LITTLE ROCK — As fall continues, I hope that everyone will remember the importance of receiving the influenza vaccination. These days, it could not be easier, as the vaccine is now routinely given at your neighborhood pharmacy. Who knows whether this flu season will be mild or severe? There is always the possibility that a rapid outbreak of an unusual strain of the influenza virus can lead to millions of cases of infection, a great deal of suffering and many deaths.
This year, there appears to be an outbreak of influenza that can rapidly spread from pigs to man. Since July, the Centers for Disease Control and Prevention reports a rather large number of infections with an influenza A virus (H3N2) that predominantly affects pigs but can readily spread to people. For this reason, the CDC urges that anyone planning to attend a state or county fair be vaccinated as soon as possible.
To date, most infections have occurred in young children with little immunity against the influenza virus. However, serious disease may occur in anyone at high risk, including young children, pregnant women, anyone with a reduced ability to fight infections, people with heart disease or diabetes, and people over the age of 65.
A vaccination is required annually, as each year the influenza viruses included in the vaccination change.
Every February, a committee of the World Health Organization determines which of the numerous strains of the virus are likely to cause the most infections. As the flu is predominantly an illness that occurs during the winter, epidemiologists track which viruses are causing the most havoc in the Southern Hemisphere. As winter approaches the viruses march northward. They can always lead to serious illness, particularly in those who have not been vaccinated.
Currently each vaccine provides protection against three strains of virus (trivalent vaccine), but soon, a new vaccine that protects against four different strains should become available.
So should we all be vaccinated? The CDC recommends that everyone 6 months and older receive yearly vaccinations. If supplies are limited, it is critical that the vaccine be given to those at the highest risk, including children age 6 months to 4 years, pregnant women, anyone over age 50, and those with severe lung disease, a suppressed immune system, morbid obesity or diabetes.
Anyone under the age of 18 taking aspirin must be vaccinated, as they are more prone to develop a serious complication from influenza called Reye’s syndrome. Every nursing home patient should be vaccinated, as should all health-care providers, caregivers or workers who come in frequent contact with young children or older people.
For the very old and those with the greatest difficulty fighting infections, a high-dose flu shot should be considered. Called Fluzone HD, this vaccine contains four times as much antigen (a protein in the virus that stimulates the immune system to produce antibodies). Research has shown that the high-dose vaccine is as safe as the regular kind, and leads to a much more robust immune response in those over the age of 65. The experience with this vaccine is still insufficient to determine if the higher dose provides a greater protection against developing a severe infection. The CDC emphasizes that the high-dose vaccine should not be used in anyone under the age of 65.
Some elect to receive the influenza vaccination as a nasal spray. This form should not be used in children between the age of 6 and 23 months or in adults over the age of 50.
A doctor’s prescription is not needed for a flu shot. Whether receiving the vaccination from a pharmacist or another health care provider, ask whether other vaccines should be given.
The evidence is compelling that vaccination is the most critical way to prevent serious complications from influenza. Remember that if you are young and healthy and become infected, not only will your symptoms be significant, but spreading the virus to everyone around you may lead to a life-threatening infection in someone much more susceptible than you.
Dr. David Lipschitz is a geriatrician in Little Rock. More information is available at:
drdavidhealth.com
High Profile, Pages 41 on 10/07/2012