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Health Column: Foil the flu!

Phil Mohler, M.D.
MOHLER’S MEDICATION MAXIMS
Free Press Health Columnist

The signs have been in the grocery store parking lots for six weeks now — “Get your flu shot today!” Our practice received its first injectable vaccine in late September, but we are still waiting for the intra-nasal live vaccine.

WHAT’S THE SAME AS LAST YEAR?



The Centers for Disease Control and Prevention recommendation remains that everyone over 6 months of age should receive the influenza vaccine. Like every other vaccine, the flu vaccine is not 100 percent effective, but it remains the best tool we have to prevent illness and death from the flu virus.

As in previous years, the guidelines suggest getting the vaccine as soon as it becomes available. It makes absolutely no difference where you get the vaccine (grocery store, health department, doctor’s office) as all vaccines are produced by the same handful of pharmaceutical companies. This year we will see more of the quadrivalent vaccines (four different flu strains) that may offer a slight advantage over the trivalent products (three flu strains). The strains in the 2014-15 vaccines are identical to those in the vaccines from last year.



WHAT’S NEW? GOOD NEWS FOR KIDS!

This year, based on recent studies, the CDC is recommending that children aged 2-8 years receive the “in the nose” FluMist vaccine. In a study of almost 8,000 kids, the intra-nasal live vaccine was more effective in preventing influenza than the “shot in the muscle” inactivated vaccine.

In the past, the CDC has recommended not giving intra-nasal FluMist to kids with asthma. A recently published study of children and adolescents with asthma aged 6-17 years showed no more wheezing with the FluMist than with the shot in the arm inactivated vaccine. The FluMist kids also got the flu less often. Thus, the CDC has opened the door a tad to giving the FluMist vaccine to kids with asthma. Using FluMist in kids with asthma demands a discussion with your child’s physician, however, as the severity of the asthma may warrant sticking with the inactivated injectable vaccine.

WHAT’S NEW FOR THE MATURE?

The high dose (HD) injectable vaccine for those over 65 years was introduced last flu season. It is being heavily marketed again this year to the fanfare of a study that showed it decreased influenza cases by 25 percent compared with the standard vaccine. That sounds like a big deal! Looking at the study a little harder, 1.4 percent of the HD group came down with the flu versus 1.9 percent of the standard vaccine group. That is indeed actually a 26 percent reduction, but in real life terms it means that 200 persons would need to be immunized with the HD vaccine rather than the standard vaccine to prevent one case of flu. Beware those (Pharma companies and old doctors) who try to sell you something based on relative percentages. The HD vaccine has a few more side effects (sore arms and fevers) than the standard flu vaccine. Medicare Part D buys seniors either of the vaccines.

Note to the wise: Do not delay vaccination to wait for a specific vaccine if there is an appropriate vaccine available.

VACCINE FALSEHOODS

1) “It causes the flu” — None of the vaccines available now can cause the flu. Current flu vaccines do not cause any more systemic reactions (fever, aching) than placebo (sugar) injections.

2) “It doesn’t work” — Like all vaccines, it does not offer 100 percent protection, but in average years about 1/2 to 2/3 of those vaccinated are protected. Those numbers are better than Babe Ruth’s lifetime batting average. Even when the match between the vaccine and the flu virus is not perfect, the vaccine is helpful in protecting against the illness.

3) “I never get the flu/I am healthy” — Healthy adults may not develop classical severe influenza when infected, but even those with minimal or no symptoms may transmit the virus to others. This is one of the major reasons that widespread vaccination is recommended. Refusing vaccination because you believe you are at low risk ignores the potential threat to close contacts, especially those who cannot get vaccinated or those who may not be protected by the vaccine. I know we are in Western Colorado, where we don’t like to be told what to do, but none of us want to give the flu to a six week old baby or a 90 year old with cancer.

The Mesa County Health Department now has a full complement of vaccines. Call 970-248-6900 or check their website for details, http://www.mesacounty.us.

GJ Free Press health columnist Dr. Mohler has practiced family medicine in Grand Junction for 39 years. He has a particular interest in pharmaceutical education. Phil works part-time for Rocky Mountain Health Plans. Email him at pmohler69@gmail.com.


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