Health Leader, The Flu Shot

STORY BY

David Theis

So—another flu season came and went, and, like the vast majority of Americans, you didn’t get your vaccine. You figured, why would anybody ever get a shot that they didn’t absolutely need? Besides, it’s just the flu, right?

Wrong. The flu shot can do more than prevent you from feeling lousy for a few days or weeks—it can possibly save your life.

Flu, Heart Attacks and Strokes

Researchers are now making connections between influenza and both heart attacks and strokes. It appears that an annual flu shot is one of best (and cheapest) ways of keeping these killers at bay.

The connection between the flu and heart disease was first studied by a team of doctors at The University of Texas Health Science Center at Houston. Cardiologist S.Ward Casscells, said in a recent interview with heartwire, “Time and time again, we were seeing people in our practice who had had an upper-respiratory infection and then suffered a heart attack. When we dug into the literature, we saw reports that many heart attacks, as many as 35 percent, were preceded by an upper-respiratory infection. We also saw that patients who had received their flu shots were less likely to have a heart attack.”

Vaccinated Heart Patients are Smiling

Casscells, Dr. Mohammad Madjid, assistant professor of medicine at the UT-Houston Medical School, and Dr. Morteza Naghavi (formerly with UT-Houston), conducted a case control study (comparing two groups of patients with heart disease who did and did not develop secondary heart attacks, in terms of influenza vaccination) which indicated that patients with heart disease who were vaccinated were 67 percent less likely to suffer future heart attacks than those who were unvaccinated.

The report was received with some skepticism, as case control studies are considered less definitive than clinical trial studies, where trial subjects are taken at random from the general public, with half given the test medicine, and the other half a placebo (or a different medication) and their results can be used in clinical practice.

But as so often happens, results started coming in around the same time from other, related studies. Four more studies suggested that the flu vaccination does in fact protect against atherosclerosis,

Other Studies Agree

Most recently, a large study (280,000 patients) by the New England Journal of Medicine established that the flu vaccination may significantly reduce both mortality rates (from all causes!) and the rate of hospitalization for stroke and heart disease.

Encouraged and intrigued by these results, the UT-Houston recently held “The First Symposium on Influenza and Cardiovascular Disease: Science, Practice, and Policy,” which brought together experts in the various fields to discuss both the data and the need for better vaccination policies. “Only 30 percent of heart patients are vaccinated,” says Madjid. “We have some difficulty in getting the message out, both with patients and doctors.”

This, despite the fact that, as Casscells notes, “Getting the flu shot probably reduces the risk of heart attack, stroke, or sudden death by 20 or 25 percent. If you had to choose between a lifetime supply of ACE inhibitor, beta blocker, statin, or a flu shot, you’re going to choose the flu shot.”

Arterial Plaque and Flu

But, why would a flu vaccination have any impact on strokes or heart attacks? Aren’t these medical conditions vastly different?

There is a powerful connection, according to Madjid. “Influenza begins as a severe and acute inflammation in the body which can also inflame the plaque in the arterial wall.” This inflammation can destabilize the plaque, thus leading to stroke or heart attack. It also increases the possibility of clot formation.

Getting the Word Out

The relationship between the flu vaccine and heart disease has “great clinical implications,” according to Madjid, and it is important to “educate the doctors and the public” about what we already know.

But the final word on the topic still hasn’t been spoken. “We need to do clinical trials,” Madjid says, and to test the vaccine’s effectiveness on patients “who are at high risk of myocardial infarction such as those with multiple risk factors.”

But in the meantime, we’ve all been given another extremely compelling reason to get our shots before the next flu season begins, now that we are beginning to understand yet another way that influenza can hurt us.

Last Updated: 5-12-2003

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About Dr. Casscells:

Dr. Samuel W. Casscells Cardiologist Samuel W. Casscells is the John Edward Tyson Distinguished Professor of Medicine at the UT Medical School.

See Dr. Casscells also at:

Health Tip:

Packing Bag Lunches Safely

If you pack lunches for your child to take to school, be careful that you do not accidentally expose them to foodborne illness.

Bagged lunches, especially those containing perishable foods, need to be packed and handled properly in order to keep the food safe. In general, perishable foods should not be left at room temperature for more than two hours. If left out too long, the temperature of the food can enter the danger zone where bacteria grow most rapidly, which is between 40 and 140 degrees Fahrenheit.

Below are some tips to help families pack bagged lunches safely:

Pack foods that are nonperishable and won't require refrigeration.
If you do pack perishable foods such as luncheon meats or prepackaged cheese and crackers, include a frozen gel pack or a frozen juice carton with the food in an insulated lunch bag or box.
Pack only the amount of perishable food that your child can eat at lunch.
Preparing lunches the night before and storing them in the refrigerator until you pack your child's lunchbox in the morning can help keep food cold longer the next day.
Don't reuse packaging materials such as paper or plastic bags, aluminum foil, etc. as they can contaminate other foods and cause foodborne illness. Have your child discard all used food packaging and paper bags after lunch.

Before eating lunch or snacks at school, make sure your child washes his or her hands with soap and warm water for at least 20 seconds. If your child's school does not have a handwashing program in place, encourage them to adopt a such a program, as handwashing is one of the best ways kids and parents can protect health and stop the spread of germs.