#17,690
While I firmly believe that the seasonal flu vaccine reduces morbidity and mortality, and have gotten the jab every year now for more than two decades, I've written often about the dangers of `overselling' its benefits to the general public (see here, here, and here).
But in 2011 the CDC lowered expectations somewhat, stating in a FAQ: `. . . recent RCTs of inactivated influenza vaccine among adults under 65 years of age have estimated 50-70% vaccine efficacy during seasons in which the vaccines' influenza A components were well matched to circulating influenza A viruses.'Up until about a dozen years ago, the oft repeated mantra from the CDC was: ". . . for healthy adults under the age of 65, in years when the vaccine is a good match to circulating strains, effectiveness ranges from 70%-90%."
Over the past decade we've seen flu shots struggle to even reach that 50% vaccine effectiveness (VE) mark, particularly when H3N2 influenza was the dominant subtype. A few (of many) blogs on these less-than-stellar results include:
Based on more recent studies, the CDC's revised assessment of flu vaccine VE now reads:
While vaccine effectiveness (VE) can vary, recent studies show that flu vaccination reduces the risk of flu illness by between 40% and 60% among the overall population during seasons when most circulating flu viruses are well-matched to those used to make flu vaccines. In general, current flu vaccines tend to work better against influenza B and influenza A(H1N1) viruses and offer less protection against influenza A(H3N2) viruses.
While much closer to reality, a quick Google search finds that some state health departments continue to use the CDC's long-abandoned `70%-90%' VE estimate from 2011. The Arkansas Health department website flatly states, with no caveats, that:
- The best way to prevent the flu is to get the flu vaccine each year. The vaccine takes one to two weeks to start working and is 70 to 90 percent effective in preventing seasonal flu.
I've found similar messaging on other state health department websites, including Illinois ("Studies of healthy young adults have shown influenza vaccine to be 70 percent to 90 percent effective in preventing illness"), albeit with considerably more qualifiers.
While I understand public health's desire for simple-to-deliver public health messages, these are the sort of blanket statements that can quickly backfire.
If you oversell the protective qualities of the flu vaccine, yes, you may get higher uptake of the vaccine. But at the same time you may also convince people that they are more `protected' than they really are, and they may take fewer `flu hygiene' precautions during flu season.
You also risk alienating people who get the vaccine - catch the flu anyway - and who may then conclude it isn't worth getting the vaccine next year. Even if the illness they suffered was less severe due to the vaccine.
What you end up with are a lot of disappointed people, expecting `up to 90% protection' from the flu - on Facebook, Instagram, or Twitter/X - telling the world the vaccine doesn't work.
On Friday the CDC unveiled a new strategy, hoping to `reset' public expectations this fall as to what benefits they can realistically expect from the flu vaccine, emphasizing a reduction in severity over simply preventing infection.
I'll have a bit more after the break.
New Wild to Mild Campaign Drives Key Message to Tame Flu and Reset Expectations
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September 22, 2023—This fall CDC launched a new flu vaccine campaign called Wild to Mild to share key information with the public about how getting a flu vaccine can reduce your risk of flu and its potentially serious outcomes. The campaign focuses on encouraging flu vaccination among higher risk groups, especially pregnant people and children, given drops in vaccination uptake in those groups since the COVID-19 pandemic.
While seasonal flu activity is low across most of the United States, September marks the beginning of the optimal window for most people to get their annual flu vaccine.
The Wild to Mild campaign is based on consumer research showing that many people believe flu vaccination doesn’t work because of first or second-hand experience where vaccination may not have prevented illness. Flu vaccine varies in how well it works. For many years, CDC measured vaccine effectiveness according to how well it prevented illness that required medical treatment. In recent years, however, CDC has expanded its vaccine effectiveness work to include looking at how well flu vaccine works at preventing serious outcomes, like emergency department visits and hospitalizations.
This work has contributed to a strong and growing body of evidence that flu vaccination reduces the risk of serious outcomes in people who get vaccinated but still get sick. The Wild to Mild campaign visually shows how flu vaccination can tame flu illness from wild to mild by showing a wild animal, like a tiger, juxtaposed against a more domesticated animal or toy like a kitten. Other examples include a bear with a teddy bear and a shark with a goldfish.
The intent of the Wild to Mild campaign is to reset public expectations around what a flu vaccine can do in the event that it does not entirely prevent illness. Participants found this information useful and even motivational in consumer testing. For pregnant people, the information about how vaccination during pregnancy could not only protect the pregnant person but also their baby for several months after birth was particularly persuasive.
Everyone 6 months and older should get a flu shot. September and October are the best times for most people to get their annual flu vaccine.
This season’s Wild to Mild campaign is part of an annual educational effort to encourage vaccination among Americans, including among people who are at higher risk of serious flu complications. A separate campaign, “Get My Flu Shot,” w`resethich is a collaboration between the CDC, American Medical Association, and the Ad Council, focuses on trying to reduce long-standing disparities in flu vaccine coverage among Black and Hispanic Americans.
The Wild to Mild campaign is mainly digital and will include social media content, micro-influencer partnerships, and paid placement of educational ads in various online channels and radio spots. Promotional graphics encouraging social media interaction with friends and loved ones also are available.
In recent weeks, influenza A(H1N1) and influenza B viruses have been detected at low levels in the United States, with most of these viruses being similar to the viruses that spread most commonly in the Southern Hemisphere during its flu season. Data from several South American countries showed flu vaccination during their season reduced flu hospitalizations against the predominant flu viruses, influenza A(H1N1), by 55% and against influenza B viruses by 46%.on the flu shot re
Last flu season started early in the United States, with activity increasing nationally at the beginning of October 2022 and peaking in early December 2022.
CDC expects multiple viruses to spread this fall and winter, including flu, COVID-19, and respiratory syncytial virus (RSV). Respiratory diseases can be very serious, especially among people at higher risk of developing serious complications, and CDC urges everyone to get up to date on their recommended vaccines.
You can use Vaccines.gov to find a flu vaccine near you.
Whether internet memes portraying `vaccine attenuated flu' as a kitten, a unicorn, or plush toy will `reset public expectations' on the flu shot remains to be seen. It doesn't speak to me, but then, I'm not the target audience.
But the key message - that even if the flu vaccine doesn't always prevent infection, it can often reduce the severity of one's illness - is a step in the right direction.
This is something we've looked at repeatedly over the years, including the flu vaccine's impact on reducing heart attacks and strokes caused by influenza infection.
Study Suggests Flu Vaccine May Lower Stroke Risk in Elderly ICU Patients
While I much prefer this sort of messaging over internet memes, in the end all that matters is that people are able to make informed decisions.
