Influenza and pneumococcal vaccination in heart failure: a little applied recommendation

Heart failure (HF) is associated with frequent decompensation and admissions to the emergency service. Influenza (INF) and Pneumococcal (pneumonia) vaccinations are recommended in the guidelines, however, respiratory infections are the third leading cause of hospitalization in heart failure. To assess the frequency of vaccination against INF and PNM in patients with HF in government healthcare units. An observational study carried out in Teresópolis, a mountain region in Rio de Janeiro, employed three strategies: (I) study of requests for vaccine against INF and/or PNM in the Health Department of Teresópolis between 2004 and 2006; (II) direct inquiry to 61 patients with heart failure treated in primary care about their vaccination status against INF and PNM; (III) direct inquiry about their vaccination status against INF and PNM to 81 patients with decompensated chronic heart failure treated in the only emergency service open to the public. In strategy I, INF and/or PNM vaccination was 15.3% of those with indications for cardiovascular and respiratory diseases. The median time between indication and vaccination was 32 days. In strategy II, the percentage of patients vaccinated against INF, aged > 60, was 23.1% and 24.6% against PMN at all ages. In strategy III, the percentage of patients vaccinated against INF was 35.8% and against PNM was 2.5%. The rate of vaccination against INF and PNM in patients with HF is very low and even lower in those with decompensated HF treated in emergency services.