Research Highlights:

  • Research shows an annual flu shot is an easy and inexpensive way to prevent illness and death in people with heart disease.
  • A new study shows nearly one in three people with heart disease don’t get a flu shot each year.

Embargoed until 4 a.m. CT/5 a.m. ET Monday, Nov. 11, 2019

DALLAS, Nov. 11, 2019 — An annual flu vaccination is inexpensive, easy and proven to prevent illness and death in people with heart disease, however, almost 1 in 3 patients skip the flu shot, according to preliminary research to be presented at the American Heart Association’s Scientific Sessions 2019 — November 16-18 in Philadelphia. The Association’s Scientific Sessions is an annual, premier global exchange of the latest advances in cardiovascular science for researchers and clinicians.

The vaccine rates are worse among the uninsured and those who lack regular medical care.

“Patients need to be educated about the benefits of the flu vaccination,” said lead study author Gowtham Rama Harsha Grandhi, M.B.B.S., M.P.H., an internal medicine resident physician at MedStar Health in Baltimore. “People with heart disease are at higher risk of medical complications or death from the flu.”

Researchers examined vaccination rates in more than 15,000 people age 40 and older who had experienced a heart attack, stroke or had other conditions related to clogged arteries. All were participants in the national Medical Expenditure Panel Survey between 2008 and 2015. Researchers found:

  • Almost 1 in 3 had not been vaccinated against the flu in the past year;

  • Of those who had insurance and a regular source of medical care, almost 30% hadn’t been vaccinated for flu; and

  • Uninsured, low-income individuals had the highest rate of non-vaccination at 65%.

“Our study sheds light on key inequalities related to disparities in flu vaccination rates. We hope that flu vaccinations among heart disease patients becomes an integral part of quality of care measures and will facilitate processes to limit these unintended care gaps among the most vulnerable in our society” said senior author Khurram Nasir, M.D., M.P.H., M.Sc., chief of Cardiovascular Prevention & director of Outcome Research at Houston Methodist. “Future studies should put emphasis on patient and health system factors driving these disparities and practical interventions to overcome these challenges”.

“Cardiologists, primary care doctors and other clinicians need to have a conversation about flu vaccination well in advance of the onset of flu season to encourage patients to have routine follow-up appointments early in the flu season. Additionally, they should be offering vaccination and possibly providing walk-in appointments for flu vaccination at their centers,” Grandhi said.

Because information on medical conditions and vaccination history was obtained through surveys and not verified with medical records, inaccuracies in patient recall might have influenced the results. In addition, the study was not able to analyze the vaccination rates in young adults because there weren’t enough survey participants in the 18-39 age group who had heart disease.

According to the American Heart Association’s Chief Medical Officer for Prevention, Eduardo Sanchez, M.D., M.P.H., FAAFP, this study provides additional merit for a new Association project.

“We are partnering with the American Lung Association and the American Diabetes Association to collectively deliver a message to providers and to the general public that all adults and all children, by and large, should be getting influenza vaccinations year after year, but in particular, for our patients who have chronic diseases like high blood pressure, diabetes or emphysema, it is critically important to get that flu vaccine. Because the consequence of the flu with complications is far, far greater for those with chronic diseases,” said Sanchez.

Co-authors are Javier Valero-Elizondo, M.D., M.P.H.; Reed Mszar; Rohan Khera, M.D.; Nihar R. Desai, M.D., M.P.H.; Michael J. Blaha, M.D., M.P.H.; Ron Blankstein, M.D.; Salim S. Virani, M.D., Ph.D.; Harlan M. Krumholz, M.D.; Saad B. Omer, M.P.H., Ph.D.; and Khurram Nasir, M.D., M.P.H. Author disclosures are in the abstract.

Additional Resources:

Statements and conclusions of study authors presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at

The American Heart Association’s Scientific Sessions is a premier global exchange of the latest advances in cardiovascular science for researchers and clinicians. Scientific Sessions 2019 is November 16-18 at the Pennsylvania Convention Center in Philadelphia. More than 12,000 leading physicians, scientists, cardiologists and allied health care professionals from around the world convene at the Scientific Sessions to participate in basic, clinical and population science presentations, discussions and curricula that can shape the future of cardiovascular science and medicine, including prevention and quality improvement. During the three-day meeting, attendees receive exclusive access to over 4,100 original research presentations and can earn Continuing Medical Education (CME), Continuing Education (CE) or Maintenance of Certification (MOC) credits for educational sessions. Engage in the Scientific Sessions conversation on social media via #AHA19.

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on, Facebook, Twitter or by calling 1-800-AHA-USA1.


For Media Inquiries and AHA Volunteer Expert Perspective:

AHA News Media in Dallas: 214-706-1173

AHA News Media Office, Nov. 16-18, 2019 at the Pennsylvania Convention Center, Philadelphia: 215-418-2450

For Public Inquiries: 1-800-AHA-USA1 (242-8721) and