What’s New with Flu (2017-18)

The autumn months bring temperature changes and remind us of the influenza (flu) season that will occur soon.  Influenza is a highly infectious virus that causes 20,000 preventable deaths and 200,000 hospitalizations annually. The seemingly low protection (45%) of last year’s flu vaccine spells uncertainty for most of us when deciding to vaccinate for flu this year; however, all major medical organizations, including the CDC (Center for Disease Control), the American College of Physicians and the American Academy of Pediatrics, recommend that all people over the age of 6 months get a yearly flu vaccine.  Influenza causes moderate to severe illness in all age groups around the world.   Common symptoms of the flu include fever, body aches, fatigue, cough, sore throat and congestion.  Cardiopulmonary and chronic diseases can be exacerbated by influenza.  We can still do our best to prevent this illness by taking an annual flu shot each year.  Last year’s predominate influenza strain, A/Hong Kong H3N2 is a virulent strain of flu that is difficult to achieve a high percent of protection.  However, vaccinating against this strain is highly recommended. Most years the vaccine is highly protective against our seasonal strain.

The 2017-2018 season brings news of new varieties of flu vaccines for specific groups. The quadrivalent (QIV) vaccine is the predominant vaccine used this year in all age groups because of its broader coverage. It consists of 4 strains of influenza – the 2 predominant type A strains that we see each year in the trivalent vaccine and 2 type B strains. The second strain of B is primarily a risk for children and young adults, but it can also be passed to older adults who may care for their young grandchildren, or to those in high risk groups.  Experts agree that the quadrivalent vaccine will significantly reduce influenza hospitalizations and deaths in this younger age group.  It is also recommended for all health care workers and international travelers who may need broader protection this season.  The QIV vaccine is readily available this year and there should be no shortages.

The intranasal form of the flu vaccine, Flu Mist, is not recommended this year because concerns about efficacy.  The good news for those with severe allergies to egg products is that there is a non-egg formulation of flu vaccine called Flucelvax. It was released in 2014 and is now available in most flu clinic locations. The Flucelvax is a cell-based quadrivalent vaccine and is available for those 4 years and older.  There is also an intradermal vaccine available that does not go into the muscle.  The intradermal vaccine has a smaller needle and is injected superficially on the skin (0.1cc) and may cause less pain than the injection.  This is licensed for people 15-64.  Older adults (65+) will have a choice of the quadrivalent flu vaccine, the high-dose 65+ vaccine (Fluzone) or the Fluad vaccine.  Fluzone High-Dose vaccine contains four times the amount of antigen contained in regular flu shots. The Fluad licensed in 2015 is an alternative for the 65+ group. It is not a HD of flu antigen; instead it has an added adjuvant that increases the immune response in this age group.  The clinical studies on the high dose vaccine and the Fluad show higher antibody responses in this age group and we are hopeful that it will reduce the high incidence of flu in older adults. Most physicians and pharmacies do recommend the high dose flu vaccine or the Fluad for the 65+ groups, especially those with chronic debilitating diseases. The CDC and ACIP (Advisory Committee on Immunization Practices) supports all influenza vaccinations without any preference of type. Discuss with your doctor the best choice for you this year.

In summary, there are many options for effective prevention of influenza.  Unless there’s a reason not to, most of us should be sure to get the flu vaccine this winter season. And there is never a time that is “too late” to get your flu vaccine but optimal time is our winter season in the United States.  It takes about 2 weeks after the vaccine to get full immunity.  Because influenza can cause significant illness and even death, please make time to get the vaccine.  Pregnant women especially should get the injectable flu vaccine to prevent themselves and their unborn babies from severe illness.  For more information on the flu vaccine, check out the CDC website.