New Mexico News
| HEALTHBITS - Get Flu Vaccine Every Year |
| Posted by () on May 21 2008 at 6:57 PM |
YOUR CHILD'S HEALTH: As always, I read microbiologist Steve Young's report on virus isolations this morning to learn what kinds of problems I'd be seeing in my office all week. Dr. Young is in charge of the microbiology lab at TriCore, which serves University of New Mexico Hospital and Presbyterian Medical Center in Albuquerque and St. Vincent Regional Medical Center in Santa Fe and their associated clinics, so it serves as a barometer for what's going on in the state as a whole.
Dr. Young's report for the last week in February showed that 55 children had been found to have respiratory syncytial virus and 33 children and adults grew influenza virus during that week. Compared with summer numbers, that's a lot. Compared with previous weeks, it shows a slowing of isolations, portending the onset of spring as well as the buds on the willow tree outside my window. We can't be sure of that, since most of us doctors don't get a viral culture on every patient we diagnose as having the flu or the RSV-caused bronchiolitis. In general, it's not worth the expense.
You may have heard that this year's flu vaccine has not been very effective. Unfortunately, that is true: It has been only about 50 percent effective against the strains circulating this year, so many of those immunized have been infected, to their great dismay and discomfort. The Wall Street Journal's health blog starts out its story on the phenomenon like this: "Making flu vaccine is easy. All you need is the ability to predict the future, the better part of a year and lots of chicken eggs" and continues, "The predicting the future part eluded America's flu mavens last year; this season's flu shot wasn't built to stop the strains that wound up being the most common."
Here's how the prediction process works:
1. World Health Organization scientists characterize strains circulating in the Far East (it's usually these strains that will affect the Western Hemisphere come winter here).
2. A WHO decision is made in February as to which strains will be grown by all the vaccine makers.
3. Vaccine makers get samples of the chosen viruses and infect millions of chicken eggs where the viruses grow and multiply.
4. Everything going well, the flu vaccine reaches the market in summer or fall, filling the orders by physicians, clinics, and hospitals the previous winter.
5. You and I line up at doctors' offices, flu shot clinics, or drug stores and get poked in the arm or snuffled with the relatively new intranasal vaccine.
It would be nice if there were a more efficient manner of predicting what will come to us across the Pacific Ocean, growing the vaccine virus in a more predictable manner, and getting the vaccine into the arms and noses of our patients. Maybe we can look forward to improvements in the future, but this is the best we have at present.
Does that mean we should not get in line for our shots next fall? I think the answer is clearly "Get in line!"
Fortunately for the 50 percent of us who were protected by the vaccine, the shot saved us 100 percent from a week or two of fever, cough and agony, and, if we're older, a real chance of death.
The average excess death count per year from influenza is 36,000 in the United States; those 50 percent will not be part of this year's toll. For those where it didn't work, we are sorry, but that's better odds than gambling your time and money away at the casino, isn't it?
In fact, you may have already read that the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practice recommended recently that we begin inoculating all school-age children annually against the flu. It is uncommon for children that age to die from it, but the sick ones miss a week or two of school, keeping their parents home with them and further clogging up clinics and ERs. And perhaps most important, they carry their disease home to their older and younger friends and relatives— not a kind gift of a not very kind disease.
Lance Chilton, M.D., is a pediatrician at the Young Children's Health Center in Albuquerque, associated with the University of New Mexico. He is happy to hear from those with questions at 272-9242 or lancekathy@yahoo.com.
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