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Flu shots advised, but effect is varied

Last year’s flu season turned nasty.

And, to make matters worse, the vaccine was a bit of a flop.

Last season’s flu vaccine was just 23 percent effective at reducing someone’s risk of catching the flu and going to the doctor’s office or urgent care center, the Centers for Disease Control and Prevention found. That compares with effectiveness rates of 50 to 60 percent in recent years.

So far, as people are now getting their flu shots, it looks as though this season’s vaccine does a better job of fighting the major circulating strain of the virus.

“The vaccine is still the best way to prevent the flu, and there’s optimism this year it is a good match,” said Dr. Gale R. Burstein, the Erie County health commissioner.

But given the unpredictable nature of influenza, no one knows for sure how effective the vaccine will be this year.

Still, the benefits of getting a flu shot outweigh the risks of not getting one, experts say.

So George Noto, of Niagara Falls, and his wife, Claudia, lined up recently for a shot at an immunization clinic in Amherst organized by the Visiting Nursing Association of Western New York. “I had the flu when I was younger, and it was miserable,” he said.

At age 75, he wants to reduce his risk of getting the illness again.

“I’ve been to the hospital enough times at my age without the flu that I’m not taking any chances,” he said.

Flu shot campaigns are well underway. Health authorities recommend annual flu vaccination for everyone 6 months and older.

With most forms of the vaccine available, the manufacturers plan to distribute as many as 179 million doses nationwide, according to the CDC.

Last year, 47.1 percent of the U.S. population got vaccinated, a slight increase from the previous year. But coverage varies by group, with children and those 65 and older having higher immunization rates. The rates fall for those 18 to 64.

The only shortage reported is with FluMist, the nasal spray vaccine approved for those 2 to 49. Production problems encountered by MedImmune caused delays. Burstein said shipments of all doses are expected later this month and early December, but other flu vaccines are widely available at medical offices, pharmacies and immunization clinics.

How much flu illness is out there? Authorities cannot count every case. Instead, public health officials track the spread and level of sickness by testing certain samples from patients and examining reports of visits to doctors and hospitals for influenzalike illness. Reports as of mid-November show minimal flu activity across the country, with confirmed cases in Western New York only in Erie, Wyoming and Chautauqua counties.

For most people, seasonal flu means coughing, a runny nose and a sore throat – similar symptoms that come with colds and other respiratory illnesses caused by viruses. But the flu harbors a more dangerous side. It can lead to serious illness, especially among the elderly, young children and those with chronic medical conditions.

Viruses constantly mutate

No one knows exactly how many people die from complications from the flu, and the number varies year to year. One widely used estimate indicates that flu-associated deaths in the United States ranged from 3,000 to 49,000 in any given year between 1976 and 2007. Most of those who die are 65 or older.

“People need to understand the consequences of the flu to themselves and others, especially for individuals at higher risk of complications. They need to understand the risk of dying from the flu versus other things,” said Dr. Kevin T. Shiley, medical director of infection control for Catholic Health.

The thinking goes that the more people who get vaccinated, the more people will be protected from getting sick or spreading the contagious virus to others, especially those most vulnerable. “If you don’t get vaccinated, it’s not just a personal decision,” Shiley said. “It’s a decision that can affect your entire family.”

Most people can afford the cost. In many cases, health insurance covers immunization. Prices range from $11 to $33, depending on the type of vaccine.

The viruses that cause influenza constantly mutate, requiring manufacturers to regularly update the vaccine based on predictions of which three or four strains will dominate. Among other things, experts track the major strains of the virus circulating in the Southern Hemisphere, where it’s winter when it’s summer in the Northern Hemisphere.

Manufacturers can’t switch up the formula on the fly if the virus changes, the case last year, because the vaccine takes months to produce, including incubating the vaccine inside millions of eggs.

The vaccine effectiveness varies by the age and health of individuals. What’s more, studies of effectiveness over the years have used different methods and are of variable quality.

Caution on using antibiotics

For instance, the Cochrane Collaboration, an independent organization that evaluates medical research, looked at effectiveness differently and concluded that, for healthy adults, 40 people need vaccination to prevent one case of flu symptoms. For healthy children in a similar review, the group found the vaccine had greater value, with eight children over the age of 6 needing to be vaccinated to prevent one case of flu symptoms.

The key take-away: Until a better vaccine is developed, the one that’s available may be flawed but remains the best way to prevent the flu, according to physicians. Even with low effectiveness, the vaccine prevents thousands of illnesses and hospitalizations.

“The more people who get immunized, the less opportunity there is for the dominant flu virus to take hold,” Burstein said.

Widespread immunization also reduces health care costs.

“Fewer people go to the emergency room or get hospitalized,” Burstein said. “There are a lot of compelling arguments for getting vaccinated.”

Physicians say they constantly encounter misinformation about vaccines that discourages people from getting immunized.

They say the vaccine, made from inactivated virus, is safe and doesn’t cause the flu. Side effects are usually mild, such as soreness in the arm or low-grade fever. Severe allergic reactions remain rare.

They also cautioned against using antibiotics, which don’t work against viruses like colds and flu.

“A lot of people confuse the flu with other respiratory illnesses,” said Dr. Richard P. Vienne Jr., Univera Healthcare vice president and chief medical officer. “It feeds the myth that the vaccine doesn’t work.”


Flu shot effectiveness

How well vaccines work differs from flu season to flu season

Flu season Effectiveness

2004-05: 10%

2005-06: 21%

2006-07: 52%

2007-08: 37%

2009-10: 56%

2010-11: 60%

2011-12: 47%

2012-13: 49%

2013-14: 51%

2014-15: 23%

Note: The CDC defines effectiveness as how well the vaccine reduces the risk of a person with the flu seeing a doctor. Effectiveness studies can vary based on their design, and the age and health of those examined. Researchers place more confidence in findings from recent years.

Source: Centers for Disease Control and Prevention