We should know that vaccine-preventable diseases were rarely mild, natural immunity comes at a cost, and that those who died from smallpox, diphtheria, measles, and polio aren’t around to talk about their experiences on Facebook (survivorship bias).
We should never forget that vaccine-preventable diseases were once big killers, and the only reason some folks have grown to fear the side effects of vaccines more than the diseases they prevent, is because we don’t see those diseases very much any more. If more people skip or delay getting vaccinated, we will though.
Even before you get to talk about problems with flu vaccine effectiveness, it becomes clear that everyone wants a better flu vaccine.
One big problem with the current generation of flu vaccines?
You have to get them each and every year.
Developing a Better Flu Vaccine
So what would we all want in a new and better flu vaccine?
last longer, so you didn’t have to get a new vaccine every year
be more effective
cover more flu vaccine strains, so it wasn’t a “guess” about which flu strains to include in the flu vaccine each year and we didn’t have to worry about drifted flu vaccine strains or new and emerging strains for which there is no vaccine
A universal flu vaccine, which covers all possible flu strains, would be ideal.
So why haven’t we been working on developing a universal flu vaccine?
Well, we have.
It just isn’t that easy.
Many different research teams have been working on a universal flu vaccine for years and some have already had some success.
Does that mean we will see a universal flu vaccine soon?
Unfortunately, of the almost 40 organizations working on improved flu vaccines, including a universal flu vaccine, about 30 are still in preclinical or phase 1 trials. So the answer is no, we will not see a universal flu vaccine soon.
The Strategic Plan to Develop a Universal Influenza Vaccine
Maybe that will change now that more and more folks are pushing for a better flu vaccine and we see the effects of severe flu seasons without a good vaccine.
Of course, talk isn’t enough.
“A priority for the National Institute of Allergy and Infectious Diseases (NIAID) is development of an influenza vaccine providing durable protection against multiple influenza strains, including those that may cause a pandemic, i.e., a universal influenza vaccine. To invigorate research efforts, NIAID developed a strategic plan focused on knowledge gaps in three major research areas, as well as additional resources required to ensure progress towards a universal influenza vaccine. NIAID will use this plan as a foundation for future investments in influenza research and will support and coordinate a consortium of multidisciplinary scientists focused on accelerating progress towards this goal.”
Erbelding et al on A Universal Influenza Vaccine: The Strategic Plan for the National Institute of Allergy and Infectious Diseases
That’s why it is also encouraging that we have seen the:
the Pathway to a Universal Influenza Vaccine workshop convened by the National Institute of Allergy and Infectious Diseases (NIAID) in 2017
the Strategic Plan for Developing a Universal Influenza Vaccine by the NIAID that was announced in 2018
U.S. Sen. Ed Markey (D-MA) introduced the Flu Vaccine Act, which would invest $1 billion towards development of a universal flu vaccine
Knowing that developing a universal flu vaccine is a priority of the NIAID and that so many organizations are already working towards this goal is very reassuring.
Hopefully we are a lot closer than some folks thing.
Does your child qualify for a medical exemption? All states allow kids to claim medical exemptions to getting vaccinated. True medical exemptions are rare though, as you can see from the rates in states that actually require screening and approval of medical vaccine exemptions.
Are you a Christian Scientist? In 47 states, laws allow religious exemptions to vaccinations. Ironically, these exemptions are often abused, as you don’t actually need to belong to a religion that is against vaccines to claim a religious exemption to vaccinations.
“When you are challenged by the viewpoint of a denomination, pastor, publication, or atheist authority: You do not worship any pastor, church, religious publication, or denomination. Your pastor’s personal view on vaccines is irrelevant to your stance because pastors do not learn about the biblical implications of vaccinating during seminary and your pastor isn’t God. (Though if you have a pastor willing to go to bat for you, use him.)”
Megan on How To Get a Vaccine Religious Exemption Like a Boss
It is not even a secret that parents abuse the religious vaccine exemption, claiming them even when they don’t have a sincere religious belief against getting vaccinated.
