Thursday, January 10, 2013

Bad flu season in full swing, but flu shot still helpful

This is basically what I looked like getting my Flu Mist vax.
Source: Wikimedia Commons; credit: CDC.
By Emily Willingham, DXS editor in chief


The flu season that is unfolding is a killer, with influenza having already taken dozens of lives across the United States. Deaths from flu during the flu seasons are actually the norm, ranging from 3000 to 50,000 annually, but this year's outbreak arrived early and features a strain that is infamous for its virulence. Forty-four states now have met the cutoff for "widespread" flu activity as of this writing, and in hotspots like Boston, MA, cases are 10 times the number from the same time last year. In many areas, hospitals have taken to setting up temporary tent shelters outside the buildings to manage the flood of cases and prevent spread inside the facility. ETA: This USA Today article gives an overview of how clinicians are experiencing this outbreak on the ground. [Update: As of 1/18/13, a total of 48 states are now at widespread status, and 29 children have died. Forty percent of hospitalized children have had no known underlying medical conditions.]

Public health officials from the US Food and Drug Administration and the Centers for Disease Control and Prevention (CDC) are urging people who have not gotten their flu shots to do so, saying that there is still time for the vaccination to work for you against the flu. The most vulnerable population is children, and 18 children have already died in the United States during this year's season. According to reports, far less than half of the eligible population in the US has gotten a flu vaccination.

People express reluctance to get the flu vaccine for several reasons. Among them are fears that the vaccine contains mercury as part of a preservative, thimerosal, that has been used for years in various immunizations, although it's been removed from many. For the flu, only vaccines from multidose vials contain this preservative, which is needed to protect the contents from contamination when the vials are opened for repeated use. Single-dose shots and the inhaled Flu Mist do not contain this preservative, which an abundance of studies have shown does not cause harm despite diligent efforts from anti-vaccine organizations to argue otherwise. For more information about this preservative in multidose vials of flu vaccines, the CDC offers a Q&A.

Another source of reluctance is the fact that the flu vaccine, like several other vaccines--or indeed, having the infection itself--is not 100% protective against the illness. In fact, it appears to be about 60% effective in preventing illness, although those who have been vaccinated and do fall ill with the strain included in the vaccine might experience less intense symptoms. The CDC also offers a Q&A addressing why some people who have been vaccinated still catch the flu. My personal feeling is that I'd rather give my children that 60% chance in a rampant flu season with a virulent strain that's hospitalized tens of thousands than give them no protection at all. Any number of interventions don't carry a 100% guarantee of effectiveness, but they certainly enhance the favorable odds. My children and I all received the Flu Mist vaccine back in October. ETA: A recent report found that different forms of the vaccine have different levels of effectiveness in different age groups and that the vaccines and vaccine program require improvement. For more information about the report, which concluded as we've written here that flu vaccines offer moderate protection and have a good safety profile, please see this post by an epidemiologist.

People also forgo a shot because they think that only people in poor health or with pre-existing conditions are susceptible to the most dreaded outcomes with flu: hospitalization and death. That's not actually the case. "Influenza" is the name we give to the highly variable viruses that play games of genetic mix-and-match in different species, with results that are unpredictable and rapidly changing. No one's previous experience with flu will necessarily be predictive of later experiences with the virus. Some flu strains do hit certain populations with specific existing health problems, but other strains kill the young and healthy preferentially. And whether or not you yourself are in perfect health, if you get the flu, you risk passing it along to someone who is not. ETA: For a personal look at who some of those people are, please see the Faces of Influenza site. Some people cannot get a flu shot for medical reasons, and anyone who has had a reaction to a vaccine should obviously consult with their medical professional about vaccines.

A final source of reluctance is that the flu vaccine each year is developed based on educated guesses. No one can predict with certainty which strains will gain the upper hand. As it happens, one strain in circulation this year falls outside of the vaccine target, but medical authorities report that so far, 91% of strains identified in circulation are targets of the vaccine. Because we are talking about influenza and several circulating strains, if you do not get a vaccination, it's entirely possible for influenza viruses to hit you or your family hard more than once this flu season.

Bottom line? Without a vaccination, you're 100% exposed no matter what your age, health, diet, exercise routine, or supplement intake. And if you get sick, you'll endanger everyone you've been around and contaminate every place you've been. Flu carries innumerable potential and unpredictable outcomes, from complete recovery to death, and hospitalizations this year are extremely high. People with a genuine case of influenza end up floored for days, in body-wide pain, with high fevers and wracking coughs and a risk for pneumonia, hospitalization, and death, sometimes with unpredictable rapid progression. Even for those who don't end up in the hospital, complete recovery from these deadly and unpredictable viruses typically takes weeks, meaning lost school, lost productivity, lost work, lost wages. Meanwhile, the vaccine cost ranges from free to about 20-40 bucks at various pharmacies. 

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Here is a basic video explaining some of the complexities of the flu vaccine and its success rate:



The opinions expressed in this article do not necessarily reflect or conflict with those of the DXS editorial team or contributors.

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