Friday, September 16, 2011

Get the Flu Shot Now - It’s Never Too Early in the Season to be Vaccinated, a Doctor Says

How many types of flu are there? What will be this year's big flu virus? What are the most effective treatments? What's better: injections or nasal shots? An expert in the field answers your most common questions about this respiratory illness. Plus, is your hygiene heinous? Find out by taking our quiz...

Fall and flu shots. They’re not exactly synonymous.

After all, isn’t flu season really in January or February? What’s the point in being vaccinated so early, when it’ll probably wear off, right?

Wrong.

“The protection from the influenza immunization will last through an entire season, so getting it when the vaccine becomes available in your community is probably the best strategy because we never know when flu will arrive,” says Jeffrey Duchin, M.D., professor of medicine in the division of allergy and infectious diseases at the University of Washington, in Seattle.

“If you wait until flu is in your community, you’re vulnerable for two weeks while your body produces the protective response,” he says. “So it doesn’t really make a lot of sense to wait, because you expose yourself to the flu unnecessarily.”

September or October is a good time to get the flu shot, he says, and high-risk people, such as pregnant women, the elderly and people with chronic diseases, such as diabetes, asthma or rheumatoid arthritis, should definitely get shots because they have a greater chance of developing flu complications, such as pneumonia.
In this exclusive Lifescript interview, Duchin explains what every woman needs to know about vaccines, the new warning against bird flu and what he does when he has a cold or flu.

What flu virus is expected to hit this year, since there’s usually a different strain every year?
We’re predicting something close to those we saw last year. Each [flu] season, we expect two strains of influenza: type A and one of type B. This is good news [when making a] vaccine because we can target viruses that are very similar to [those] targeted before.

There are three kinds of flu shots – regular, intradermal and high-dose. Who are these shots geared toward, and is one better than the others?
The regular vaccine is recommended for everyone over 6 months old.

It’s particularly important for people with a high risk of flu complications and their close contacts, like family members, coworkers, and health-care providers. Those at high risk include people with lung disease, cardiac disease, chronic neurological diseases, asthma, diabetes, kids under age 2, the elderly and pregnant women – their infants are very vulnerable.

The high-dose vaccine was designed by manufacturers to better protect people 65 and older, and the studies they’ve done show the vaccines produce very good antibody levels. We don’t know yet if it is more effective than a normal dose, and the study is still ongoing.

It’s a more expensive vaccine, so whether it makes sense to spend money on a high-dose vaccine is a decision individuals can make. It’s an option for those 65 and older – but it’s not preferred because there is no evidence it may make a difference.

The intradermal vaccine is a flu vaccine given with a smaller needle into layers of the skin – not through the skin and into muscle, like the regular vaccine is. It also injects a smaller volume and has comparable effectiveness to other vaccines. It’s only available for 18- to 64-year-olds.
Why only that age group?
That’s the group for which it was licensed [by the Food and Drug Administration (FDA)]. The manufacturer applies to the FDA to give a recommendation for an age range, based on the population for which the product has been studied.

There’s also the nasal spray, which is available only for people 2 to 49 years old who are not pregnant and otherwise healthy.

For most people, the two choices are: get the nasal spray or flu shot.

Which is more effective: the nasal spray flu vaccine or shot?
The injectable vaccine has no live virus, only selected pieces of the flu virus that cause the body to develop a protective immune reaction.

The nasal spray puts a weakened [live] flu virus into the nose and allows the body to develop a response. Both are considered very effective in adults. Some studies show that the nasal spray may be more effective in children, and possibly in some adults.

Why is it more effective for children?
We [don't] know the explanation for that yet. Live virus vaccines tend to produce very strong reactions. The nasal spray provides immunity on the surface of the nose, where influenza is introduced, which may be very effective in preventing attachment of the virus.

Both cause good antibody levels in the blood, which is the most important thing.

Will swine flu be a concern this season?
We expect it to circulate for a number of years. Over time, we expect it to undergo [many] mutations. A vaccine that was used for the 2009 pandemic was incorporated into the flu vaccine and that provided very good protection.
The U.N. recently issued a warning for the resurgence of bird flu. What’s the likelihood that it could come to the U.S.?
The bird flu virus [doesn't] infect humans very easily. What the World Health Organization (WHO) is concerned about is that the bird virus seems to have changed significantly from the original one that the vaccine was prepared for. There’s concern that the vaccine may not be as effective. But we’re not in more danger of a human outbreak than we were before.

Should travelers still protect themselves from the bird flu virus?
Some precautions are avoiding places where live chickens are held or kept, and having good hand hygiene. You can’t get it from eating poultry or eggs. A human outbreak is unlikely, but people who have close contact with birds should take precautions.

The best source for preventive measures is the CDC travelers’ health Website.

What are common misconceptions people hold about the cold or flu?
People sometimes feel that if they get the flu shot, the vaccine should protect them against all wintertime colds.

The vaccine protects you against the three strains of influenza that are circulating, but not other viruses. So it’s still important to use good hygiene and stay away from those who are ill since other infections can be transmitted.

Another common misconception is that you can get flu from the vaccine – but you can’t get it from the live injection.

Some people get a little ache-y or feel other symptoms they recognize as a viral infection. That’s a reaction from your immune system, and it’s a good sign. It’ll just be a mild one- or two-day issue, and in exchange, you get protection for the entire flu season.
For pregnant women, even though they’re otherwise young and healthy in general, they’re at high risk of developing serious complications of influenza.

Studies show that vaccinating the mother, especially during the second and third trimesters, has benefits that are transferred to the baby. Then the baby is protected from severe influenza during the first few months of life when they can’t be vaccinated.

Why do some people get the flu and others don’t?
The underlying genetic makeup of an individual and their immune system very strongly relates to how they react to infections. The same virus can infect two people and cause a mild illness in one and a serious illness in another.

One key thing to understand is that even people who have mild cases of influenza can spread it. We recommend that people who live with high-risk persons also get the flu shot so that they don’t inadvertently spread influenza to those at high-risk.

When you feel a cold or the flu coming on, what do you personally do?
I make sure I get plenty of sleep, and stay well-hydrated and active. If I’m feeling really ill, I just rest until I’m feeling better.

Sometimes, if I’m feeling just a little hint of something coming on, I try to exercise, eat healthy and stay hydrated.
Is Your Hygiene Heinous?
When it comes to your hygiene habits, would those who know you praise your penchant for cleanliness or cry foul over your questionable ways? Good hygiene cannot be underestimated - your health, not to mention reputation, depends on it.

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