And in 20 states, it is even easier to claim a vaccine exemption. These are the states that allow philosophical or personal belief vaccine exemptions, in which you can typically just say that you are against vaccinating and protecting your kids “for reasons of conscience.”
What reasons? You don’t usually have to go into much detail…
In many states, it is easy to abuse vaccine exemptions because medical exemptions aren’t verified and approved and it is often easier and more convenient to get an exemption than to get vaccinated. Believe it or not, some doctors will even sell you a medical exemption for your child. Also, parents are made to feel so scared by anti-vaccine propaganda that they think that they need to get an exemption.
“Permitting personal belief exemptions and easily granting exemptions are associated with higher and increasing nonmedical US exemption rates. State policies granting personal belief exemptions and states that easily grant exemptions are associated with increased pertussis incidence.”
Omer et al on Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence.
But just because you can claim an easy exemption in a state without strong vaccine exemption laws doesn’t mean that you should.
While there are no benefits to delaying or skipping vaccines, there are plenty of risks. And the risks aren’t just to your unvaccinated child. We continue to see and hear about kids who are too young to be vaccinated or who couldn’t be vaccinated getting caught up in outbreaks caused by others who simply chose to not get vaccinated.
“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”
While it is typically not hard to claim a vaccine exemption for your child, since vaccines are safe and necessary, be sure you understand the risks of delaying or skipping any vaccines if your child doesn’t need a true medical exemption.
We know that kids die from the flu, not just this year, but every year.
In fact, on average, just over 100 kids die of the flu each year!
The flu is a terrible disease.
How Many Kids Die from the Flu?
The CDC started to track pediatric flu deaths in the fall of 2004, when it became nationally reportable. This followed a particularly bad 2003-04 flu season (H3N2-predominant), during which the CDC got reports of 153 pediatric deaths from only 40 states.
Since then, the number of pediatric flu deaths has ranged from a low of 37, during the 2011-12 flu season, to a high of 289 deaths during the swine flu pandemic.
2004-05 flu season – 47 pediatric flu deaths
2005-06 flu season – 46 pediatric flu deaths
2006-07 flu season – 77 pediatric flu deaths
2007-08 flu season – 88 pediatric flu deaths (H3N2-predominant)
“During past seasons, approximately 80% of flu-associated deaths in children have occurred in children who were not vaccinated. Based on available data, this remains true for the 2017-2018 season, as well.”
CDC on How many flu-associated deaths occur in people who have been vaccinated?
And we also know that it isn’t too late to get a flu shot to get protected for the rest of this year’s flu season.
What to Know About Pediatric Flu Deaths
The flu vaccine isn’t perfect, but there is no denying the fact that year after year, most pediatric flu deaths are in kids who weren’t vaccinated.
And like most anti-vaccine propaganda, there isn’t even a teeny tiny kernel of truth in their statements about Gardasil being “pushed on infants.”
While there was a study about giving Gardasil to kids who have already had at least three relapses of respiratory papillomatosis caused by HPV 6 or 11, those kids had to be between 1 and 17 years old.
No infants (children under 12 months old) were ever in this study which was supposed to start in 2014 in Budapest, Hungary.
“Recurrent respiratory papillomatosis in children caused by HPV 6,11 can be a life threatening condition resulting in surgical interventions. The maturing and disintegrating papillomas are the sources for the subsequent HPV relapses and immunization might slow down or even prevent this ongoing process.
After an initial immunological and ear-nose-throat (ENT) assessment children with at least 3 relapses in their patient history will be vaccinated with 4-valent HPV vaccine according to the following schedule: 0., 2., 6. months. It will be followed by an immunological and 3 ENT examinations to assess response to vaccination.”
4-valent HPV Vaccine to Treat Recurrent Respiratory Papillomatosis in Children
Will Gardasil work for kids who already have recurrent respiratory papillomatosis, even though they got the HPV infection when they were born?
Hopefully it will.
“Any child presenting with a voice disturbance with or without stridor is recommended to have diagnostic flexible fiber-optic laryngoscopy. Recurrent respiratory papillomatosis should be considered in children when other common pediatric airway diseases either do not follow the natural history or do not respond to treatment of the common disorder.”
