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Wednesday, September 21, 2011

We Need A Better Flu Vaccine

Coming soon to your child’s school and your workplace: the fevers and aches and cough that mean the winter’s flu season has begun. As anyone who’s had the flu will tell you, it is not just a “bad cold.” If you get the flu—the real flu—you’re looking at about 5 days of hiding under the covers, shivering with fever, and wishing that your skin didn’t hurt so much. It’s really quite miserable. And, for some, deadly: about 36,000 Americans die each year from complications of the flu. Many are elderly and in ill-health to begin with, but some are young, and some are babies.

Prevention is much better than treatment. Wash your hands! Stay away from sick people! If you are sick with flu symptoms, stay home! And, though it’s not perfect, you should get yourself an your kids older than six months a flu vaccine.

I’ll be honest with you: the current flu vaccines, both injected and nasal, aren’t the best vaccines we’ve got. In good years, they probably provide about 80% protection, at least when given to young healthy children and adults (it’s less effective in the elderly.) Some years, it’s less effective than that. So if 50 million Americans get a flu vaccine, about 10 million of them won’t really get a whole lot of protection. That means many people who get vaccinated are still susceptible.

Still, 40 million people will be protected—meaning not only are they safe from flu, but they can’t spread it around the neighborhood. The best protection we have (for now) is for everyone to get vaccinated. It doesn’t work in everyone, but the more people in the herd who are protected, the less likely people who didn’t get the vaccine (or who didn’t respond to the vaccine) will come in contact with the flu. It’s imperfect, but a combination of good public health resources, personal hygiene, and universal vaccination is the best way to protect everyone.

Why is the flu vaccine less than perfect? Flu strains change, so the target of the vaccine has to be tweaked from year to year, based on an educated guess that some years turns out to be more accurate than others. Immunity to influenza infection, whether from vaccination or natural infection, also tends to wane with time. Elderly people and children have a less-robust immune response to the vaccine.

There is some exciting news: a “universal flu vaccine” is now being tested in animal studies, and preliminary results are promising. The vaccine targets parts of the flu virus that don’t change from year to year, and may even provide protection against very new strains (like the next “swine flu.”) If this vaccine is shown to be safe and effective in people, it might be able to provide many years of protection—or even lifetime protection—with a few shots, eliminating the yearly flu vaccines given now. A more-effective vaccine, lasting longer, that protects against flu strains that haven’t even appeared yet? Cool.

The current vaccines are very safe, and can help keep you and your family healthy. Go get yours. Future vaccines may be even better, which will be good news for everyone!

Posted by: Roy Benaroch, MD, FAAP at 1:48 pm

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