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Don't Forget Those 'Flu Shots!

post #1 of 8
Thread Starter 
New York Times

An Easy Means of Prevention: A Flu Shot

October 23, 2001


While millions of Americans fret over the threat of anthrax spread by terrorists, they may ignore another infectious disease that will soon descend on the country and probably claim tens of thousands of lives. That disease is influenza. And while an anthrax vaccine is not available to the general public, a flu vaccine is, and it can prevent a vast majority of cases of influenza and the death and disability they can cause.

In a typical year, 10 percent to 20 percent of Americans come down with influenza, 200,000 people are hospitalized and more than 20,000 die from flu-related complications. Most of this can be prevented by a shot that costs $10 to $15.

So whether or not you are anxious about anthrax, you would be wise to follow the most current flu prevention guidelines. These guidelines are issued each year by the Centers for Disease Control and Prevention to assure that those most at risk of suffering severe and potentially fatal consequences of the flu are protected first, before the rest of the population depletes supplies of vaccine.

Vaccine availability varies from year to year because it must be made anew each summer and fall to protect against the viral strains likely to cause the greatest problems in the coming winter. For example, this season's vaccine will protect against three viral strains: A/Moscow, A/New Caledonia and B/Sichuan; the Moscow and Sichuan strains were not in last year's vaccine. And while there was an extended delay in vaccine production last fall, a delay is not expected this year. Still, there is a limit to how much vaccine can be available at any one time.

Now is the time for those at highest risk to get their flu shots. If past years are any indication, at best only 60 percent of Americans most likely to become hospitalized or to die as a result of the flu will get the shot.

And with so much attention now focused on anthrax, chances are flu vaccine percentages will take a big hit this season, resulting in a greater toll than usual on the health of Americans and the economic well-being of a nation already under financial stress.

Whom to Immunize and When

The newest guidelines from the disease control centers establish an immunization timetable that calls for people with the greatest risk of serious complications from the flu to be protected first - now, in October. Those who should get the vaccine without delay include the following:

¶ Everyone over 65. As people age, their ability to fight off infections wanes and they become more susceptible to complications like pneumonia, which can be life-threatening. Even if an older person's immune system fails to respond strongly enough to the vaccine to prevent the flu, the vaccine can reduce the severity of the illness and lower the risk of serious complications.

¶ Anyone with a chronic medical condition: heart or lung disease, including asthma; diabetes; kidney disease; liver disease; chronic anemia; or chronic malignant conditions like leukemia and lymphoma, as well as people with AIDS and those who are H.I.V. positive.

¶ People receiving treatments that suppress the body's ability to ward off infections: those taking high levels of corticosteroids for conditions like rheumatoid arthritis and ulcerative colitis; those undergoing treatments like chemotherapy or radiation treatments for cancer; and organ transplant recipients who take drugs to prevent rejection.

¶ Children and teenagers who must take aspirin for long periods, since they may develop a serious illness called Reye's syndrome if they come down with a viral illness like influenza.

¶ All women who will be in the second or third trimester of pregnancy (months four through nine) during the flu season, which in North America starts in November and usually lasts through March.

¶ All health care personnel who minister to high-risk people, whether in a hospital, nursing home, outpatient clinic or home, since if caretakers contract the flu they could readily transmit it to someone likely to become seriously ill.

Next in line for flu shots, to be administered in November, are those at lesser risk of complications or of causing illness in others at higher risk.

¶ Healthy people between 50 and 65. Last year, the C.D.C. added middle-aged healthy people to the list of those at higher than usual risk of flu complications after studies showed that hospitalizations and deaths associated with the flu start rising considerably at age 50.

¶ Household members who live with people 65 and older or with anyone with a chronic medical condition (see the list above), since they could increase the risk to those more vulnerable to flu complications.

¶ Anyone else, including children, who would like to avoid getting the flu.

Many people were long under the impression that flu vaccine was only suitable for older people, when it has always been true that anyone of any age can benefit from it. In fact, the younger you are, the more effective the vaccine is likely to be.

Further, a study over several years in Japan showed that immunizing children against the flu protected older people because children were the primary vectors of the disease. Lacking immunity to flu viruses, children are most likely to acquire the virus, spread it among themselves and transmit it to others.

