Tuesday, March 3, 2009

Why Does My Child Need a Flu Shot?

It’s official – we are in the middle of flu season. According to the Centers for Disease Control (CDC), the percentage of flu tests that came back positive during the week ending February 21 (the most recent time period for which we have data) continues to rise steadily and has not yet peaked.

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For most people, influenza is just a nuisance infection. If you get the flu, you have a fever, stuffy nose, and body aches. You rest in bed for a few days, and when it’s over, you’re back to normal. For children, the elderly, and people with underlying medical problems, however, influenza can be a life threatening infection. So far this year, influenza has caused 17 deaths among children in the US. Eight of these deaths occurred just last week! As reported by CNN this week, even perfectly healthy children die of influenza. It is because influenza can kill children even if they have no other medical problems that this year New Jersey began requiring flu shots for children to be allowed to attend preschools and day care centers.

Perhaps even bigger flu-related news, though, came in a pair of articles published this week in the Journal of the American Medical Association (JAMA). Unlike most viral illnesses, there are actually effective drugs to treat influenza. One of these, oseltamivir (Tamiflu®) is FDA-approved to reduce the duration of symptoms if taken within 48 hours of feeling sick. An older drug, Amantadine, is no longer useful for the treatment of influenza because more than 90% of the circulating influenza A viruses are resistant. Because of the way Tamiflu was designed, many physicians and pharmacologists believed widespread resistance to this drug was not possible. Unfortunately, this is not the case. Although in the 2007-2008 flu season only 12.3% of influenza isolates were resistant to oseltamivir, preliminary results from this year (reported in this week’s issue of JAMA) indicate that 98.5% of isolates are resistant! Once again, nature is outsmarting us and drugs that used to be effective for treating infections are becoming useless.

So if we can’t treat the flu, the best thing we can do is prevent the flu. And the only way to prevent the flu is with a flu shot. Who needs a flu shot? According to the Advisory Committee on Immunization Practices (ACIP), all children between the ages of 6 months and 18 years should be vaccinated, as should adults 50 years of age and older and any adult at risk for medical complications from influenza. The recommendation to vaccinate all children arises from concerns that even otherwise healthy children can die of influenza, a concern that sadly is born out year after year in children whose parents asked, “Why does my child need a flu shot?”

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Bravo New Jersey!


Gwyn said...

I was horrified to learn that an otherwise healthy teenager in our community died of Influenza B last week.

My own daughter brought home this strain, and it wiped us out for over a week. It's too late for the vaccine this year, but you can bet we'll get it next year.

Doctor David said...

Actually, Gwyn, it's NOT too late for this season (well, for your family it is, but for people who have not been infected yet, it is not). Although we usually think it takes 4-6 weeks to get an optimal antibody response to a vaccine, antibodies can rise to modestly protective levels in as few as 2 weeks. So, since we have not yet reached the peak of flu season, there may still be benefit for people who have not been vaccinated and have not had an infection yet this year.

Megan said...

I think there are some factors playing into why parents who otherwise routinely vaccinate their children have not sought the flu vaccine:
1). As you point out, it's still optional in most states and not a requirement by schools.
2.) There have been shortages in vaccine supply in recent years where it was reserved for the most susceptible among us, leaving parents with "healthy" children to feel that they shouldn't take a shot away from someone who needs it more.
3). The media has often highlighted those seasons when the vaccine did not target the specific strain of flu that was being passed around, causing parents to question its effectiveness even now.
4). As a corollary to number 3, some people who get the flu shot still get the flu--or so they believe, or have mild symptoms from the vaccine itself, again making them question if it is worth it.

I think to address some of these concerns, a more concerted effort should be made by the government (in the way of PSA's and the like) to correctly inform the public of the need for the flu vaccine and to reduce the amount of disinformation that is out there.

Of course, I believe that this should occur for ALL vaccines, since they have been erroneously linked to autism. But that's a subject for another time. . .

Doctor David said...

Megan, you make some excellent points. Number 3 is especially relevant this year, when the strains covered by the vaccine actually match the strains that are circulating, making the deaths among unvaccinated children that much more tragic.

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Kerri M said...


I have found this article among others in your blog very interesting. Though I am in no way a medical professional, I thought you may interested in the information in this article: "Doctors, Air Purifiers and UV Lights: Another Way to Stay Healthy" http://www.flamefurnace.com/blog/?p=304

This discusses how indoor air quality products such as air purifiers can be used to reduce bacteria, diseases etc... in both doctor's offices and the home

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