Thursday, August 21, 2014

I Got It From Carol




# 8980

My annual flu shot, that is.      


One of the reasons I’m a little late posting this morning is that I had some errands to run, and on the way popped into my local pharmacy to get the flu  vaccine.  Carol is my friendly local CVS pharmacist, and she gives a damn fine shot.


I know what you are thinking: It’s only August . . .flu season is still a couple of months away . . . .


True, but flu viruses circulate year-round, not just during `flu season’ and flu cases can start to ramp up as early as September.  Since it takes a couple of weeks for flu shot to reach maximum effectiveness, I always try to get the flu shot earlier rather than later.  


Here was what the CDC has to say about the timing of getting flu shots.


Should I wait to get vaccinated so that my immunity lasts through the end of the season?

CDC and the Advisory Committee on Immunization Practices (ACIP) recommend that flu vaccinations begin soon after vaccine becomes available, ideally by October. However, as long as flu viruses are circulating, it is not too late to get vaccinated, even in January or later. While seasonal flu outbreaks can occur as early as October, flu activity most often peaks in January or later. Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against flu virus infection, it is best that people get vaccinated in time to be protected before flu viruses begin spreading in their community. Although immunity obtained from flu vaccination can vary by person, previously published studies suggest that immunity lasts through a full flu season for most people.

There is some evidence, however, that immunity may decline more quickly in older people. For older adults, another flu vaccine option is available called the “high-dose” vaccine, which is designed specifically for people 65 and older. This vaccine contains a higher dose of antigen (the part of the vaccine that prompts the body to make antibody), which is intended to create a stronger immune response in this age group. For more information, see Fluzone High-Dose Seasonal Influenza Vaccine Questions and Answers.


I also get the flu vaccine early each year, because if I’m going to promote the practice, I’d darn well better be willing to be first in line to get the shot.  Here are the CDC’s recommendations for who should get the shot each year.

Everyone who is at least 6 months of age should get a flu vaccine this season. This recommendation has been in place since February 24, 2010 when CDC’s Advisory Committee on Immunization Practices (ACIP) voted for “universal” flu vaccination in the United States to expand protection against the flu to more people.

While everyone should get a flu vaccine this season, it’s especially important for some people to get vaccinated.

Those people include the following:

  • People who are at high risk of developing serious complications (like pneumonia) if they get sick with the flu.
  • People who live with or care for others who are at high risk of developing serious complications (see list above).
    • Household contacts and caregivers of people with certain medical conditions including asthma, diabetes, and chronic lung disease.
    • Household contacts and caregivers of infants younger than 6 months old.
    • Health care personnel.

More information is available at Who Should Get Vaccinated Against Influenza.


Even though I get the jab every year, I do recognize its limitations.


As we’ve discussed before, flu vaccines – while considered very safe – most years only offer a moderate level of protection against influenza, that their VE (vaccine effectiveness) can vary widely between flu shot recipients, and is often substantially reduced among those older than 65 or with immune problems.


As an example, in October of 2011, in CIDRAP: A Comprehensive Flu Vaccine Effectiveness Meta-Analysis, we saw a major review indicating the TIV (Trivalent Influenza Vaccine) - during 8 of 12 flu seasons (67%) – produced a combined efficacy of only 59% among healthy adults (aged 18–65 years).


They found the protective effects of the flu vaccine could vary considerably from one season to the next, as well as among different age groups (see Study: Flu Vaccines And The Elderly).


Still, given their safety record, and relative low cost, I consider them to be good insurance against what can sometimes be a serious illness – particularly as I’m getting older.  As an added incentive, we recently saw a study - that while far from conclusive - suggesting that the Flu Vaccine May Reduce Heart Attack Risk.


There is no doubt that we need better flu vaccines – particularly for those at greatest risk from influenza infection; the elderly and those with chronic illnesses (see CIDRAP: The Need For `Game Changing’ Flu Vaccines). But until they can be developed, the vaccines we have can and do help reduce the spread of the virus.


While you might not have thought about it, getting your seasonal flu shot each year should be part of your overall preparedness plan. During a disaster or prolonged emergency you are likely to be tired, stressed, and your immune systems could be weakened.


The last thing you need during a crisis is to be sick with the flu on top of it.


All things considered, getting a flu shot every year makes a lot of sense.  For more, you may wish to revisit:


CDC: Flu Shots Reduce Hospitalizations In The Elderly

Research: Low Vaccination Rates Among 2013-2014 ICU Flu Admissions

Two Studies On The 2009 Pandemic Flu Vaccine & Pregnancy

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