Government health officials predicted a harsher and earlier flu season this year, and so far, the forecast appears to be coming true.
Physicians in the Boston area have already reported record numbers of patients coming in with flu-like symptoms such as body aches, cough, fever, and excessive fatigue. As of late December, nearly 4,000 state residents had laboratory-confirmed cases of the flu — most had the more severe type A strain — compared with barely more than 100 confirmed cases at the same time last year.
But if you haven’t been sick yet, and haven’t gotten around to getting an annual flu vaccine, it’s not too late, said Dr. Alfred DeMaria, an infectious disease specialist at the Massachusetts Department of Public Health, since the season probably won’t peak for another month or so.
But a flu shot is no guarantee of protection. And, recently, questions have been raised about the effectiveness of popular drugs in treating the illness. Thus, despite your best efforts, you could still come down with the flu this season, leaving you out of commission for a week or more. The latest research dispels common myths about influenza, and offers a reality check on what we should expect in preventing the flu and lessening its impact.
Without a doubt, getting a yearly flu vaccine is the best preventive step you can take — and this year’s vaccine is well matched against the circulating strains — but plenty of people who get vaccinated wind up getting infected with the virus later on.
A 160-page University of Minnesota analysis of the flu vaccine published last October concluded that the yearly immunization is, at best, about 60 percent effective in children and young healthy adults and may not be very effective at all in elderly people who are most at risk of dying from flu-related complications.
“Public health officials have sent out the message that the flu vaccine works about as effectively as other vaccines, about 70 to 90 percent of the time, but I would say that’s been overestimated,” said Michael Osterholm, an epidemiologist at the University of Minnesota’s Center for Infectious Disease Research and Policy who led the team that issued the flu vaccine report. “But some protection is better than nothing, so it’s still a good idea to get the vaccine. I just don’t think we should be overselling its benefits.”
The report called for more investment into experimental flu vaccines that would provide stronger protection against multiple influenza strains and last for up to a decade.
The government’s Advisory Committee on Immunization Practices began recommending in 2010 that everyone age 6 months or older get a yearly flu vaccine, but it’s not yet clear how much of an impact that has had on preventing the estimated 3,000 to 49,000 deaths that occur every year in the United States from the flu. Population studies indicate that people who get an annual flu vaccination have about a 4 percent lower risk of dying from the flu compared with those who don’t get annual vaccinations, according to Osterholm.
He and his colleagues’ analysis of 31 studies examining the flu vaccine’s effectiveness — excluding hundreds of studies that didn’t use adequate lab testing to confirm flu infections — concluded that “evidence for consistent high-level protection is elusive for the present generation of vaccines.” For those more likely to have life-threatening complications from the flu because they are older than 65, or have an impaired immune system or a lung condition such as asthma, that’s especially true.
But not everyone agrees with these conclusions. DeMaria pointed out that Osterholm’s team excluded important papers such as a 2004 Dutch study, which found that elderly people who had annual flu shots were less likely to die of any cause during the flu season than those who didn’t get vaccinated.
And Japan saw a temporary sharp decline in elderly flu deaths after the country began requiring yearly flu immunizations for all children in public schools — a policy that has been revoked because of logistical problems.
About two-thirds of children in Massachusetts get a yearly flu vaccination, which probably helps prevent some spread to seniors — though not as much as if children were required to be vaccinated for school entry. DeMaria said there are no plans for such a policy.
Parents may want to consider for their children the nasal spray form of the vaccine, which has a live attenuated virus, since it appears to work more effectively in young children ages 2 to 9, compared with the shot. For older children and adults, the needle jab appears to be more effective than the nasal spray. A higher-dose flu vaccine shot approved for those age 65 and over could “lead to greater protection against the flu” among this population, according to the federal Centers for Disease Control and Prevention’s website.Continued...