Tag: flu deaths

Who Dies from the Flu?

While some folks still believe that the flu is a mild infection, most people understand that the flu is a very dangerous disease.

A dangerous disease that kills hundreds of children and tens of thousands of adults each year in the United States.

Who Dies from the Flu?

In addition to thinking that the flu isn’t dangerous, some folks misunderstand just who is at risk for dying from the flu.

While it is certainly true that some people at higher risk than others, including those who are very young, very old, and those with chronic medical problems, it is very important to understand that just about anyone can die when they get the flu.

Just consider the 2017-18 flu season, in which 181 children died.

As in most years, half of the kids who died of flu during the 2017-18 flu season had no underlying medical condition. Of those who did, the most common were neurologic and pulmonary conditions.
As in most years, half of the kids who died of flu during the 2017-18 flu season had no underlying medical condition. Of those who did, the most common were neurologic and pulmonary conditions.

In addition to the fact that half of the kids who died were otherwise healthy, without an underlying high risk medical condition, it is important to realize that up to 80% were unvaccinated.

That’s a good clue that flu vaccines work and that everyone should get vaccinated and protected each year.

“Influenza vaccination during the 2015-2016 influenza season prevented an estimated 5.1 million illnesses, 2.5 million medical visits, 71,000 hospitalizations, and 3,000 P&I deaths.”

Estimated Influenza Illnesses, Medical Visits, Hospitalizations, and Deaths Averted by Vaccination in the United States

Flu vaccines aren’t perfect, but even when they are less effective than we would like, they have many benefits, including reducing your risk of dying from the flu.

Who dies from the flu?

Consider that one of the first flu deaths of the season was a 29-year-old Raleigh lawyer.

And the first pediatric flu death was an unvaccinated child in Florida without any underlying medical conditions.

Anyone can die from the flu.

Get your flu vaccine now.

More on Flu Deaths

Is Flu Season Starting Already?

It seems like every year we get early reports of the start of flu season.

Why?

Because a few people had positive flu tests somewhere…

Is Flu Season Starting Already?

While there are many things about the flu that are unpredictable, including when flu season will start, peak, and end, there are some things that have become rather routine.

One of the things that we have come to expect every year is folks declaring an early start to flu season.

Not surprisingly, they are usually wrong.

A few positive flu tests doesn't mean that flu season is starting early.
A few positive flu tests doesn’t mean that flu season is starting early.

So why do some folks test positive in August or September if it isn’t because flu season is starting?

“During periods when influenza activity is low and there is low influenza virus circulation among persons in the community, the positive predictive value of influenza tests is low (that is, the chance that a positive result indicates that the patient has influenza is low – consider potential for a false positive result), and the negative predictive value is high (the chance that a negative result indicates that the patient does not have influenza is high – likely true negative result ).”

CDC on the Algorithm to assist in the interpretation of influenza testing results and clinical decision-making during periods when influenza viruses are NOT circulating in the community

When flu activity is low, such as it is during the summer or early fall before flu season has really started, you have a higher chance for a false positive flu test. So even though you have cold or flu symptoms and a positive rapid flu test, you might not really have the flu. The test is falsely positive. It’s wrong.

“Influenza prevalence varies between and within seasons. On the basis of our estimates, rapid tests are of limited use when prevalence is <10%”

Grijalva et al on Accuracy and Interpretation of Rapid Influenza Tests in Children

While other, more accurate flu tests are available, they are more expensive and take longer to process and get results. And since the diagnosis of the flu is often made clinically anyway, classic flu signs and symptoms during flu season, you typically don’t need a flu test unless being admitted to the hospital or if the results will really change how you are being treated.

So how do you know when flu season has started? You will see an uptick on flu activity maps. Hopefully you will have gotten your flu vaccine by then.

While flu season usually starts in October, it is the peak that we are usually more concerned about. That’s when you are most likely to be exposed to someone and get the flu.

When does flu season usually peak?

It depends, but usually sometime between December and March, typically in February. Getting back to how unpredictable flu season can be, there have been a few times that flu season has peaked as early as October though.

How can you reduce your chances of having a false positive flu test?

That’s easy. Don’t get a flu test unless flu activity is high in your area and you have classic signs and symptoms of the flu.

More on the Start of Flu Season

Three Reasons to Skip a Flu Shot This Year

We sometimes hear that folks are going to skip their yearly flu vaccine because they don’t believe in flu shots, they never get sick, or they think that flu shots don’t work or are dangerous.

Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.
Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.

Of course, none of those are good reasons.

Three Reasons to Skip a Flu Shot This Year

Flu vaccines are safe and have many benefits, even if they aren’t any where near 100% effective.

So are there any legitimate reasons to skip a flu shot?

