NIVW 2012

 

Credit CDC

 

# 6759

 

Regular readers of this blog know by now that I get the flu vaccine every year, and that I encourage others to do the same. Not because the vaccine is perfect (it isn’t), but because it is the best preventive measure we have available to us at this time.

 

This week (Dec 2-8)  is National Influenza Vaccination Week (NIVW), the CDC’s annual attempt to reach flu vaccine holdouts before the heart of the flu season arrives.

 

So this week, you’ll be hearing a lot about the flu vaccine on the news and online.

 

The theme this year is It’s Not Too Late To Vaccinate.

 

The CDC will hold a Twitter chat on Wednesday, December 5th, from 1-2pm EST hosted by Dr. Mike Jung. You can participate or follow the conversation via the twitter hash tags @CDCFlu and #NIVW2012.

 

And you’ll find videos and promotional materials on the National Influenza Vaccination Week website, including:

• NIVW Matte Article: It’s not too late to vaccinate – Get your flu vaccine today!  [106 KB, 2 pages]
• 2012-2013 NIVW Update  [223 KB, 2 pages]
• 2012 NIVW Key Points  [308 KB, 3 pages]
• CDC Influenza Awareness Campaign: Media Toolkit  [521 KB, 22 pages]
• NIVW 2012 Flyer and Poster including customizable versions

 

 

I’d be remiss if I didn’t point out that In this year’s NIWV talking points, noticeably absent are any estimates of vaccine effectiveness.

 

Flu campaigns in the past have touted that 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%. This year, that message is replaced with a more generic:

The flu vaccine is the best way modern medicine currently has to protect against this potentially serious disease.

a.  While how well flu vaccines work can vary, the findings of many studies from multiple countries across age groups support the benefits of vaccination, especially during years when the vaccine is well-matched to circulating viruses.

The reason for this change is that studies in recent years have shown the effectiveness of the flu vaccine to vary considerably from year-to-year, and among different age cohorts.

 

A little over a year ago, CIDRAP’s  Comprehensive Flu Vaccine Effectiveness Meta-Analysis) found the trivalent inactivated vaccine (TIV) had a combined efficacy of 59% among healthy adults (aged 18–65 years).

 

Among children aged 2-7, the LAIV proved more protective, showing efficacy in 9 out of 12 flu seasons (75%) with a pooled efficacy of 83%.

 

Not awful, but not terrific either. This is a problem we’ve covered many times before, including:

 

CID Study: Effectiveness Of 2010-11 Flu Vaccine

Study: Flu Vaccines And The Elderly

Flu Shots For The Elderly May Have Limited Benefits

 

 

All of which makes issuing blanket statements about the vaccine’s effectiveness problematic. While I might prefer the CDC could find a way to be more precise, I have to admit are simply too many caveats and exceptions to fit into an easily deliverable press meme.

 

Despite their limitations, flu shots have an excellent safety profile (see Harvard Study Reaffirms Safety Of Flu Vaccine), and remain one of the most important steps we can take to avoid catching influenza each year.

 

Of course, flu shot or not, practicing good flu hygiene is important, too.  Washing your hands frequently, covering coughs & sneezes, and staying home when sick.

 

Flu shots are like seat belts in your automobile. They may not guarantee you’ll walk away from a collision unscathed, but they certainly improve your chances.  

 

Which is why I buckle up every time I get into a car, and why I get the flu shot every year. Not because I’m 100% certain of a good outcome, but because sometimes you’ve just got to play the odds.

NIVW: Dec 4th – 10th, 2011

 

 

 

# 5991

 

Although the reports of influenza remain low across most of Europe and North America right now, most years flu activity doesn’t peak until February. 

 

 

Flu Activity Week 47 – CDC FLUVIEW 

 

Which means it is not too late to get a flu shot this year, and this week – Dec 4th-10th – is National Influenza Vaccination Week.

 

The link below is to this week’s MMWR, which has the announcement for this year’s campaign, after which I’ll return with a bit more on the safety and effectiveness of the seasonal flu vaccine.

 

 

Announcement: National Influenza Vaccination Week — December 4–10, 2011

Weekly

December 2, 2011 / 60(47);1624

National Influenza Vaccination Week (NIVW) is a national observance established to highlight the importance of continuing influenza vaccination and to foster greater use of influenza vaccine through the holiday season into January and beyond. The U.S. Department of Health and Human Services, CDC, and other partners are conducting related activities during NIVW (December 4–10, 2011).

 

Approximately 128 million doses of influenza vaccine had been delivered in the United States as of mid-November (2). During NIVW, CDC will highlight the importance of preventing influenza by vaccination. The Advisory Committee on Immunization Practices (ACIP) recommends influenza vaccination for all persons aged ≥6 months (1). However, certain groups are at higher risk for influenza-related complications. These high-risk groups include children aged <5 years, but especially children aged <2 years; persons with certain chronic health conditions, such as heart disease, asthma, and diabetes (types 1 and 2); pregnant women; and adults aged ≥65 years. Children aged 6 months–8 years who did not receive at least 1 dose of the 2010–11 influenza vaccine will need 2 doses this season to be fully protected.

