Tag: predictions

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

Will This Season’s Flu Shot Fail?

Flu season hasn’t even started yet, but we are all seeing anti-vax myths warning that the flu shot will fail in epidemic numbers. Where are they coming from?

Most of these anti-vax folks don't think that any vaccines work...
Most of these anti-vax folks don’t think that any vaccines work…

A lot of it is from the usual suspects…

Will This Season’s Flu Shot Fail?

Anyway, is there anything to this?

Can anyone really predict whether or not this season’s flu vaccine will be effective or if it will fail?

Probably not.

What they can do is scare folks into thinking that the flu vaccine won’t work, so that they don’t get vaccinated and protected, ensuring that we really will have a bad flu season!

Consider last fall. Many were predicting a mild flu season in North America following a mild season in the Southern Hemisphere and yet, 136 children died.

And this year?

Will a moderate to severe flu season in the Southern Hemisphere mean that we will be seeing a severe flu season too?

Maybe, but consider that the issue in the Southern Hemisphere wasn’t a vaccine mismatch.

Last year's flu vaccine in Australia was a good match.

They had a good match with their flu vaccine. The problem was just that they had a lot of flu!

So why do folks think that we will have a mismatch?

The A strains in the southern and northern hemisphere flu vaccines are different.

It’s because the A strains in the Southern and Northern Hemisphere flu vaccines are different, which is a little unusual, but not unheard of.

“Additional data obtained in recent weeks has confirmed the wide regional differences in the relative proportion of A(H3N2) viruses belonging to the phylogenetic subclade 3C.2a1b and clade 3C.3a. The majority of A(H3N2) viruses collected and genetically characterised from September 2018 to February 2019 belonged to the phylogenetic subclade 3C.2a1b; however, the proportion of viruses falling into clade 3C.3a has increased substantially since November 2018 in several countries in western Europe, Israel and especially in the United States of America.”

A lot of work goes into figuring out which strains to include in each year’s flu vaccine and that got us to where we are now.

Unfortunately, a lot of different flu vaccine strains circulate each season, which is why some folks get sick even though they have been vaccinated.
Unfortunately, a lot of different flu vaccine strains circulate each season, which is why some folks get sick even though they have been vaccinated.

Did they make the right decision?

Is our flu vaccine a match?

Some folks are saying that since they changed it again, for next year’s southern hemisphere flu vaccine, then they must have messed up.

So which flu virus strains are circulating so far? Will it be the 3c3.A clade of H3N2 that is in our flu vaccine? Will it be an H1N1 virus?

Of course, it is too early to tell.

“A/H3N2 viruses continue to show substantial diversity in HA sequences with a deep split between 3c3.A and 3c2.A1b viruses. The most notable recent developments are the rapid rise of clade A1b/137F – a subclade of A1b/135K – in China and Bangladesh and clade A1b/197R – a subclade of A1b/131K – which dominates the ongoing season in Australia. Our models predict that A1b/137F and A1b/197R will be the dominant clades next year with A1b/197R accounting for most circulation. There is, however, large uncertainty in the true extent of A1b/137F circulation.”

Bedford et al on Seasonal influenza circulation patterns and projections for September 2019 to September 2020

While we are seeing sporadic cases, flu activity is very low, which makes it a great time to get vaccinated and protected, before flu season really gets started.

And the predictions of a failed flu vaccine?

“Over the last 18 months, 3c3.A viruses have increased markedly in the US and Europe and accounted for 60% of isolates in North America and 10-20% in Europe during the last NH winter.”

Bedford et al on Seasonal influenza circulation patterns and projections for September 2019 to September 2020

I won’t let it get in my way of getting my family vaccinated and protected.

I’ll be getting my flu vaccine, crossing my fingers that they are wrong, and hoping that a universal flu vaccine gets here much sooner than later.

Even if they are right and one strain is mismatched, I understand that being vaccinated is the best protection against the flu and still provides many benefits, including the chance for milder symptoms and less severe disease.

And I know that the only true fail here, in addition to pushing misinformation about flu vaccines, is in skipping a yearly flu vaccine.

More on This Season’s Flu Shot

Flu Season Predictions

No, I can’t see into the future…

I predict that I will continue to get a flu shot each year, at least until they come out with a universal flu vaccine.
I predict that I will continue to get a flu shot each year, at least until they come out with a universal flu vaccine.

But some things are very easy to predict.

Flu Season Predictions

Here are some predictions for this year’s flu season.

  1. We will have a flu season epidemic in the United States this year. Surprised by that prediction? Don’t be. Flu activity reaches epidemic levels each and every year. What we don’t always have are flu pandemics, during which flu activity is very high in multiple parts of the world. By definition, flu season is an epidemic.
  2. Almost all states will eventually report having widespread influenza activity as flu season peaks. Again, this is not a bold prediction. It happens every year. How severe is flu season going to be? No one can really predict that, but we can look at the proportion of people seeing their health care provider for influenza-like illness (ILI) and laboratory-confirmed influenza-associated hospitalization rates as flu season moves along to get some idea. Remember, measures of the geographic spread of the flu don’t really tell you anything about the severity of flu activity.
  3. Dozens of kids will die with the flu – most of them unvaccinated. Remember, 37 kids died in the mildest flu season we had.
  4. A little under half of adults will get a flu vaccine, even though the current recommendation is that everyone who is at least six months old without a true contraindication get vaccinated each year.
  5. A little over half of parents will get their kids a flu vaccine.
  6. Some people who get a flu vaccine will still get the flu. You know the flu vaccine isn’t the most effective, but it still has plenty of other benefits, so even if you did still get the flu, hopefully you got a milder case, weren’t hospitalized, and didn’t die.
  7. Some people who get a flu vaccine and get the flu will blame their flu shot, even though it is well known that the flu shot can’t give you the flu.
  8. Many people who aren’t high risk will be prescribed Tamiflu. Or Xofluza, because it is new.
  9. Tens of thousands of adults will die with the flu. Even in a mild flu season, the flu is very deadly.
  10. Some folks will continue to push the idea that there is a vaginal spermicide in flu shots, even though that anti-vaccine talking point has been refuted a thousand times already.

What else can you predict about flu season?

Some folks will think it is too late to get a flu shot.

It isn’t.

Get your flu shot if you haven’t and get protected for the rest of flu season.

Another bold prediction? Elderberry syrup and Oscillococcinum are not going to help prevent or treat your flu symptoms.

More Flu Season Predictions