Influenza vaccination for all elderly

In the elderly, incidence, morbidity, complications, and mortality due to influenza are greatly underestimated. There are several reasons why influenza vaccination is unjustly denied to many elderly. In a number of countries such as the United Kingdom and The Netherlands, health authorities do not recommend to vaccinate all elderly persons above a certain age, and influenza vaccination is offered only to those with conventional risk factors such as cardiac or pulmonary disease. However, conventional risk factors are often not present or are not recognized in the elderly. There now is convincing evidence that age in itself leads to increased vulnerability and thus is a risk factor for influenza and its complications. It no longer seems justified not to vaccinate all elderly, including the healthy, against influenza.