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A problem with flu shots? Not enough for people to get it

Every year, flu kills millions of people. But usually too few Americans get the flu shot to protect everyone from the infectious disease.

For maximum protection, the Centers for Disease Control and Prevention recommends 70% of Americans get the shot. During the past decade, fewer than 50% were vaccinated annually, sometimes dipping as low as 42%.

This means that people who cannot be vaccinated – including about 1.9 million infants who are too young – are more at risk than

Public health workers are not only worried about the fever, pain and throat caused by the flu. Worse than these are life-threatening conditions that the respiratory tract can trigger, including inflammation of the heart, brain or spinal cord.

"It's really the complications related to the flu that we should be afraid of," said Libby Richards, associate professor of nursing at Purdue University. "That's what the vaccine helps prevent or reduce."

At greatest risk is the elderly.

People 65 years and older accounted for 86% of influenza-related deaths and 69% of hospitalizations during the 201

7-18 influenza season. , the most recent period when the data is available. In total, an estimated 960,000 people were hospitalized that season and more than 79,000 died.

CDC does not publish the number of infants who are sick with the flu, but it was estimated that 27,778 children aged 4 and younger were hospitalized with the virus and 118 died.

The flu vaccine is recommended for people 6 months old and up. The rate of vaccination varies with age, with children tending to be immunized at a higher rate than adults. Last flu season, 62.6% of children between the ages of 6 and 17 were vaccinated, but only 45.3% of adults 18 and older were vaccinated.

Well, maybe.

"What I think is important to keep in mind with these numbers is that they are based on self-reported data," Dr. Richards. "People don't necessarily tell the truth."


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Public health workers face several obstacles to achieve maximum vaccine coverage. Some people avoid flu shots as a matter of principle. Some believe it can cause flu. And some refuse the vaccine because they do not think it is effective enough to be worth the trouble.

Let's start with whether the vaccine can cause the flu. The short answer is: No.

Influenza vaccine administered with a needle is manufactured with killed viruses or with only a single virus gene (as opposed to the full virus). Neither can cause flu according to CDC. But it takes a few weeks for the vaccine to take effect, and during that period someone who has been vaccinated can come down with the flu before their immunity kicks in.

Flu vaccine administered through a nasal spray is different. (The spray vaccine was previously found to be ineffective, but it is now among the recommended alternatives.) The spray contains attenuated live virus that, according to the CDC, cannot cause influenza – yet the spray is not approved for pregnant women, although they can safely receive the shot.

It leaves out the question of efficiency.

In a good year, the flu vaccine is 60% effective, which means that people who get it are 60% less likely to get sick. The last time it worked so well was the 2010-11 flu season.

Because the vaccine must be formulated months in advance, when administered, the virus it is intended to counteract may have been mutated, or a surprising strain may have become dominant and decreased the efficacy of the vaccine.

Last season it was only 29% effective. The year before, it was 38% effective. And in 2014-15 it was only 19% effective.

Public health workers still say it's worth it.

"It will reduce the severity of symptoms and help reduce the risk of complications of the flu," Dr. So Richards. "You can still get the flu, but it won't be as bad as it can be."

The CDC recommends getting the vaccine at the end of September to October – but it can be administered at any time during the season, which usually peaks between December and February and can last until May.

As the elderly are more likely to experience complications, they receive a high-dose vaccine containing 60 micrograms of antigen, the substance that provokes the body's immune response, per 0.5 milliliter dose. It is four times the amount given to younger adults who receive 15 micrograms of antigen per 0.5 ml dose. Children receive 7.5 micrograms of antigen per 0.25 milliliter dose.

With or without the vaccine, if someone gets the flu, it is likely that self-medication with a non-disk medicine is sufficient, says Dr. Richards. But anyone who gets short of breath, has a fever that doesn't respond to medication or who can't consume enough fluids to stay hydrated should consult a doctor – from a distance.

"It's probably a better idea to call your health care provider than to show up at a doctor's office or emergency care," Dr. Richards said. "Then you just share it with everyone else."

Write to Jo Craven McGinty at [email protected]

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