Tag: vaccine effectiveness

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

Is This Year’s Flu Shot Only 9% Effective?

Why do some people think that this year’s flu shot is only 9% effective?

A statement or tweet from the CDC?

The CDC has not released any information on the effectiveness of this year's flu shot yet.
The CDC has not released any information on the effectiveness of this year’s flu shot yet.

Not exactly…

Is This Year’s Flu Shot Only 9% Effective?

As the 2019-20 flu season is just getting started, we don’t actually know how effective this year’s flu vaccine will be…

She was tweeting an old story about last year's flu vaccine and the 9% number was just about one strain in the vaccine. The adjusted overall vaccine effectiveness for the 2018-19 flu vaccine was actually 47%.
Greta Van Susteren was tweeting an old story about last year’s flu vaccine and the 9% number was just about one strain in the vaccine. The adjusted overall vaccine effectiveness for the 2018-19 flu vaccine was actually 47%.

Early estimates are typically posted in mid-February.

Will we get this year’s flu vaccine effectiveness estimates early because flu season started early?

As some predicted, the circulating H3N2 strains are of a different clade than the ones in the vaccine though…

Will it help that all circulating strains are antigenically similar to the flu virus strains in this year’s flu vaccine?

Or that we are seeing more flu B this year?

During the 2017-18 flu season, the flu vaccine worked much better against flu B strains.

We don’t typically talk about flu vaccine effectiveness against flu B strains because they aren’t a big part of our flu seasons, but in general, flu vaccines work well against flu B.

“In general, current flu vaccines tend to work better against influenza B and influenza A(H1N1) viruses and offer lower protection against influenza A(H3N2) viruses.”

Vaccine Effectiveness: How Well Do the Flu Vaccines Work?

In fact, they often work better against flu B than against other strains, so maybe it will turn out to be a good thing if we see more flu B than H3N2 this year…

The flu vaccine has many benefits besides preventing you from getting the flu.
The flu vaccine has many benefits besides preventing you from getting the flu.

But most importantly, we know that the flu vaccine has many benefits and few side effects, so even when it isn’t a perfect match it makes sense to get vaccinated and protected.

And know that until we get a better, universal flu vaccine, folks should know that talk about flu vaccine effectiveness is largely academic, as a yearly flu vaccine remains the best way to protect yourself from getting the flu and developing serious complications from the flu.

More on Flu Vaccine Effectiveness

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

Did Bobby Kennedy Admit That Chickenpox Kills People?

The usual talking point from folks who are anti-vax is that vaccine-preventable diseases are mild. Some even go so far to say that they are good for you! It isn’t too often that these folks admit that these diseases, from measles and polio to chickenpox, do indeed kill people.

Bobby Kennedy finally gets it right, admitting that chickenpox killed 100 people a year in the pre-vaccine era.
Having chickenpox doesn’t protect you from developing shingles – it’s why you develop shingles!

No, chickenpox doesn’t kill 1 in 100 people, but that doesn’t mean that people don’t die with chickenpox, especially if they are unvaccinated and unprotected.

Did Bobby Kennedy Admit That Chickenpox Kills People?

Do we want to go back to the days when more folks were dying with chickenpox?

“The total cost to theoretically save 50 children is approximately $900 million dollars or $17.5 million per life saved.”

Bobby Kennedy

What else does Bobby Kennedy say?

“Chickenpox can reactivate as shingles when an adult’s immunity wanes or is not boosted by periodic exposure to children with chickenpox. CDCs clinical studies predicted that widespread vaccination would double shingles rates among adults and children and precipitate a shingles epidemic. “

Bobby Kennedy

While it is true that chickenpox can reactivate as shingles, a bonus of getting vaccinated and protected with the chickenpox vaccine is that it actually decreases your risk of developing shingles later in life!

And those countries that didn’t vaccinate and protect their kids with the chickenpox vaccine, because they thought it might cause a later shingles epidemic if fewer kids were sick and boosting the immunity of adults who had already had chickenpox still saw a rise in shingles cases.

That’s probably why many of those countries are now considering adding the chickenpox vaccine to their schedule.

What else did Bobby Kennedy say?

“…chickenpox presents as a mild rash and slight fever and confers lifetime immunity to chickenpox and significant protection against shingles, heart disease, atopic diseases, and cancers including glioma, brain, and spinal tumors. “

Bobby Kennedy

The part about getting lifetime immunity to chickenpox is true.

Does chickenpox provide significant protection against heart disease, atopic disease, or cancer?

Nope.

And of course, if you have ever had chickenpox, you know that it is far more than “a mild rash and a slight fever.”

Unvaccinated kids with chickenpox typically have 250 to 500 blisters over their entire body.
Unvaccinated kids with chickenpox typically have 250 to 500 blisters over their entire body. Photo courtesy CDC/ Dr. John Noble, Jr..

In a routine case of chickenpox, the fever typically rises to at least 102°F and lasts for at least 2 to 3 days, with the rash persisting for up to a week.

Unfortunately, not all chickenpox cases are routine.

In addition to the deaths, there are plenty of reports of kids having complications with chickenpox and developing skin superinfections, pneumonia, encephalitis, or having strokes.

What else does Bobby Kennedy say?

“Merck’s vaccine is only 60% effective after 5 years, leaving adults vulnerable to shingles.”

Bobby Kennedy

Actually, it has been found that one dose of the chickenpox vaccine is 100% effective at preventing severe disease!

So why do we get two doses?

“This study confirmed that varicella vaccine is effective at preventing chicken pox, with no waning noted over a 14-year period. One dose provided excellent protection against moderate to severe disease, and most cases occurred shortly after the cohort was vaccinated. The study data also suggest that varicella vaccination may reduce the risks of HZ in vaccinated children.”

Baxter et al on Long-term effectiveness of varicella vaccine: a 14-Year, prospective cohort study.

Two doses of the chickenpox vaccine are up to 94% effective at preventing any chickenpox disease, even breakthrough cases.

And again, several studies have confirmed that getting vaccinated and protected with the chickenpox vaccine decreases your risk of developing shingles!

Do you really want your kids to be at risk to get chickenpox and have a higher risk to get shingles later in life?

Of course not. That’s why you hopefully don’t listen to folks like Bobby Kennedy and you vaccinate and protect your kids.

More on Chickenpox Deaths