I doubt that anyone who reads this month’s newsletter does not realize that this is a time for flu to reach the United States once again. In spite of everyone’s best predictions about when and where it will strike and how severe an epidemic may or may not be, these are difficult predictions to make. However, the most prevalent strains are known and each year industry provides a new flu vaccine always containing the two most common A strains and a B strain. Thus, when you get your annual flu shot, you are really getting protection against three but not all of the flu strains that you could encounter.
There is no doubt about the safety and effectiveness of the flu vaccine. In a study I recently reviewed, volunteers either received a flu shot or sterile water and the incidence of reactions was essentially the same in both who received the active vaccine and those who received the “blank”, with a bit more sore arm in the active vaccinated group compared to the control group. Virtually no one complained of any illness, fever or achiness as a result of the flu shot.
Influenza can be devastating disease for both old and young alike. Certainly anyone with a chronic disease, such as COPD, congestive heart failure, chronic renal disease, diabetes, liver disease or, in fact, probably anybody over the age of 50 should receive this year’s vaccine. Now is the best time to receive it although it would still be effective within two weeks of the appearance of the flu in a community. This vaccine is about 80% effective in protecting against contracting flu and if flu occurs nonetheless, it is usually in a very mild form.
Almost everyone can take the flu vaccine excepting those individuals who are allergic to eggs. This is because the flu vaccine is made from egg embryos. There is an alternative drug known as amantadine or its first cousin rimantadine that can be taken to prevent or abort flu in those most susceptible such as nursing home residents. This drug, taken by mouth, is also quite safe and has only mild side effects.
It would also be wise, in my opinion, to be sure that all COPD patients have a pneumonia vaccine commercially known as Pneumovax. Older versions of this vaccine were effective against 14 strains. The newest version combats 23 different strains. Although it was originally believed that a single vaccination once in a lifetime was enough, recent evidence suggests that revaccination every 5-6 years is more reasonable. Both flu and Pneumovax can be given at the same doctor’s visit. Pneumovax is not as effective in preventing pneumococcal pneumonia, the most common bacterial pneumonia, that affects all populations in the community, particularly the aged, but it most often makes the disease less severe. Thus, I highly recommend that everyone have Pneumovax as well as the flu vaccine for the protection that they afford.
Finally, all health care workers should be vaccinated against flu. They will inevitably contact it in their work and become unnecessarily ill or even spread the virus should they have continued contact with patients.
I’ll be in touch next month.
Thomas Petty, MD