Vaccine Concerns

Some people should not get the flu vaccine. Anyone with an allergy to eggs (the vaccine virus is grown in chick embryos, and traces of egg may remain in the finished vaccine) and anyone who has had an allergic reaction or who developed Guillain- Barré syndrome (a condition causing paralysis of involuntary muscles) after a previous flu shot should not get the vaccine. Also, people who are sick and have fevers should wait until they recover before getting the vaccine. On the other hand, having a minor illness like a cold or a seasonal allergy is not a reason to delay a flu shot.

Typical side effects of a flu shot are soreness at the injection site and sometimes a low fever and achiness. There are people who avoid the vaccine because they say that previous immunizations gave them the flu. This is not possible, since the vaccine is prepared with killed virus that cannot multiply in the body.

But people totally lacking immunity to one or more of the viral strains in the vaccine may experience a reaction lasting two or three days that resembles a mild case of the flu. Unlike an actual case of influenza, this vaccine reaction, though it may be temporarily debilitating, is not dangerous, and infectious disease specialists say it should not deter someone at high risk of flu complications from being immunized.

Others hesitate to get the vaccine because they don't like shots. Unfortunately, although tests of a nasal spray vaccine called FluMist have shown it to be highly effective, the company that makes it, Aviron of Mountain View, Calif., is not yet ready to market it because the Food and Drug Administration is not yet convinced of its safety.

For people who cannot or will not get the flu vaccine, there are several prescription drugs available that can either help to prevent the flu or reduce the severity of an attack.

Two preventives that can also reduce symptoms of Type A influenza are amantadine (Symmetrel and generic versions) and rimantadine (Flumadine). Two drugs that can reduce symptoms of both Type A and Type B influenza are zanamivir (Relenza) and oseltamivir (Tamiflu).


Copyright 2001 The New York Times Company

post #2 of 8
Yeah, well, you know what?

Every year my uncle gets his flu shot and every year he gets the flu.

Every year my aunt, his wife, forgoes her flu shot and every year she is healthy. :laughing: :laughing2

So I'm a little skeptical of them myself, though I know people do still die from influenza.

I think it's just that they don't want a jillion folks showing up in emergency rooms with aches and pains, convinced they've all been exposed to anthrax!
:paranoid3 :paranoid2

And there is your proof that I am both a cynic and a skeptic, though I keep both of those to myself most of the time! :confused2
post #3 of 8
Thread Starter 
In my book, it's perfectly all right to be a skeptic — and it's hard not be be a cynic during times like these. But watch out! There are those who consider skepticism a flaw. I think of it more as an indication of circumspection.

post #4 of 8
I get my shot every year, and I don't believe that I have had the flu, unless it was soooo mild I thought it was a passing cold.

Here is an article from "New Yorker Magazine" this week.
I don't know what to believe anymore!!!!


Issue of 2001-10-29
Posted 2001-10-22

If you are wondering what to worry about when it comes to biological weapons, you should concern yourself, first of all, with things that are easy to deliver. Biological agents are really dangerous only when they can reach lots of people, and very few bioweapons can easily do that. In 1990, members of Japan's Aum Shinrikyo cult drove around the Parliament buildings in Tokyo in an automobile rigged to disseminate botulinum toxin. It didn't work. The same group also tried, repeatedly, to release anthrax from a rooftop, and that didn't work, either. It's simply too complicated to make anthrax in the fine, "mist" form that is the most lethal. And the spores are destroyed so quickly by sunlight that any kind of mass administration of anthrax is extremely difficult.

A much scarier biological weapon would be something contagious: something a few infected people could spread, unwittingly, in ever widening and more terrifying circles. Even with a contagious agent, though, you don't really have to worry about pathogens that are what scientists call stable—that are easy to identify and that don't change from place to place or year to year—because those kinds of biological agents are easy to defend against. That's why you shouldn't worry quite so much about smallpox. Deadly as it is, smallpox is so well understood that the vaccine is readily made and extraordinarily effective, and works for decades. If we wanted to, we could all be inoculated against smallpox in a matter of years.

