Statins could stop flu jab from working properly and put elderly at risk, scientists warn

Statins work by cutting inflammation but they can also stop vaccines taking hold, scientists now believe

Statins can stop the flu jab from working properly making pensioners more vulnerable to dangerous strains of influenza in winter months, two new studies suggest.

Around 13 million people are eligible to take statins in the UK, and most will be over 50 years old.

Currently the NHS recommends that over 65s are vaccinated against flu because they are more vulnerable to the virus.

But two new studies in the US show that statins can hinder the effectiveness of the flu jab, cutting protective antibodies by up to 67 per cent. They also raise the chance of being admitted to hospital with a serious respiratory illness.

"Apparently, statins interfere with the response to influenza vaccine and lower the immune response, and this would seem to also result in a lower effectiveness of influenza vaccines," said lead author Dr Steven Black, of Cincinnati Children's Hospital Medical Centre.

The flu vaccine has proved controversial in recent years. In August Public Health England admitted that just one in three people had been protected by the jab after the virus mutated in a way that immunologists were not expecting.

Health experts said the poor protection rates coupled with the new risk warrants further investigation.

"Statins are widely prescribed to older adults to reduce cholesterol levels, but are known to have a suppressive effect on the immune system," said Prof Sarah Gilbert, Professor of Vaccinology, University of Oxford.

“Older adults are more likely to develop severe disease with life-threatening complications if infected with influenza, and so annual influenza vaccination is recommended for everyone over the age of 65.

“We already know that the influenza vaccine is only moderately effective in older adults, so the new findings that taking statins may reduce vaccine effectiveness requires further investigation.”

Last year the health spending watchdog Nice recommended that 17.5 million people should be taking statins in guidance which aimed to cut50,000 deaths a year from strokes and heart attacks.

It means that most men over 60 and women over 65 are now offered the drugs, even if they only have a one in 10 chance of developing cardiovascular disease within 10 years.

But the new studies suggest that the cholesterol-busting drugs have a detrimental effect on the immune response of the influenza vaccine and the vaccine’s effectiveness at preventing serious illness in older adults.

In one study, researchers looked at data from 7,000 people over 65s who took part in flu vaccine trial conducted between 2009 and 2011.

Statin users had a significantly reduced immune response to vaccination compared to those not taking statins, as measured by the level of antibodies to the flu vaccine strains in their blood three weeks after being vaccinated.

In a second study, Emory University researchers looked at the records of 140,000 people to see whether statins had raised the risk of being admitted to hospital with a serious respiratory illness despite having the vaccine. They found that those on statins were 25 per cent more likely to be admitted with an illness like bronchitis or pneumonia.

Statins are thought to affect the flu vaccine because they are anti-inflammatory and so fight off the immune response. While this is beneficial in heart conditions, it can stop vaccines taking hold.

"What we found was a potential signal that the effectiveness of flu vaccine in older people may be compromised somewhat if they are on statins, compared to those who are not on statins," said lead author Dr Saad Omer of Emory University in Atlanta, Georgia.

The authors say that more research needs to be done before guidelines on statins and the flu vaccine.
However the Royal Pharmaceutical Society said there not enough evidence to show that the risks outweighed the benefits.

Sotiris Antoniou, a spokesperson for the RPS on cardiovascular medicine said: “Statins are known to have effects on the immune system and so a potential interaction with the flu jab is indeed possible.

“However, we must recognise that the findings of a reduced effect of the flu jab may be due to other things. There’s good evidence to show taking statins protects your health. Until more research is done to answer the question of a potential interaction between statins and the jab and the implications of a the vaccine having a reduced effect, you should go on taking your statins as normal. “

Dr Ben Neuman, a virologist, of the school of Biological Sciences at Reading University, added : “It’s not as bad as it seems. Although statins did reduce the immune response, they didn’t wipe it out altogether and the so there was still some protection there.

“We know from other studies that it is a little bit unpredictable who will end up in hospital with the flu and it effects everyone a bit differently so it can be hard to draw conclusions from studies like this.”

Professor Stephen Evans of the London School of Hygiene and Tropical Medicine said: “The effects are too uncertain to suggest that patients stop their statins.

“For many people taking them there will be very certain benefits in heart disease and to stop them for an uncertain harm in respiratory disease would be unwise, based on this evidence.”

Professor Peter Weissberg, Medical Director at the BHF, said: "No one who is planning to have a flu vaccination this winter should stop taking their statin on the basis of these studies. Indeed patients with heart disease are at greater risk of a heart attack if they catch flu and therefore need the protection of their statin. It is important that patients with heart disease should be vaccinated against flu and continue to take all of their medication.”

New research also published in Pulse magazine today showed that GPs are resisting the push to prescribe more statins.
The number of statins prescribed per 1,000 patients on GP lists has risen by a 0.9 per cent since new guidelines were issued last year.

However Nice said doctors should continue to prescribe the drugs: ‘If a well patient and their doctor measure the risk and decide statins are the right choice, the weight of evidence clearly shows no credible argument against their safety and clinical effectiveness in people with a 10 per cent risk over 10 years.’

The research was published in The Journal of Infectious Diseases.

http://www.telegraph.co.uk/news/health/news/11961304/Statins-could-stop-flu-jab-from-working-properly-and-put-elderly-at-risk-scientists-warn.html