention, flu vaccination prevented roughly 4.4 million flu illnesses, along with 58,000 hospitalizations and 3,500 deaths linked to the flu from 2018 to 2019.  

While some people who get the flu vaccine may still get the flu, according to Shaffner, their illness is likely to be less severe. They are less likely to to be hospitalized and admitted to an intensive care unit. And they are less likely to die. 

For people who do not feel safe traveling to a clinic or pharmacy during the pandemic, drive-thru clinics for flu shots may offer a safer alternative, according to Rebecca Conant, founding director of the University of California San Francisco Housecalls Program, which provides in-home care for older adults who are home-limited.  

Meanwhile, Conant said clinicians will administer flu shots for patients of the UCSF Housecalls Program at their homes, and many of them have dementia and mobility issues. “It’s people coming into the home potentially bringing [the flu] to them,” she told Being Patient. “It’s families, friends, caregivers.” 

Experts say that people who are concerned about exposure to COVID-19 if they plan to get a flu shot should consult their medical providers. And people should also seek advice from their medical providers for the ideal time for a flu vaccination. 

 

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