Chief Cushie ~MaryO~ Posted November 6, 2002 Chief Cushie Report Share Posted November 6, 2002 Flu: Give It a Shot By Jennifer Huget Special to The Washington Post Tuesday, November 5, 2002; Page HE01 The word "flu" has been misapplied to illnesses ranging from the common cold to upset stomach for so long that it has lost some of its well-deserved menace. The real thing -- officially known as influenza -- is a highly contagious disease of the upper respiratory system that delivers five or more days of some combination of high fever, headache, fatigue, sore throat, dry cough, congestion and achiness. You don't want to get it. And in most cases (more on this qualification later), you don't have to. This year's flu vaccine, unlike those of the past few years, is in ample supply: Between 92 million and 97 million doses will be available this fall and winter at community clinics, hospitals and doctor's offices. All you need is one shot. And for about $20, you can ward off the disease that kills an estimated 20,000 Americans each year -- lots more than anthrax, West Nile virus and malaria put together. You still have questions? We knew that. HOW DOES THE VACCINE WORK? The vaccine is formulated anew each year as epidemiologists track strains of flu virus circulating worldwide and identify those most likely to cause widespread illness during our flu season, which starts in earnest in November and runs through March or April. The vaccine consists of dead or inactivated viruses -- two "A" strains and one "B" strain -- which, when injected, prompt your immune system to produce antibodies to fight those viruses. This year's mix is calculated to combat a variant of Hong Kong B virus similar to a strain that was epidemic in the United States in 1988 and is expected to return this winter. The vaccine takes about two weeks to be fully effective; that's why vaccination efforts started in October. WILL THE SHOT MAKE ME SICK? Because the biological agents in the vaccine are dead, they can't give you the flu. Still, some people experience mild fever and achiness within a few days after their shot. People with egg allergies shouldn't be vaccinated, because the viruses used to make the vaccine are grown in hen's eggs. Though no link has been clearly established, some believe the vaccine may cause Guillain-Barr? syndrome. The Centers for Disease Control and Prevention (CDC) speculates that even if such a link were established, only one person in 1 million receiving the flu vaccine might develop the nerve-damaging syndrome, which is fatal in about 6 percent of all cases. Sadly, a small percentage (the number varies from year to year, according to how well the vaccine matches the circulating flu strains) of those who get the shot will still come down with the flu, albeit generally a milder-than-usual case. WILL THE SHOT HURT? Of course it will. Get the shot anyway. MaryONote: It doesn't hurt much, just a tiny prick. ?We've been through MUCH worse!color> WHO'S AT GREATEST RISK OF SERIOUS FLU COMPLICATIONS? While anyone can get the flu, those with weakened or compromised immune systems are more likely to get it and also to experience complications that may put them in the hospital. People over 65 have long been known to be at high risk because the immune system naturally grows weaker -- less able to produce antibodies to fight the virus -- as we age. But the CDC this year has expanded its high-risk list to include children between 6 months and 23 months. Research has shown that children in this age group face about the same risk of being hospitalized for flu-related complications as seniors. While the CDC has not yet made its recommendation official, it now suggests that parents consider having children of this age vaccinated. Children younger than 6 months face the same risk as older babies and toddlers, but the vaccine is not licensed for use in babies this young. To offer them some protection, the CDC has further expanded its priority-vaccination group to include those who live with or are caregivers for infants and toddlers. Those between 50 and 65 years old are more likely to have chronic medical conditions, so they're in the high-risk category, too, as are those who are household contacts or caregivers for high-risk people of any age. Women who are in the second or third trimester of pregnancy during flu season are considered at increased risk of complications from the illness and should talk with their doctors about whether to get a shot. WHAT ABOUT OLDER CHILDREN? Healthy schoolchildren have long been known to be at low risk of flu-related complications, and therefore have not been included in priority groups. But those with asthma, cystic fibrosis and other chronic conditions are at high risk of complications and should be considered priority recipients. A University of Washington School of Medicine survey of illness among school-age children during one flu season estimated that for every 100 children followed, there were 28 illnesses and 63 missed school days attributable to influenza. Also, for every 100 children followed, their parents missed 20 days of work due to their children's illness. Kids younger than 9 who are getting vaccinated for the first time should get their shots right away (October would have been ideal) because they will need a booster a month later to ensure full protection. I GOT A SHOT LAST YEAR. AM I STILL COVERED? Still trying to weasel out of it, aren't you? No, last year's shot doesn't carry