Of course.

In fact, three very good reasons to skip a flu shot include:

  1. being younger than 6 months of age
  2. having a severe allergic reaction (e.g., anaphylaxis) after a previous dose of flu vaccine or to any component of the flu vaccine
  3. and, uh…

Actually, although folks might have many of bad excuses, there are only two good reasons to skip a flu shot…

So, infants who aren’t old enough to be vaccinated yet, and anyone who has had a life-threatening reaction to a previous dose.

Additional precautions, but not true contraindications, do including having had Guillain-Barré syndrome <6 weeks after a previous dose of influenza vaccine and having a moderate or severe acute illness with or without fever when you are planning to get vaccinated.

What about egg allergies?

Even if you have had a severe reaction to eggs, you can still get a flu shot. Just get it get it in an inpatient or outpatient medical setting (such as a hospital, clinic, health department, or physician’s office), so that you can be supervised by a health care provider who is able to recognize and manage severe allergic reactions.

Bad Reasons to Skip a Flu Shot

Are you scared of shots? Flumist is back.

Are you skipping the flu shot because you never get sick? How lucky do you feel this year? Don’t continue to gamble that you won’t get the flu. Increase your chances of staying well by getting a flu shot, the best way to avoid the flu.

There aren’t any natural alternatives that work better, no matter how hard you want to believe that going to a chiropractor, using essential oils, or homeopathic remedies might be helpful.

The flu vaccine doesn’t weaken your immune system.

There are no hidden or harmful ingredients in flu vaccines.

The flu vaccine is not going to give you the flu.

And the flu is definitely not a mild disease! There were 176 pediatric flu deaths last flu season, and as in most years, most were unvaccinated.

Don’t wait. Get your flu shot.

More on Flu Vaccine Contraindications

Why Do Some Folks Wear a Mask During Flu Season?

Wearing a surgical mask is very common when people are sick and want to avoid spreading their germs to others. They are also commonly worn when people are healthy and are just afraid of getting sick.

Why Do Some Folks Wear a Mask During Flu Season?

Is that why you see some folks wearing masks during flu season?

If you are worried about your privacy, why announce something on Facebook?
If you were worried about your privacy, would you talk about it on Facebook?

Maybe, but some folks actually have to wear a mask during flu season.

Well, they have to because they decide they don’t want to get a flu vaccine, but still want to keep their job that could put others at risk if they got sick with the flu. So basically, it is unvaccinated health care personal and others who work around sick and vulnerable people who might have to wear a mask when they are at work.

Why don’t they just get vaccinated and protected against the flu?

That’s a good question…

Some other questions to consider as you think about flu vaccine mandates include:

  • Do unvaccinated health care workers pose a risk to others in the course of their jobs? Of course they do. Health care personal are at high risk to get the flu, since they are often around people who are sick with the flu, and are at higher risk to get the flu if they are unvaccinated.
  • Does wearing a mask protect anyone? – Yes, they actually do and recent studies have concluded that “surgical face masks worn by infected persons are potentially an effective means of limiting the spread of influenza.”
  • Does getting a flu shot prevent you from catching the flu? – Flu shots aren’t the most effective vaccine we have, but they are the best way to avoid catching the flu, being 10 to 60% effective since 2004.
  • Does getting a flu shot prevent you from spreading the flu to others? Yes, and several studies have shown lower rates of nosocomial cases among hospitalized patients as more health care personal get vaccinated!
  • Does getting a flu shot just cause you to have milder symptoms? The flu vaccine does has many benefits besides preventing the flu, but it is certainly not limited to just causing milder symptoms.
  • Does wearing a mask violate your HIPAA rights? No. Unless you announce it, no one knows why you are wearing a face mask. Maybe you have herpes or a cold or are just afraid of getting sick. And the Health Insurance Portability and Accountability Act only protects patients, not employees.

So why don’t all health care personal get a flu vaccine each year?

Most do.

And while some people seem to be against the idea of mandates for health care workers getting flu shots, most think it is a great idea.

“I support this requirement. I think it is a good idea. Ethically, it makes total sense. First, every doctor, nurse, and HCW knows that they are supposed to put patient interests ahead of their own interests. Whatever you think about flu shots, it is good for patients that their healthcare providers are vaccinated against the flu, particularly among patients who cannot themselves be vaccinated, such as some of the elderly, babies, people with immune diseases, and people who just received transplants or are getting cancer treatment. Vaccination does not help them. They are all immunosuppressed.”

Art Caplan on The Law: Get a Flu Shot or Wear a Mask, Healthcare Workers!

In fact, most think that there is both an ethical and a legal rationale for flu vaccine mandates for health care workers.