(Continue . . . )

While the effectiveness of the influenza vaccine can vary from one year to next (usually depending on how closely matched the vaccine is to strains in current circulation), and some people may experience a lower level of protection than others (often due to age > 65, individual immune response, or other health issues), a yearly flu shot remains the best defense against influenza.

 

Last October in CIDRAP: A Comprehensive Flu Vaccine Effectiveness Meta-Analysis we saw the largest meta-analysis to date of vaccine studies that found:

 

TIV showed efficacy in preventing influenza during 8 of 12  flu seasons (67%) with a combined efficacy of 59% among healthy adults (aged 18–65 years).

 

And among children aged 2-7, the LAIV proved even more protective, showing efficacy in 9 out of 12 flu seasons (75%) with a pooled efficacy of 83%.

The authors concluded that while better vaccine technologies are sorely needed, and their results were lower than have been commonly stated in the past, today’s flu vaccines were shown to provide a moderate level of protection.

 

The other side of the coin is the safety of flu vaccines, and despite the non-stop demonization of vaccines by activists on the net, the safety profile of flu vaccines is excellent.

 

A few blogs on this subject include:

 

Harvard Study Reaffirms Safety Of Flu Vaccine

MJA: Safety Of Flu Shot In Young Children

NEJM: Study On China’s H1N1 Vaccine Safety

Lancet: Immunogenicity and safety Of Adjuvanted Flu Vaccines

 

 

While no vaccine (or drug) can be said to be 100% safe – and rare but sometimes serious adverse effects have been reported - the preponderance of evidence continues to support the scientific consensus that flu vaccines are very safe and most years, reasonably effective.

 

Given that influenza-related illnesses claims thousands of lives each year in the United States (cite Estimating Seasonal Influenza-Associated Deaths in the United States), the smart money is on getting the vaccine every year.

 

Even if the shot isn’t perfect.

Vaccines: Weighing The Risk/Reward Ratio

 

 

 

Note: This week is National Influenza Vaccination Week (NIVW).   Today is my attempt to put the risks of vaccination in perspective.

 

# 5122

 

 

Practically every time I mention vaccines in this blog (which is pretty often), I end up with 1 or 2 scathing comments about the `evil’ vaccines do, and links to the usual suspects that peddle vaccine paranoia.

 

Those comments almost always end up deleted, since they offer little more than vaccine vitriol and the same tired arguments. Invariably they contain a reference to someone whose life was seriously disrupted by a flu vaccine.   

 

In the ultimate personification of irony, I know smokers who refuse the vaccine each year because they don’t know what `poisons’ might be in it.

 

But as I’ve pointed out in virtually every vaccine essay I’ve written, vaccines are not 100% safe or completely benign.  

 

 

They can have side effects. Sometimes, albeit rarely, those side effects can be serious.

 

And that is true for all medicines, medical procedures, and just about everything you ingest in life.

 

I almost died at the age of 17 from an anaphylactic reaction to penicillin.  It took a trip to the ER, and IV epinephrine, to alleviate the crisis. That doesn’t make penicillin a bad drug, it is just the wrong drug for me (and others with a similar allergy).

Even aspirin and NSAIDs – sold over the counter – contribute to thousands of hospitalizations and deaths each year.

 

There are risks in just about everything you do.

 

As I’ve said before, if you want a guarantee in  life . . . buy a Craftsman.   

 

Today Fergus Walsh, BBC’s medical reporter and blogger, has a terrific essay called:

 

Aspirin, cancer risk and a personal decision

 

This is an interesting article on cancer and the potential protective effects of aspirin, but I highlight it because it illustrates quite well that we must always consider the downside to every medical decision we make.  

 

Even if it is something as seemingly innocuous as taking an aspirin every day.

 

We must weigh the risks against the potential reward and accept that all medicines are a double-edged sword.

 

Okay, back to the flu vaccine.

 

Last year in excess of 12,000 Americans are believed to have died from the Swine flu, and the CDC estimates there were roughly 274,000 pandemic flu related hospitalizations.

 

Overwhelmingly, those killed or hospitalized were under the age of 65.

 

Despite near-hysterical warnings over the safety of the pandemic vaccine, no deaths were attributed to the Swine flu shot (see CIDRAP VAERS study finds H1N1 vaccine safety similar to seasonal vaccines') and most reported side effects from the vaccine were minor, and temporary.

 

Only 726 serious adverse reactions were reported, out of more than 80 million shots given.

 

• 0 deaths from the Vaccine  vs 12,000 deaths from the flu.
• 726 severe reactions  vs.  274,000 flu hospitalizations

 

That’s the risk reward ratio to consider.  

 

Even if the vaccine were only 50% effective in preventing the flu, a greater uptake could have saved thousands of lives and tens of thousands of hospital stays.

 

The truth is, the benefits of the flu shot far exceed its risks. 

 

 

And that holds true every year, not just during a pandemic.