Five Questions With: Vincent Mor

Vincent Mor is professor of medical science in the Brown University Department of Health Services, Policy and Practice as well as research health scientist at the Providence Veterans Administration Medical Center. He has been a national gerontology expert for more than 30 years. He recently co-authored a study establishing the effectiveness of flu vaccines among the elderly.

PBN: Were you surprised by any of the results of your study? What really stood out for you?
MOR:
We were surprised at the size of the mortality effect and that it was replicated in the overall mortality attributable to influenza in the 122 cities that CDC monitors.

PBN: Your recent research displayed the effectiveness of flu vaccine for the elderly, but not everyone in the field agrees. What kind of arguments do some physicians make against flu vaccines for an elderly population?
MOR:
I don’t believe that any practicing physicians don’t believe in the value of influenza vaccine for the elderly. The disagreements are really about the quality of the evidence as viewed by epidemiologists, clinical trials specialists and particularly infectious disease epidemiologists who know how difficult it is to prove a vaccine to be effective. Their argument is that there have not been any rigorous randomized clinical trials of flu vaccination in the elderly, particularly the frail elderly, and they don’t believe that observational studies can be done without various forms of bias that can invalidate the results.

PBN: Your research also showed the strong year-to-year variability for flu vaccine makers’ success in producing a good match with that year’s virus. Is there any early word on this year’s vaccine and this year’s virus and how they match up?
MOR:
The adequacy of the match to the prevailing strain(s) of influenza is not known until the end of the flu season. The vaccine is designed based upon what kinds of influenza strains are observed to be prevalent in the Far East and in the southern hemisphere in the northern hemisphere summer. While this is a reasonably good guess, there are obviously some seasons in which the predicted flu variant does not materialize in the northern hemisphere. Today, there are vaccines that include protection against multiple strains, but not all may work equally well.

- Advertisement -

PBN: What percentage of elderly individuals should get a yearly flu shot, and what are reasons to consider not getting a flu shot for an elderly individual?
MOR:
The public health goal should be to vaccinate at least 85 to 90 percent of the population. While those living in nursing homes achieve this rate, in the community it is much closer to 50 percent. There are numerous reasons for people not to get vaccinated, such as a lack of trust, belief or understanding of its importance. The power of individual anecdote, stories of family members and individuals’ experience very powerfully shape people’s behavior.

PBN: Why are flu vaccination rates so much higher among nursing home residents – and what can be done to get more elderly people who live independently to get shots?
MOR:
In nursing homes vaccinating long stay nursing home residents is a publicly reported quality measure for nursing homes so they have an incentive to spend the time to talk reluctant patients into being vaccinated, but still a small proportion refuse vaccination.

No posts to display