“Doctors and other healthcare providers have an ethical obligation to make decisions and take actions that protect patients from preventable harm. 5 Many patients are highly vulnerable to flu, so choosing not to be vaccinated is choosing to do harm—a choice that has no place in healthcare.”

Doctors choosing not to be vaccinated is choosing to do harm

It is hard to imagine that some doctors and nurses not only skip getting vaccinated, putting others at risk, but then don’t even want to wear a mask.

More on Wearing Masks During Flu Season

Are Your Kids at High Risk for Flu Complications?

Everyone should get a flu vaccine each year, as long as they are at least six months old and have no true contraindications.

Everyone needs a flu shot. When will you get yours?
Everyone needs a flu shot. When will you get yours? Photo by Gabriel Saldana (CC BY-SA 2.0)

That has been the recommendation since at least the 2010-11 flu season.

And while most kids get vaccinated, not all do.

Are Your Kids at High Risk for Flu Complications?

There are some kids, those at high risk for flu complications, who definitely shouldn’t skip or delay their flu vaccine.

  • all children aged 6 through 59 months (younger than age 5 years);
  • children who have chronic medical conditions, including pulmonary (such as asthma and cystic fibrosis), cardiovascular (excluding isolated hypertension), genetic (Down syndrome), renal, hepatic, neurologic (cerebral palsy, epilepsy, stroke, muscular dystrophy, and spina bifida, etc.), hematologic (sickle cell disease), or metabolic disorders (including diabetes mellitus and mitochondrial disorders);
  • children who are immunocompromised due to any cause (including immunosuppression caused by medications or by HIV infection);
  • teens who are or will be pregnant during the influenza season;
  • children and adolescents (aged 6 months through 18 years) who are receiving aspirin- or salicylate-containing medications (like for Kawasaki disease) and who might be at risk for experiencing Reye syndrome after influenza virus infection;
  • residents of nursing homes and other long-term care facilities;
  • American Indians/Alaska Natives;
  • children who are extremely obese (body mass index ≥40).

You also shouldn’t skip or delay getting a flu vaccine if your:

  • kids are household contacts of children aged ≤59 months (i.e., aged <5 years) and adults aged ≥50 years, particularly contacts of children aged <6 months;
  • kids are household contacts of someone with a medical condition that puts them at higher risk for severe complications from influenza.

Again, since everyone should get a flu vaccine, these higher risk classes shouldn’t determine whether or not you vaccinate your kids, but they might influence the timing.

Again, don’t skip your child’s flu vaccine because they aren’t in a flu high risk group.

In most flu seasons, about 80% of children with the flu who die are not vaccinated. And many of them will be otherwise healthy, without an underlying high risk medical condition.

Get your child vaccinated against the flu. And if they are in a high risk group, make sure you do it well before flu season starts and maybe as soon as flu vaccine becomes available in your area.

More on Being at High Risk for Flu Complications

When Should I Get My Flu Shot?

For most the folks, the real question isn’t if they should get a flu shot, but when.

When Should I Get My Flu Shot?

The original flu shot recommendations  were based on the fact that flu vaccine became available for distribution in September, but was not completed until December or January. And that high-risk folks should get vaccinated “to avoid missed opportunities for vaccination” if flu vaccine was available in September and they were already at a doctor’s appointment or in the hospital.

Everyone needs a flu shot. When will you get yours?
Everyone needs a flu shot. When will you get yours? Photo by Gabriel Saldana (CC BY-SA 2.0)

But for most people, the original recommendation was really that “the optimal time for vaccination efforts is usually during October–November.”

“Persons and institutions planning substantial organized vaccination campaigns (e.g., health departments, occupational health clinics, and community vaccinators) should consider scheduling these events after at least mid-October because the availability of vaccine in any location cannot be ensured consistently in early fall. Scheduling campaigns after mid- October will minimize the need for cancellations because vaccine is unavailable.”

Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (2006)

What was the problem with this strategy?

Early flu seasons.

And trying to vaccinate over 100 million people in such a short time.

While it might work fine if flu season doesn’t hit until January or February, waiting until mid-October could leave a lot of folks unvaccinated if you had an early flu season that was peaking in November or December.

Fortunately, we don’t have to rush to get people vaccinated so quickly anymore. For one thing, manufacturers have gotten much better at distributing flu vaccine and are able to get a lot of the doses out at the very beginning of flu season. And with more manufacturers, we are seeing fewer delays and shortages of flu vaccine than we used to.

That’s why the recommendation on the timing of flu vaccination has changed over the years.

“In general, health-care providers should begin offering vaccination soon after vaccine becomes available and if possible by October. To avoid missed opportunities for vaccination, providers should offer vaccination during routine health-care visits or during hospitalizations whenever vaccine is available.”

Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (2010)

That nice, simple message has changed yet again though.

To balance the concerns that getting a flu shot too early might leave you unprotected at the end of a late flu season, but getting a flu shot too late might leave you unprotected at the beginning of an early flu season, the latest recommendations from the CDC on the timing of flu vaccination aren’t so clear cut:

  • Balancing considerations regarding the unpredictability of timing of onset of the influenza season and concerns that vaccine-induced immunity might wane over the course of a season, it is recommended that vaccination should be offered by the end of October.
  • Community vaccination programs should balance maximizing likelihood of persistence of vaccine-induced protection through the season with avoiding missed opportunities to vaccinate or vaccinating after onset of influenza circulation occurs.
  • Revaccination later in the season of persons who have already been fully vaccinated is not recommended.
  • Vaccination should continue to be offered as long as influenza viruses are circulating and unexpired vaccine is available.
  • To avoid missed opportunities for vaccination, providers should offer vaccination during routine health care visits and hospitalizations.
  • Optimally, vaccination should occur before onset of influenza activity in the community.
  • Although vaccination by the end of October is recommended, vaccine administered in December or later, even if influenza activity has already begun, is likely to be beneficial in the majority of influenza seasons.

What’s the problem with these recommendations?

If everyone waits until the end of October to get vaccinated, then you might have a hard time getting a flu vaccine. And you might get stuck if you try and time your flu shot with the onset of flu activity. Unless you have a crystal ball, you don’t know when flu season is going to start.

Still, it is important to note that the CDC doesn’t actually say to wait until the end of October. They say to get vaccinated by the end of October. Getting your kids vaccinated as soon as you can is the best way to make sure that happens.

Could getting a flu shot early leave your kids unprotected at the very end of flu season?

Maybe, but that’s typically when flu activity is low. And we have that same type of low flu activity in early October, well before flu season peaks.

So just remember that your child could end up unvaccinated and unprotected if you mistime their flu vaccine.

What to Know About the Best Time to Get a Flu Vaccine

Experts say to get vaccinated by the end of October. Getting your kids vaccinated as soon as you can is the best way to make sure that happens.

More on the Best Time To Get a Flu Vaccine

Personal Stories About Vaccine-Preventable Diseases

Parents these days seem to get bombarded with vaccine injury stories and videos on Facebook.

Is that because vaccines cause so many bad reactions?

Of course not.

It’s because some folks think that everything that happens to their kids is a vaccine injury.

Personal Stories About Vaccine-Preventable Diseases

If you are going to watch those videos and listen to their stories, getting scared in the process, be sure to also listen to the stories of parents who’s kids have suffered through actually getting a vaccine-preventable disease.

While it’s great that these diseases are much less common because most people vaccinate and protect their kids, one side effect of that progress is that we don’t have many reminders of just how terrible these diseases are anymore.Have you ever seen a baby with congenital rubella syndrome?

Or a child with tetanus or diphtheria?

Have you ever even seen photos of these diseases?

Will you read these stories of parents who have lost a child to a vaccine-preventable disease.

“Kimberly Coffey was buried three days before her high school graduation in the prom dress she didn’t get to wear. She didn’t have the opportunity to be vaccinated against Meningitis B.”

Kim’s Meningitis Story

In Kimberly‘s case, the Men B vaccine wasn’t yet available, but in many other cases, parents have shared their stories of unvaccinated children who suffered with a disease that was vaccine preventable at the time.

“From 2010 to 2016, young children continued to be at the greatest risk for influenza-associated pediatric deaths. Children without preexisting medical conditions accounted for half of all deaths. Vaccination coverage was low among influenza-associated pediatric deaths.”

Shang et al. on Influenza-Associated Pediatric Deaths in the United States, 2010–2016

Tragically, there are also many flu stories.

But the flu isn’t the only vaccine-preventable disease that still harms children.

This family didn't have a choice about their son getting sick - he was too young to be vaccinated when he was exposed to an unvaccinated child with measles.
This family didn’t have a choice about their son getting sick – he was too young to be vaccinated when he was exposed to an unvaccinated child with measles

There are other diseases. Other stories.

Read these stories.

Listen to these parents.

Are the stories supposed to scare you into vaccinating your kids?

Of course not. Just like you shouldn’t let the myths and propaganda from the anti-vaccinate movement scare you away from vaccinating and protecting your kids.

Instead of being motivated by fear, you should make your decision because you understand that the many benefits of vaccines are far greater than their small risks.

What to Know About Vaccine-Preventable Disease Stories

Reading stories of vaccine-preventable diseases are a good reminder that these diseases are not so mild as some folks suggest, and they are instead life-threatening diseases that are best avoided by getting fully vaccinated.

More Vaccine-Preventable Disease Stories