What you really should worry about, then, is something that is highly contagious and highly unstable, a biological agent that kills lots of people and isn't easy to treat, that mutates so rapidly that each new bout of terror requires a brand-new vaccine. What you should worry about, in other words, is the influenza virus.

If there is an irony to America's current frenzy over anthrax and biological warfare—the paralyzed mailrooms, the endless talk-show discussions, the hoarding of antibiotics, and the closed halls of Congress—it is that it has occurred right at the beginning of the flu season, the time each year when the democracies of the West are routinely visited by one of the most deadly of all biological agents. This year, around twenty thousand Americans will die of the flu, and if this is one of those years, like 1957 or 1968, when we experience an influenza pandemic, that number may hit fifty thousand. The victims will primarily be the very old and the very young, although there will be a significant number of otherwise healthy young adults among them, including many pregnant women. All will die horrible deaths, racked by raging fevers, infections, headaches, chills, and sweats. And the afflicted, as they suffer, will pass their illness on to others, creating a wave of sickness that will cost the country billions of dollars. Influenza "quietly kills tens of thousands of people every year," Edwin Kilbourne, a research professor at New York Medical College and one of the country's leading flu experts, says. "And those who don't die are incapacitated for weeks. It mounts a silent and pervasive assault."

That we have chosen to worry more about anthrax than about the flu is hardly surprising. The novel is always scarier than the familiar, and the flu virus, as far as we know, isn't being sent through the mail by terrorists. But it is a strange kind of public-health policy that concerns itself more with the provenance of illness than with its consequences; and the consequences of the flu, year in, year out, dwarf everything but the most alarmist bioterror scenarios. If even a fraction of the energy and effort now being marshaled against anthrax were directed instead at the flu, we could save thousands of lives. Kilbourne estimates that at least half the deaths each year from the flu are probably preventable: vaccination rates among those most at risk under the age of fifty are a shameful twenty-three per cent, and for asthmatic children, who are also at high risk, the vaccination rate is ten per cent. And vaccination has been shown to save money: the costs of hospitalization for those who get sick far exceed the costs of inoculating everyone else. Why, under the circumstances, this country hasn't mounted an aggressive flu-vaccination program is a question that Congress might want to consider, when it returns to its newly fumigated, anthrax-free chambers. Not all threats to health and happiness come from terrorists in faraway countries. Many are the result of what, through simple indifference, we do to ourselves.

— Malcolm Gladwell

post #5 of 8
Thread Starter 
Thanks for posting that very interesting article. I think it reinforces the article I'd posted, in that it points out the widespread mortality influenza brings each and every year. I agree with the author of the article you posted: If we spent a fraction of the energy and money on combatting influenza as is now being marshalled for combatting anthrax, we'd see a dramatic drop in the number of deaths caused by influenza.

In the nation's capitol, politics drive national health-priorities: The big winners in that financial tug-of-war are AIDS and "no smoking." The losers are everything else, including influenza. Mind, more than 50,000 people a year in this country die as a result of motor-vehicle accidents. What, pray tell, is being done about our nutty "car culture"? Very little, indeed.

post #6 of 8
I get my flu shot every year. We are lucky in Canada. The government has made available the flu shot to anyone who wants it at no cost. The hope in doing so to have less work force reduction due to illness (as well I like to think they care about us). There should be no excuse for anyone in Canada not to get it.
post #7 of 8
Last year I got the flu, and I really thought I was going to die. It was awful. My kids had it on Christmas, which was a bummer, plus they were so miserable it broke my heart. Then I got it on New Years when we went to my parents to celebrate Christmas. So the flu basically wiped out our Christmas last year. My husband gets his shot every year, and when we were all so sick last year, he was only congested. So I'm now a firm believer in the shot. I'm going to call the kids' pediatrician and see about them getting it too.

Thanks for the reminder!
post #8 of 8
I never get the choice
All nursing staff have to have them unless you react to it.
I for one am glad that I have it every year, the amount of people I am in contact with, its better to be safe then sorry, thats not to say I wont get a flu but at least I wont get the deadly one .
If you can have it do so, it really is worth it, think of your family as well.

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