Zacharisen et al on Recurrent Respiratory Papillomatosis in Children: Masquerader of Common Respiratory Diseases
What to Know About Those HPV Vaccine Trials in Infants
The idea that the HPV vaccines are now being tested on infants is just another example of anti-vaccine propaganda. They are using a clinical trial of children and teens with recurrent respiratory papillomatosis to scare you away from vaccinating and protecting your children.
Is this going to be the worst flu season in history?
That certainly seems to be how the media is playing it.
Have you read any of these articles?
California’s deadly flu season could be worst in a decade
Defending against this season’s deadly flu: 5 things to know
The CDC says this year’s flu may reach ‘epidemic’ proportions
Worst of deadly flu season may still be to come, Dallas County officials say
Texas Is Suffering Through its Worst Flu Outbreak in Decades
Hospital Overrun By Flu Cases Having To Turn Them Away
Get ready, some medical experts are predicting the worst flu season in history
Worst flu season in history? Really?
Flu Season Hazard
Flu season can be deadly.
That’s not hype.
That’s why every one should get a flu shot each year.
Early flu seasons can be bad.
Why? They overlap with RSV season. That means that everyone is sick at the same time with bronchiolitis, croup, colds, and the flu.
They are especially bad because many people haven’t taken the time to get their flu shot yet.
And an H3N2-predominant flu season can be especially bad. In addition to high levels of pediatric flu deaths, the CDC reports that the four flu seasons that were H3N2-predominant in recent years were “the four seasons with the highest flu-associated mortality levels in the past decade.” H3N2 virus strains drift easily, so that flu vaccines are less effective.
Flu Season Hype
Right off the bat, one big problem with most of these headlines, and the way that this year’s flu season is being hyped, is folks going out of their way to use the word “deadly” every chance they can.
Every flu season is deadly!
And guess what?
Flu season reaches “epidemic proportions” each and every year!
“The United States experiences epidemics of seasonal flu each year. This time of year is called flu season.”
CDC on Frequently Asked Flu Questions 2017-2018 Influenza Season
And we get to the point, in many cities, where a hospital fills up for a few days and has to turn away flu cases. It happens with RSV too. Its called a “code Yellow” in some hospitals.
The biggest problem with the current news coverage though, is that there hasn’t been much evidence that this is going to be the worst flu season that we have seen, although it is starting to live up to some of the hype.
“The Centers for Disease Control and Prevention says flu season runs from about September to May. Most years in Texas, a number called the ILI percentage — the number of patients doctors see with flu-like symptoms — checks in at about 2 percent or 3 percent during the offseason and crests to about 6 percent during the worst of the flu season. This year, according to a model developed by a Carnegie Mellon University team led by Roni Rosenfeld, Texas’ ILI percentage has already risen above 13 percent.”
“This is really record-breaking. In the last 20 years [the estimated number of people presenting flu symptoms] hasn’t reached that height,” Rosenfeld says. “It’s the highest it’s been this early in the season, and it’s the highest it’s been period.”
Dallas Observer on Texas Is Suffering Through its Worst Flu Outbreak in Decades
Do you know what is wrong with that report in the Dallas Observer?
It misses that the ILI percentage was above 14% in Texas during the 2014-15 flu season too! So no records were being broken.
The ILI percentage was actually between 10 to just over 14% for three out of four years recently.
Will hyping the flu to make it sound even more dangerous scare folks into getting a flu shot?
An important take away from their first story? It actually reported on a lower hospitalization rate (at the time, it has since increased) this year than the 2014-15 flu season.
Why is the 2014-15 flu season important?
For one thing, looking at real data and not just trying to scare folks, we can say that this year’s flu season has looked a lot like the 2014-15 flu season. That was also an H3N2-predominant flu season that got off to an early start, but tragically, ended up killing at least 148 children.
I’m sure that few people remember, but the 2014-15 flu season looked a lot like another H3N2-predominant flu season – the 2012-13 flu season. That year, we also got off to an early start and again, tragically, we ended up with 171 pediatric flu deaths.
So, is this going to be a bad flu season?
