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'Tis the season for prevention As Erie County reports its first confirmed case of flu, health officials worry about low levels of vaccination, despite plentiful supplies

The flu has yet to arrive in Buffalo, but flu shot season is nearing its peak.

Manufacturers are expected to produce and distribute a record amount of vaccine this year in contrast to worrisome shortages in the past.

With the growth in the supply, public health officials are urging more Americans to get vaccinated, especially groups considered prime spreaders of flu and those at high risk for complications.

Only 18 percent of children 6 months to 23 months received an influenza shot in the 2005-2006 season, and the immunization rate among health care workers continues to hover around 40 percent, according to the federal Centers for Disease Control and Prevention.

"Influenza vaccine appears to be more widely available than ever before, and we want people who should be receiving an annual flu vaccination to be sure that they do," Dr. Jeanne Santoli, deputy director of the CDC's immunization branch, said in the government's most recent flu briefing.

Flu cases generally peak in January and February. But mid-October through November is considered the best time to get a shot because this gives the body the several weeks it needs to build immunity as the season progresses.

Influenza, caused by viruses, usually leaves victims with fever, headache, sore throat and a cough. But each year in the United States, more than 200,000 people are hospitalized from flu complications, such as pneumonia, and about 36,000 people die, according to the CDC. The statistics can frustrate health authorities, who face brief panics over vaccine supplies while overall vaccination rates remain fairly low.

"People tend to worry about the newest threat rather than an old disease like the flu, even when the flu is potentially more dangerous and we can do something to protect ourselves," said Dr. Anthony Billittier IV, Erie County health commissioner.

It's a guessing game each year as to the severity of the flu season and how effective the vaccine will be.

So far, only two states have reported to the CDC anything more than isolated cases of the flu. Last week, Erie County reported its first laboratory-confirmed case and is one of eight counties in the state with a confirmed case, according to the state Health Department.

Just because the flu bug has yet to sweep through doesn't mean the area has escaped other viruses that cause colds and other respiratory ailments.

The flu generally is worse than the common cold. Such symptoms as fever and body aches are more common and intense, and colds usually don't worsen into serious health problems.

Flu vaccine contains three influenza virus strains that change annually, depending on scientists' best estimation of which strains will predominate in a particular year.

The viruses for vaccine are grown in chicken eggs and take about six months to produce large quantities. In some years, the vaccine is a very close match. In others, it is not. Flu viruses continually change in a number of ways, making the process difficult.

Initial reports suggest that this year's vaccine may contain two strains that no longer match the main circulating strains, although health authorities said it's too early to know if this is significant.

In years of a good match, the vaccine reduces the chance of getting influenza by 70 percent to 90 percent. Vaccine effectiveness also depends on how well a vaccinated person makes protective antibodies, which may not be as good in the elderly and very young children.

In years when the vaccine is not well matched, its effectiveness is reduced but still good, experts say.

"The severity of the flu is always an after-the-fact assessment, and the match is difficult to predict. Different regions may have different strains circulating," said Dr. Kristin Nichol, an influenza authority at the Minneapolis Veterans Affairs Medical Center and University of Minnesota.

CDC officials anticipate as many as 132 million vaccine doses may be produced by the end of this flu season. Last year, about 121 million doses were produced, of which 102.5 million were shipped for use.

Six companies are producing one of two types of vaccine -- the traditional flu shot made of strains of the virus that have been killed and the newer nasal-spray flu vaccine, FluMist, made with live, weakened flu viruses that can't cause the flu.

The situation today contrasts sharply with the 2003-2004 flu season, when the only two companies that made flu shots for the United States exhausted their supplies.

As long as the supply is adequate, anyone can get a shot. But the CDC recommends vaccination for children 6 months to 5 years old, people with such chronic illnesses as asthma and diabetes, pregnant women, people 50 and older, health care workers and individuals in close contact with high-risk groups.

The Visiting Nursing Association of Western New York, in partnership with Kaleida Health, expects to vaccinate 44,000 people in one of the region's largest annual immunization programs.

"There's no shortage this year and none anticipated," said Donna Sauer, program director.

A listing of area flu immunization clinics is available on the Internet at

Health authorities this year expanded the recommendation for FluMist, the nasal spray influenza vaccine, to include children from 2 to 5 years of age who are healthy and don't have a history of asthma or wheezing.

The vaccine had been limited to healthy children 5 and older and healthy adults up to age 50.

Despite the potential dangers of flu and recommendations for yearly vaccination, immunization rates in children are low.

More than 150 children in the United States died of influenza or its complications during the 2003-2004 flu season, according to a CDC study. Research also indicates that infants and toddlers are hospitalized with influenza at rates comparable to or higher than those for any other group, including the elderly.

"Children are more susceptible because they don't have a built-up immunity," said Dr. Richard Judelsohn, medical director in Erie County's Health Department and a private pediatrician.

He said children also constitute key spreaders of the disease, particularly because they frequently don't practice good hygiene, such as covering their mouths to cough or washing hands.

The people most likely to get vaccinated are those older than 64. In the 2005-2006 flu season, 69 percent of this age group was immunized, according to the CDC.

Only 37 percent of individuals 50 to 64 and 31 percent of high-risk adults 18 to 49, such as those with medical conditions, reported getting a flu shot. In addition, only 42 percent of health care workers get shots, even though health care workers can transmit the virus into the community from patients in hospitals and nursing homes, as well as carry the virus into the facilities.

The numbers fall far short of the government's goal: to have 90 percent of the elderly and 60 percent of young adults at high risk for complications from flu vaccinated every year by 2010.

The trend toward vaccinating more people is considered good for protecting against both seasonal flu and the possibility of a global virus emerging for which people have little or no immunity.

"As we move to increase the number of people vaccinated in the country, it makes us more prepared for pandemic flu. We would have built the capacity for making and delivering flu vaccine to a large number of people," said Dr. John Treanor, an influenza vaccine expert at the University of Rochester.

Still, efforts to vaccinate more people more often coincide with debate over the effectiveness of flu vaccine, especially in the elderly.

A recently published study led by Nichol offered hefty evidence that influenza shots reduce hospitalizations for pneumonia and flu by 27 percent and decrease the risk of death by 48 percent for the elderly.

But another group of experts in a different study argued that the benefits were exaggerated.

"The results of the studies may call into question the extent of the benefit to the elderly, but the benefit is substantial regardless of the uncertainity," Nichol said.



Flu season tips

A flu shot is considered the best way to prevent influenza.

But there are additional measures health authorities suggest to keep well or to limit the spread of the disease.

*If you are healthy, avoid close contact with people who are sick.

*If you are sick, keep away from others to protect them.

*Cover your mouth and nose with a tissue when coughing or sneezing.

*Wash your hands often to eliminate germs.

*Avoid touching your eyes, nose or mouth.

Source: Centers for Disease Control and Prevention

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