Tag: universal flu vaccine

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

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

Is H1N1 Flu Back This Year?

You remember H1N1 flu, right?

Is it back this year?

Is H1N1 Flu Back This Year?

While H1N1 seems to be the most frequently identified influenza virus type this year, in reality, since causing the “swine flu” pandemic in 2009, this strain of flu virus never really went away.

It instead became a seasonal flu virus strains.

So it is back again this year, but just like it was back during the 2013-14 and 2015-16 flu seasons.

Is that good news or bad news?

In general, it’s good news, as “flu vaccines provide better protection against influenza B or influenza A (H1N1) viruses than against influenza A (H3N2) viruses.”

“The 2009 H1N1 influenza virus (referred to as “swine flu” early on) was first detected in people in the United States in April 2009. This virus was originally referred to as “swine flu” because laboratory testing showed that its gene segments were similar to influenza viruses that were most recently identified in and known to circulate among pigs. CDC believes that this virus resulted from reassortment, a process through which two or more influenza viruses can swap genetic information by infecting a single human or animal host. When reassortment does occur, the virus that emerges will have some gene segments from each of the infecting parent viruses and may have different characteristics than either of the parental viruses, just as children may exhibit unique characteristics that are like both of their parents. In this case, the reassortment appears most likely to have occurred between influenza viruses circulating in North American pig herds and among Eurasian pig herds. Reassortment of influenza viruses can result in abrupt, major changes in influenza viruses, also known as “antigenic shift.” When shift happens, most people have little or no protection against the new influenza virus that results.”

Origin of 2009 H1N1 Flu (Swine Flu): Questions and Answers

The only reason we were so concerned about this strain of H1N1 in 2009 was because it was new.

Still, even in a good year, it is important to remember that a lot of people die with the flu, including a lot of kids. And most of them are unvaccinated.

So while it might be interesting to talk about which flu virus strain is going around, just remember that your best protection against that strain is a yearly flu vaccine.

More on H1N1 Flu

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