This post was authored by Carolyn Bridges, MD, Associate Director for Science, Immunization Services Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC).

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If you don’t make a strong recommendation for your patients to get a flu shot—who will?

Every year, CDC reminds physicians and the public that people with high risk conditions—including people with heart disease and stroke—need a flu shot to help prevent hospitalizations and even deaths from complications from influenza.
But every year, only about 40% of patients 18 to 64 years old with cardiac disease get vaccinated.

You can change that.

Some cardiologists may have traditionally felt that vaccination discussions should take place under the aegis of primary care providers or other clinicians.  And, many specialty providers may not have the staff or facility to support patient vaccination programs in their office, or they may not see their patients regularly during flu season.

It’s time for a new tradition. Studies show that a physician’s recommendation and offering flu vaccine are strong predictors of patient vaccination. In other words, if you strongly recommend a flu shot—your patients will get vaccinated.  These days, if you don’t carry flu vaccine in your office, there are multiple options for your patients to get flu shots. You can write them a ‘prescription’ to remind them and emphasize the importance of preventing severe illness from influenza.

Why is it so important for your patients?

People with heart disease are at high risk for developing serious complications from flu. In fact, among adults hospitalized with influenza, cardiovascular disease is one of the most common chronic conditions.  And, among adults that died from 2009 H1N1, cardiac disease was second only to chronic lung disease among existing co-morbidities.

Need more convincing? Having cardiac disease is estimated to increase the risk of influenza-related hospitalization by almost 3 fold. (*references 1-9)

There’s further incentive—of a positive nature: randomized studies of influenza vaccination of patients with existing cardiovascular disease show that flu vaccination decreases the risk of acute coronary syndrome and cardiovascular disease-related deaths. (*references 10-12)

Based on the risk of severe illness from influenza and the benefit and known safety of influenza vaccination, both the American College of Cardiology, American Heart Association, and the Centers for Disease Control and Prevention recommend the flu shot for patients with cardiac disease. (*references 13-14)

You’ve got both the carrot and the stick in your hands. It’s time for a new paradigm—where all cardiologists take a more active role in ensuring that their patients are vaccinated against influenza each year.  This goes beyond asking patients “So, did you get your flu shot?”  It goes beyond merely suggesting that a flu shot might be a good idea.   Your strong recommendation and instructions to patients about where to get their vaccine, if you don’t offer vaccination in your office, are needed to protect your patients against influenza.

For more information, visit the CDC website. You can order free materials, review the ACIP guidelines, or find further information for yourself, staff, and patients.

The CDC and the ACC have partnered with QuantiaMD to bring you a succinct 5-minute presentation covering recommended Immunization Practices for these high-risk patients. Please note a free QuantiaMD registration is necessary to view entire presentation.

Other resources available on the ACC’s patient-centered website, CardioSmart.org, include patient fact sheets in both English and Spanish. Follow the ACC on Twitter and Facebook for additional tips and information and participate in the Forum Discussion on Prevention in the CardioSource Communities.

*View all references here.

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Please note that statements or opinions expressed herein reflect the views of the contributor, and do not reflect the official views of the ACCF, unless otherwise noted.