Category: Immunization News

Is the Flu Deadlier This Year?

Why do people seem to think that the flu is deadlier this year?

Everyone has a prediction about flu season, but it is still too early to tell if this year will be deadlier than others.
Everyone has a prediction about flu season, but it is still too early to tell if this year will be deadlier than others.

It seems like we get these kinds of warnings and predictions every year.

Is the Flu Deadlier This Year?

Is it true this year?

“Levels of outpatient ILI remain elevated; however hospitalization rates and percent of deaths due to pneumonia and influenza remain low. This is likely due to the predominance of influenza B/Victoria and influenza A(H1N1)pdm09 viruses which are more likely to affect children and younger adults than the elderly. Because the majority of hospitalizations and deaths occur among people age 65 and older, with fewer illnesses among that group, we expect, on a population level, to see less impact in flu-related hospitalizations and deaths.”

Weekly U.S. Influenza Surveillance Report, Key Updates for Week 1, ending January 4, 2020

It is certainly true that we are seeing more pediatric flu deaths at this time of year than usual, but we don’t usually have such an early start to the flu season!

“This season so far has been particularly deadly for children, with 27 deaths reported through December 28. That’s the highest number of deaths at this point in the season since the CDC started keeping track 17 years ago.”

Elizabeth Cohen on US on track for one of the worst flu seasons in decades

If flu season also peaks and ends earlier than usual, than it might not end up being an overly severe flu season.

Will it be a deadly flu season?

Of course.

It’s flu season!

“The overall cumulative hospitalization rate was 14.6 per 100,000 population which is similar to what has been seen during recent previous influenza seasons at this time of year.”

Weekly U.S. Influenza Surveillance Report, Key Updates for Week 1, ending January 4, 2020

But there is not yet good evidence that this season is or will be much worse or deadly than others.

Influenza-like Illness numbers don't say anything about the severity of flu illness.
Influenza-like Illness numbers don’t say anything about the severity of flu illness.

Or that this year’s flu vaccine won’t be effective. We won’t get a report on the effectiveness of this year’s flu vaccine until next month.

“Although the V1A.1 and V1A.3 subclades are genetically distinct, sera from previous studies conducted among humans vaccinated with a V1A.1 virus cross-reacted well with B/Victoria viruses with a three amino acid deletion, such as the V1A.3 viruses. These findings suggest that vaccination with the current season’s vaccine might offer protection against circulating B/Victoria viruses.”

Early Season Pediatric Influenza B/Victoria Virus Infections Associated with a Recently Emerged Virus Subclade — Louisiana, 2019

And while we already know that this year’s flu vaccine isn’t a perfect match, it should offer protection.

Flu mortality surveillance data is still below epidemic threshold, although it is unlikely to stay there much longer.
Flu mortality surveillance data is still below epidemic threshold, although it is unlikely to stay there much longer.

Unfortunately, early flu seasons don’t always peak and end early. And they are sometimes among the worst, like the 2012-13 flu season. But that was an H3N2 season, which often are worse than others.

This year we are in new territory, having an early season that has been dominated by a flu strain B. Since it is not something we have seen before (at least not since the since the 1992–93 season), you can expect the unexpected, just like you should always do when it comes to the flu.

And know that there is really only one prediction that will end up holding true, that a yearly flu vaccine is the best way to protect your family from the flu.

More on Flu Deaths

Why Do Kids Die With the Flu?

There is one question that few parents or pediatricians will ever likely be able to answer well. Why do kids die with the flu in this age of readily available flu vaccines?

Oh, I’m sure that everyone has heard dozens of reasons, from the idea that flu vaccines don’t work to parents just aren’t vaccinating their kids, but in reality, there is no good answer that fits all situations, except to know that the flu is deadly.

Why Do Kids Die With the Flu?

The biggest misconception that most people have about pediatric flu deaths is that all kids who die with the flu must have some underlying medical condition, like diabetes, asthma, immune system problems, or a heart condition.

That’s not true.

Around half of the kids who die with the flu have no underlying risk factors or medical conditions.

Around half of the kids who die with the flu have no underlying risk factors or medical conditions. They were otherwise healthy before they got sick with the flu.

But it is only younger kids that die with the flu, right?

Kids of all ages die with the flu, from infants and toddlers to teens.

Kids of all ages die with the flu, from infants and toddlers to teens.

And surprisingly, they often die quickly.

Most kids die within two or three days of getting their first flu symptoms.

