Newsday Op-Ed: Déjà flu? Reasons to Get a Shot
by Marvin Tenebaum, M.D.
Roslyn, New York – In the new year, with flu season upon us, important questions are raised about lessons learned from last year's novel H1N1 pandemic: Did we fully grasp how dangerous influenza is for vulnerable populations? Did we respond appropriately? And, most important, are we ready for this year's flu season?
The novel H1N1 flu virus – erroneously known as swine flu – appeared suddenly in March 2009 and rapidly spread worldwide. Unlike the two types of influenza A and the one type of influenza B viruses that caused seasonal influenzal infections for the previous 30 years, this novel strain of H1N1 caused death in seemingly healthy young people, pregnant women and morbidly obese people, and had a much lower infection rate in individuals 65 years and older, a population accounting for more than 90 percent of the 36,000 annual deaths caused by seasonal flu.
There was a public outcry when there was a delay in production of vaccine for H1N1, which for a time was in short supply. This reaction demonstrated the success of an aggressive national and local education effort to promote influenza vaccination.
Recent reports reveal that less than 50 percent of all high-risk populations – including diabetics, asthmatics, children from 6 months to five years, pregnant women, etc. – received seasonal and novel influenza vaccinations last year. It turned out that the overall mortality rate of novel H1N1 was the same as seasonal flu viruses.
This season, the flu vaccine is recommended for all older than age 6 months. The vaccine is readily available and contains protection against all of the circulating strains of flu.
So far this season, medical authorities report that even fewer individuals are being vaccinated. Why do so few of us take advantage of this protection?
With "flu" being the diagnosis given for any feverish illness, we do not fully appreciate how truly debilitating and dangerous influenza infection is. Anyone who has had the flu will do anything to avoid a second episode.
There are many misapprehensions regarding the safety of vaccines: for example, that they cause autism (every relevant scientific study refutes this claim); and that the associated fever, malaise and muscle aches are manifestations of actual infection rather than standard reactions to the vaccine (contrary to popular belief, the injectable vaccine does not contain living flu viruses).
Some pregnant women fear the vaccine may be harmful to their fetuses, but the American College of Obstetrics and Gynecology has strongly endorsed flu vaccines regardless of trimester, recognizing that nothing is more dangerous to the fetus than something that is dangerous to the expectant mother. In fact, several studies show a significant decrease in influenza-related hospitalizations of infants in the first six months of their lives, if their mothers were vaccinated during pregnancy.
Last, people fear developing a rare neurologic entity – Guillain-Barré Syndrome – from flu vaccines, although the syndrome has only been associated with the swine flu vaccine of 1976. Reassuringly, a recent report that followed a mass H1N1 flu vaccination program in and near Beijing showed that none of the 27 people admitted to area hospitals with Guillain-Barré during the 10 weeks after that program started had been vaccinated.
There are other benefits of flu vaccination: reduced rates of cardiovascular deaths in recipients, fewer deaths in nursing home residents if staff is vaccinated, and protection of infants younger than 6 months (who are not protected by flu vaccines), if their household contacts are vaccinated.
It is critically important that Long Island residents speak to physicians about receiving this year's influenza vaccine, about the few reasons not to receive a vaccine, and any other concerns they might have. Getting vaccinated will be one of the best health decisions you make for you, your family, your co-workers and those for whom you care.
Marvin Tenenbaum, M.D., is the associate medical director and chairman of medicine at St. Francis Hospital in Roslyn and is the recipient of the Infectious Diseases Society of America's 2010 Clinician of the Year Award.
Contact:
Paul Barry, 516-705-6657, paul.barry@chsli.org
Rosemary Gomez, 516-705-6656, rosemary.gomez@chsli.org