over. The vaccine confers its fullest protection for only a few months, and then only for the specific strains it's designed to fight. Of the three viruses targeted each year, one or two will be different from those targeted the previous year. I'M WORRIED ABOUT THE PRESERVATIVES USED IN VACCINES; I'VE HEARD BAD THINGS ABOUT THIMEROSAL. Though there's no hard evidence linking thimerosal, which contains a form of mercury, to any adverse health effects, some parents are fearful enough that they'd rather skip the vaccine than expose their kids to the preservative. In response to this, one manufacturer, Evans Vaccines, offers a reduced-thimerosal pediatric vaccine, and Aventis Pasteur has just introduced a limited supply of a preservative-free vaccine for kids between 6 months and 35 months old. It is available through your pediatrician. The CDC notes that the health risks posed by the flu outweigh any risk posed by the preservative. I'M HEALTHY AS A HORSE. WHY SHOULD I BOTHER? If the prospect of feeling deathly ill doesn't motivate you, maybe the thought of using up a week of sick leave actually being sick will. Numerous studies cited by the CDC show the cost-effectiveness of vaccinating healthy adults, the major factor being lost productivity related to workers' taking sick days. A new Stanford University study based on computer models weighing the costs and benefits of vaccinating healthy people ages 18 to 50 showed an average $30 savings per vaccination. French researchers reporting in the American Stroke Association journal early this year found that the flu vaccine may lower stroke risk by as much as 40 percent, particularly in people 75 and younger, by reducing the chance of subsequent infections that might lead to blood clots. But while some studies have suggested that, by a similar mechanism, the flu virus can trigger heart attack in certain high-risk people, a study in the American Journal of Epidemiology found the vaccine offered no discernible benefit in preventing a second heart attack. The CDC has recently compiled a new vaccine schedule (including shots for tetanus and other diseases in addition to the flu) for adults. It is available on the Internet at www.cdc.gov/nip/recs/adult-schedule.htm. WHAT I CAN DO TO GET THE MOST FROM MY FLU SHOT? Become younger. Seriously, though, because they're aware that flu shots confer varying levels of protection in different groups of people, scientists are exploring what people can do to boost the immune response produced. There's anecdotal evidence that a healthy diet can help boost the immune response -- but you were already eating this way, weren't you? More substantial evidence offered in the Sept. 25 issue of the Journal of the American Medical Association suggests that being sleep-deprived when you receive your vaccine lessens your immune response, at least temporarily. Among older people, regular physical activity vigorous enough to produce sweat may increase your immunity. Researchers at Iowa State University found that a group of people 65 and older who exercised three times a week for 20 minutes at high intensity developed stronger immune responses after receiving the influenza vaccine than those who performed less rigorous exercise. The same study showed that participants with low perceived stress levels produced more antibodies to help fight the flu virus. SO I NEED TO EAT RIGHT, GET ENOUGH EXERCISE AND SLEEP AND LIMIT STRESS IN ORDER TO IMPROVE MY CHANCES OF STAYING HEALTHY? Does the word "duh" ring a bell? WHERE DO I GO TO GET A SHOT? Large companies often offer flu-shot clinics for their employees; watch for news of them at work. Flu-shot suppliers run clinics at grocery stores, pharmacies and other retail sites. You can find one by checking www.findaflushot.com, a Web site maintained by Maxim Health Systems, or call the company toll-free at 877-962-9358. (Of course, this service lists only those clinics sponsored by Maxim.) Or you can just ask your own physician for a shot. DID OLYMPIC PHYSICIANS LEARN INTERESTING THINGS ABOUT THE FLU THAT YOU'D LIKE TO TELL ME ABOUT? Why, yes. Researchers at the University of Utah School of Medicine working at the 2002 Winter Olympics in Salt Lake City found they could slow the disease's spread in a community (in their case, the athletes living in close quarters in the Olympic village) through a combination of early detection (using recently available diagnostic tests) and rapid administration of oseltamivir (Tamiflu), one of four prescription-only antiviral drugs licensed for use in the United States. (The others are amantadine, rimantadine and zanamivir, each with different indications for use.) When administered within two days of the onset of illness, oseltamivir can shorten the flu's duration by about a day; administered prophylactically to those in close contact with influenza-stricken people, the drug can slow the spread of the illness through the community. (As a bonus, researchers found they could dramatically decrease the inappropriate administration of antibiotics, which, though they fight bacteria and have no power over any virus, are all too often prescribed for flu symptoms.) I JUST CAN'T GET ENOUGH INFORMATION ABOUT THE FLU. WHERE ELSE CAN I LOOK? You're in luck: Check out the CDC's National Immunization Program Web site at www.cdc.gov/nip/flu ? 2002 The Washington Post Company Quote Link to comment Share on other sites More sharing options...
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