Age and Ageing, Vol 28, 141-145, Copyright © 1999 by British Geriatrics Society
JM Potter, B O'Donnel, WF Carman, MA Roberts and DJ Stott
INTRODUCTION: in the UK the Department of Health recommends influenza
vaccination for elderly people resident in institutional care. However, the
efficacy of vaccination may be reduced in very frail elderly people with
functional impairment, undernutrition and multiple pathologies. Nutritional
and functional status is claimed to affect vaccine responses in healthy
elderly subjects. We wished to determine if a relationship could be seen
between nutritional and functional status and seroconversion in patients
receiving long- term care. METHODS: all patients in geriatric medical
long-term care were offered vaccine. Consenting patients had pre- and
post-vaccine serology measured using single radial haemolysis.
Anthropometry was measured to enable body mass index (BMI) to be
calculated. Functional independence was assessed using the 20-point Barthel
index. RESULTS: of 260 patients who received influenza vaccine, 137 (36
male, 101 female) consented to venesection for serology and thus form the
study population. Mean age was 82 years (SD 7.9). The median Barthel score
was 3/20 and the mean BMI was 21.6 (SD 4.6, range 13-36.2). Antibodies to
influenza A were undetectable both pre- and post-vaccination in 63/137
patients. In 49 patients the antibody titre rose after vaccination and 25
had detectable antibody titres pre-vaccination which failed to rise
post-vaccine. There were no significant associations between
post-vaccination influenza antibody responses and BMI, Barthel score or
age. CONCLUSION: frail elderly patients in geriatric medical long-term care
had a poor antibody response to influenza vaccination. Within this group,
serological responses could not be predicted by nutritional or functional
status.
ARTICLES
Serological response to influenza vaccination and nutritional and functional status of patients in geriatric medical long-term care
Mansionhouse Unit, Victoria Infirmary NHS Trust, University of Glasgow, UK.
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