Most kids die within two or three days of getting their first flu symptoms.

Many kids die with flu before they can even be admitted to the hospital for treatment.

That’s likely why many die before they can even be admitted to the hospital for treatment.

But they are all unvaccinated, right?

Tragically, no.

Among children who died from influenza during the 2010-11 flu season, few (23%) were vaccinated.
Among children who died from influenza during the 2010-11 flu season, few (23%) were vaccinated.

Although most are unvaccinated, some vaccinated kids do still die.

“This report summarizes the 115 cases of influenza-associated pediatric mortality reported to CDC that occurred from September 1, 2010, through August 31, 2011. Deaths occurred in 33 states. Nearly half of the deaths (46%) occurred in children aged <5 years. Of the children who died, 49% had no known Advisory Committee on Immunization Practices (ACIP)–defined* high-risk medical conditions, and 35% died at home or in the emergency department. Of the 74 children aged ≥6 months for whom vaccination data were available, 17 (23%) had been fully vaccinated.”

Influenza-Associated Pediatric Deaths — United States, September 2010–August 2011

Still, studies have shown that getting a flu vaccine can reduce a child’s risk of dying with the flu by half if they have an underlying high-risk medical condition and even more (65 percent) if they are otherwise healthy.

Ultimately, we need a better flu vaccine. Until we get it, the one we have is our best protection against the flu.

Flu vaccines are a safe way to reduce your risk of dying with the flu.
Flu vaccines are a safe way to reduce your risk of dying with the flu.

And since they are safe, there is no good reason to not get vaccinated and protected each year.

More on Pediatric Flu Deaths

News on the Latest Measles Outbreaks of 2020

There is no doubt that 2019 was a bad year for measles.

This was the most measles cases in one year since 1992!
This was the most measles cases in one year since 1992!

Let’s hope for better things in 2020…

Measles Outbreaks in 2020

Unfortunately, it only took a few days for the report of our first case…

  • a Northeastern University student exposed others to measles in Boston (Jan 3 to 6)

We broke several records for measles in 2019.

What kind of year will this be?

Get vaccinated and protected so that you don't get caught up in a measles outbreak.
Get vaccinated and protected so that you don’t get caught up in a measles outbreak.

Even more importantly, are you vaccinated and protected with two doses of MMR?

For More Information On Measles Outbreaks of 2020:

Were Hundreds of Medically Vulnerable Children Expelled from School in New York?

Why do some people think that hundreds of medically vulnerable children were expelled from school in New York?

Hundreds of medically vulnerable children were not expelled from school in New York with valid medical exemptions.

The usual suspects…

Were Hundreds of Medically Vulnerable Children Expelled from School in New York?

So what’s the real story?

A new vaccine law in New York eliminated religious exemptions so that students with non-medical exemptions would not be able to continue to go to school if they were missing one or more vaccines.

As the law continues to allow medical exemptions, it should be clear that as others got caught up on their immunizations, this helps make sure that those who are truly vulnerable are now at less risk of being exposed to a vaccine-preventable disease.

“If a child has a medical exemption to immunization, a physician licensed to practice medicine in New York State must certify that the immunization is detrimental to the child’s health. The medical exemption should specify which immunization is detrimental to the child’s health, provide information as to why the immunization is contraindicated based on current accepted medical practice, and specify the length of time the immunization is medically contraindicated, if known.”

Dear Colleague letter regarding guidelines for use of immunization exemptions

And those kids who do not have a valid medical exemption?

It is very important to understand that their parents have a choice to get them vaccinated and protected so that they can continue go to school.

Unfortunately, some parents and even a few doctors remain confused on what it means to have a valid medical exemption.

Especially in states that have strengthened their vaccine laws, a valid medical exemption must meet certain criteria and follow “current accepted medical practice standards as defined by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.”

That doesn’t mean there can’t be exceptions, but it also doesn’t mean that a child would typically get a medical exemption for any reason simply because someone thinks they should, even if that someone is a doctor, unless the exemption is for an immunization that is “contraindicated based on current accepted medical practice.”

Were hundreds of kids in New York denied medical exemptions?

It is certainly possible when you hear parents tell stories about being denied exemptions for things like autism, ADHD, food allergies, epilepsy, clotting disorders, diabetes, psoriasis, autoimmune disorders, PANDAS, Tourette’s, or MTHFR gene mutations.

Were hundreds of kids in New York denied valid medical exemptions?

No, they weren’t.

More on New York Vaccine Laws