(The Associated Press) -- With the nation's supply of flu shots dropping rapidly and at least 13 states facing an unusually severe flu outbreak, doctors are urging healthy people to opt for a nasal-spray version of the vaccine and save the traditional one for children and the elderly.
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December 8, 2003
By James Winshall, M.D.
Harvard Medical School
What Is The Doctor's Reaction?
Influenza is a major killer every year, but this year seems on track to be worse than usual. Experts are predicting more than the typical 36,000 deaths, in part because of a virulent strain of influenza known as Fujian, and in part because this year's vaccine doesn't exactly match the virus.
Influenza preys on the chronically ill, the old and the very young. However, the virus can make anyone very sick. During the worldwide epidemic in 1918-1919, more than 20 million people died, many of them young and previously healthy people. Influenza can cause a severe pneumonia and pave the way for other germs to invade or other medical problems to worsen.
Unfortunately, we have few treatments that are effective once an influenza infection begins. That's why our major focus remains preventing influenza through widespread vaccination.
The flu vaccine won't prevent 100 percent of cases, but it dramatically cuts down the infection rate, and in cases it doesn't prevent, the illness is usually less severe. While we used to give flu vaccine only to those over age 65 or those with chronic medical problems, we now recommend it for anyone over age 50, for young children and pregnant women, and for people with a wide variety of common medical conditions such as asthma.
Vaccine manufacturers thought they had made enough flu vaccine for this year, but the early flu season has led many people who had never done so before to get shots. That means that some people at high risk may not have been vaccinated yet, and vaccine supplies are dwindling.
A new nasal vaccine called FluMist is available, but hasn't been widely used because it is more expensive and only approved for healthy adults aged 18 to 50. However, as pointed out in this news article, the more than 4 million remaining doses of FluMist might be just what's needed to ease the impending vaccine shortage.
What Changes Can I Make Now?
It's not too late if you haven't been vaccinated against the flu yet. Contact your health-care provider or local health department as soon as possible, particularly if you are in a high-risk group, including:
- Anyone 65 years of age or older
- Residents of nursing homes and other long-term health-care facilities, regardless of their age
- Anyone with chronic lung or heart lung disease, including those with asthma, emphysema, chronic bronchitis and heart failure
- Anyone who has required regular follow-up or a hospital stay within the past year for chronic medical problems including kidney disease, diabetes, and anemia
- Anyone with a weakened immune system due to HIV/AIDS, cancer, or certain medications (such as prednisone or cancer chemotherapy)
- Women who will be past the third month of pregnancy during the influenza season (November through April)
- Children and adolescents on chronic aspirin therapy
If you are unable to find the regular vaccine, are between the ages of 18 and 50 and are in good health, talk to your health-care provider about FluMist. This nasal-spray vaccine requires special handling, so not all doctors will have it on hand.
What if you are exposed to the flu and haven't been vaccinated? A few medications -- including amantadine (Symmetrel), rimantadine (Flumadine), oseltamivir (Tamiflu) and zanamivir (Relenza) -- may lower your chance of getting sick, or help to minimize symptoms if you do. Also keep in mind that good hand-washing is probably one of the best ways to keep from getting sick.
What Can I Expect Looking To The Future?
Influenza keeps coming back each year, and we have little reason to expect that we will ever "conquer" this virus in the way that we have smallpox and polio. In fact, the virus changes enough from year to year that our immune system has trouble developing effective antibodies, and new flu vaccines are needed annually. Experts remain worried that a major outbreak rivaling the 1918 epidemic could reappear someday.
In the meanwhile, regular vaccination remains a safe and effective tool for protecting most of the population. The challenge this year will be to ensure that a dose of vaccine is available for everyone who wants to be vaccinated.
Related Areas:
Flu Vaccine FAQ
Influenza
The 2003-2004 Flu Season Is Around The Corner (Flu-O-Meter)
