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The direct benefits of the influenza vaccine can be difficult to quantitate, especially among older people. Studying vaccination's indirect benefits has been more successful, and several groups have demonstrated a mortality benefit among older people when healthcare workers are vaccinated.
In a very large study of vaccinations' indirect benefits, researchers sought to ascertain the mortality benefits of state legislation that mandates or encourages annual flu shots for hospital employees. In 1995, Alabama was the only state with such legislation; by 2017, 13 more states and the District of Columbia had come on board. During these years, mortality from pneumonia or influenza declined across the country, but steeper declines were seen in state…