Monday, September 19, 2016

#NatlPrep: Giving Preparedness A Shot In The Arm















Note: This is day 19 of National Preparedness Month . Follow this year’s campaign on Twitter by searching for the #NatlPrep hash tag.
This month, as part of NPM16, I’ll be rerunning some edited and updated older preparedness essays, along with some new ones.

#11,746


After blogging about early reports of flu around the country last week, on Friday morning I paid a visit to my local pharmacy (in this case, CVS) and got my yearly flu shot, skillfully and painlessly administered by Ibukun, one of their resident pharmacists.  

Once again I opted to go with the quadrivalent shot.  One that contains 4 flu strains, not the 3 strains included in the traditional trivalent vaccine.  I’ll explain why.

Twice each year (in February for the Northern Hemisphere and September for the Southern Hemisphere), global flu experts meet to decide upon the formulation of the next seasonal flu vaccine.  It’s a dicey proposition, as the viruses in circulation can change radically over a period of months

In addition to picking two influenza A strains (H1N1 & H3N2), experts must also decide which of  two lineages of influenza B virus (Yamagata or Victoria) they believe will dominate the upcoming flu season.
But their record of success in picking the `right’ B strain over the years hasn’t exactly been sterling.


Which is why - in 2012 - the FDA approved the first Quadrivalent Flu vaccine; one containing both Victoria and Yamagata lineage B strains (see Two B's Or Not Two B's? That Is the Question).  Since then, the availability of the quadrivalent vaccine each year has increased steadily.

While influenza B doesn't get as much respect as influenza A, a study published last month in Pediatrics  (see Hospitalization for Influenza A Versus B) suggests the risk of death from influenza B in children may actually be greater than for influenza A.
 
Since I’m a bit of a belt and suspenders type guy, for the second year in a row I’m hedging my bets and going with a vaccine that is formulated to include both B lineages.   I expect that I will do so every year from now on.

 
You might not have thought about it, but getting your seasonal flu shot each year should really be part of your overall individual preparedness plan. During a disaster or prolonged emergency you are going to be tired, stressed, and your immune systems likely weakened.
 
The last thing you need to be dealing with during a crisis is to be sick with the flu on top of it. 
 
According to the CDC, more than 52 million doses of this year’s flu vaccine have already been distributed, and in excess of 160 million should be available this winter, so finding a shot should be no trouble.  
 

 
September might seem a little early to be getting the flu shot, but we are already seeing scattered reports of influenza around the country, and it takes a couple of weeks after getting the shot for immunity to kick in.  
 
The CDC recommends getting it earlier, rather than later (see Should I wait to get vaccinated so that my immunity lasts through the end of the season?)

For those of us of a certain age, getting the flu shot may also  provide additional protection against heart attacks as well (see 2015's  UNSW: Flu Vaccine Provides Significant Protection Against Heart Attack).  Other studies with similar findings include:

  • In August of 2013 (see Study: Flu Vaccine May Reduce Heart Attack Risk), we looked at study out of Australia – published in the BMJ Journal Heart, that found compelling – but not exactly conclusive – evidence that flu shots may reduce the risk of heart attacks as much as 45%.
  • In October of 2013 (see JAMA: Flu Vaccine and Cardiovascular Outcomes) we looked at a meta analysis that found among patients who had previously had a heart attack, the receipt of a flu vaccine was linked to a 55% reduction in having another major cardiac event in the next few months.

Although the `street creds’ of the flu vaccine took a major hit in 2014 after the late arrival of a `mismatched’ H3N2 virus (see CDC: Updated Estimated Seasonal Flu Vaccine Effectiveness), most years the flu vaccine provides a `moderate’ level of protection. 

For the most recent flu season (2015-2016), the CDC estimated it was nearly 50% effective in preventing the flu (see Seasonal Influenza Vaccine Effectiveness, 2005-2016).
  
While the vaccine can’t promise 100% protection, it – along with practicing good flu hygiene (washing hands, covering coughs, & staying home if sick) – remains your best strategy for avoiding the flu and staying healthy this winter.

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