Is there ever a good flu season?
“This season now looking like the 2014-15 season where H3N2 predominated.”
Dan Jernigan, MD, MPH Director of the Influenza Division in the National Center for Immunization and Respiratory Diseases
It’s hard to predict, but the odds are strongly against this being the worst flu season in history.
This year’s flu season is starting to live up to some of the hype though.
“The overall hospitalization rate is higher than the overall hospitalization rate reported during the same week of the 2014-2015 season; the most severe season in recent years.”
CDC Influenza Situation Update
On the other hand, fewer pediatric flu deaths have been reported so far (84 pediatric deaths) this year than at the same point in the 2014-15 (86 pediatric deaths) flu season.
And ILI has finally peaked (hopefully).
At 7.5%, it is the highest we have seen since the 2009 pandemic.
“The majority of the influenza viruses collected from the United States during October 1, 2017 through February 10, 2018 were characterized antigenically and genetically as being similar to the cell-grown reference viruses representing the 2017–18 Northern Hemisphere influenza vaccine viruses.”
CDC Situation Update: Summary of Weekly FluView Report
And we don’t have a mismatched flu strain or a strain that has drifted to be concerned about.
That doesn’t mean that the flu vaccine is going to work perfectly, by any means, but initial reports are that this year’s flu vaccine is much more effective than expected.
The best news, besides a very good supply of flu vaccines and anti-viral medicines, like Tamiflu, this year?
We saw the same H3N2 strain in the United States last year. Although that might not guarantee immunity if you had the flu last year, it should offer some protection against severe disease.
Also, we have some new flu vaccines, including the cell-based vaccine, Flucelvax, and high dose flu shots and flu shots with adjuvants for adults 65 years of age and older.
Still, like most H3N2-predominant flu seasons, it will at best be a moderately severe flu season.
Worst ever? That’s doubtful.
Ignore the hype, but don’t ignore the advice to get vaccinated and protected against the flu. It’s never too late to get a flu shot. Even with an early start, flu season will continue into the spring.
What to Know About Flu Season Hype or Hazard
Like other H3N2-predominant flu seasons, this year’s flu season will be moderately-severe, but warnings that it could be the worst flu season ever are likely just hype.
According to the CDC, from 2006 to 2016, at least 3,153,876,236 doses of vaccines were distributed in the United States. These are the vaccines that are covered by the National Vaccine Injury Compensation Program, such as DTaP, MMR, Hepatitis A and B, HPV, and flu, etc.
That’s over 286 million doses each year!
How about worldwide?
That’s harder to know, but consider that the World Health Organization reports that 85% of infants worldwide, or almost 100 million infants, get at least:
3 doses of DTP
3 doses of hepatitis B
at least one doses of measles
3 doses of polio
Plus, an increasing number are getting vaccines to protect them against Hib, pneumococcal disease, rotavirus, HPV, meningitis A, mumps, rubella, tetanus, and yellow fever.
“UNICEF supplies vaccines reaching 45 per cent of the world’s children under five years old as part of its commitment to improving child survival.”
How many vaccine doses are we talking about?
A lot. UNICEF alone buys 2.8 billion doses of vaccines each year! Those vaccines are then distributed to children in over 100 countries.
Vaccine-Preventable Disease Statistics
As impressive as the number of vaccines that are given each year are the numbers about what happens when we give vaccines:
there are 2 to 3 million fewer deaths in the world each year because people are vaccinated and protected
in developing countries, every $1 spent on vaccines provides $16 in direct benefits, but that goes up to $44 when you take “into account the broader economic impact of illness”
for children born in the United States during “1994–2013, routine childhood immunization was estimated to prevent 322 million illnesses (averaging 4.1 illnesses per child) and 21 million hospitalizations (0.27 per child) over the course of their lifetimes and avert 732,000 premature deaths from vaccine-preventable illnesses,” and it also “will potentially avert $402 billion in direct costs and $1.5 trillion in societal costs because of illnesses prevented”
only two countries continue to have wild polio – Afghanistan and Pakistan – and together, they only had 21 cases in 2017