Cardiovascular mortality is decreasing but remains the leading cause of death world-wide. Respiratory infections such as influenza significantly contribute to morbidity and mortality in patients with cardiovascular disease. Despite of proven benefits, influenza vaccination is not fully implemented, especially in Latin America.
The aim was to develop a regional consensus with recommendations regarding influenza vaccination and cardiovascular disease.
A multidisciplinary team composed by experts in the management and prevention of cardiovascular disease from the Americas, convened by the Inter-American Society of Cardiology (IASC) and the World Heart Federation (WHF), participated in the process and the formulation of statements. The modified RAND/UCLA methodology was used. This document was supported by a grant from the WHF.
An extensive literature search was divided into seven questions, and a total of 23 conclusions and 29 recommendations were achieved. There was no disagreement among experts in the conclusions or recommendations.
There is a strong correlation between influenza and cardiovascular events. Influenza vaccination is not only safe and a proven strategy to reduce cardiovascular events, but it is also cost saving. We found several barriers for its global implementation and potential strategies to overcome them.

Purpose. \"False consensus\" refers to individuals with (v. without) an experience judging that experience as more (v. less) prevalent in the population. We examined the role of people\'s perceptions of their social circles (family, friends, and acquaintances) in shaping their population estimates, false consensus patterns, and vaccination intentions. Methods. In a national online flu survey, 351 participants indicated their personal vaccination and flu experiences, assessed the percentage of individuals with those experiences in their social circles and the population, and reported their vaccination intentions. Results. Participants\' population estimates of vaccination coverage and flu prevalence were associated with their perceptions of their social circles\' experiences, independent of their own experiences. Participants reporting less social circle \"homophily\" (or fewer social contacts sharing their experience) showed less false consensus and even \"false uniqueness.\" Vaccination intentions were greater among nonvaccinators reporting greater social circle vaccine coverage. Discussion. Social circle perceptions play a role in population estimates and, among individuals who do not vaccinate, vaccination intentions. We discuss implications for the literature on false consensus, false uniqueness, and social norms interventions.

Influenza, an infectious respiratory disease, is one of the main causes of excess winter deaths (EWDs) in Europe. Annual flu epidemics are associated with high morbidity and mortality rates, especially among the elderly, those with underlying health conditions and pregnant women. Health Care Workers (HCWs) are also considered at high risk of both contracting influenza and spreading the virus to vulnerable patients. During the 2014/2015 season, the excess winter mortality rates observed in countries of the northern hemisphere (EuroMOMO network) and in Italy (+13%) were strongly related to the intensity of influenza circulation. Influenza vaccination is the most important public health intervention to prevent seasonal influenza transmission and infection. However, to date, influenza vaccination coverage reported in Europe (including high-risk groups) is still largely unsatisfactory. This study analyzes some international and European guidelines on influenza vaccination and the rationale that underlies evidence- based public health intervention for the prevention of influenza among the principal high-risk groups: a) the elderly (subjects aged 65 years or older); b) subjects with underlying health conditions; c) pregnant women; d) healthcare workers. Only by achievement recommended influenza vaccination coverage among high-risk groups in all European countries can we reduce the burden of disease.