Flu Season Is Coming

Sept. 24, 2008 — -- With the onset of flu season, the National Foundation for Infectious Diseases, in conjunction with a number of other major health organizations, unveiled its plan to combat influenza this flu season, holding a conference this morning to discuss new vaccine recommendations and address how this year's flu vaccine will protect recipients.

Among new recommendations for the year will include the Centers for Disease Control and Prevention now recommending flu vaccines for anyone older than 6 months of age and advising people to get vaccinated later in the season if they cannot do it sooner, because vaccinations slow down in November, while the flu peaks in February and persists through May.

While in past years having enough flu vaccine has been a problem, expectations are that enough will be available this year for anyone who tries to get a flu shot.

"Given the robust supply, I think the emphasis this year is, get out there and get protected and protect others and, for sure, protect our children," said Dr. Julie Gerberding, director of the CDC.

Other organizations participating in the announcement included the American Medical Association, the American Academy of Pediatrics, the Centers for Medicare and Medicaid Services and the AARP.

The sentiments of the conference participants have been echoed by other health professionals.

"We should have plenty of flu vaccine, given that there are people who just aren't going to take it," said Dr. Carol J. Baker, who was not at the conference.

Baker, the executive director of the Texas Children's Center for Vaccine Awareness and Research and a pediatrician at Baylor College of Medicine, said, "[We're] in much better shape to prevent influenza than we've ever been, historically."

Vaccine manufacturers are also preparing for high demand.

"We cannot anticipate how many people will receive an influenza vaccine this year. However, to help meet CDC vaccination recommendations, Novartis Vaccines is producing up to 40 million doses of Fluvirin," said Beth Birke, a spokeswoman for Novartis, one of several companies that manufactures an approved flu vaccine.

According to presenters at the conference, there should be more than 140 million doses of vaccine available.

"I think the concern this year is how we're going to immunize 30-plus million children," said Baker, referring to the additional children added under the new recommendations.

She noted that the sheer quantity could be difficult, and said that in order to step up efforts, some may need to be vaccinated at pharmacies or grocery stores or at school.

"It's going to be difficult using the model of the physician's office," said Baker.

Immunizing children has been a significant issue in past years because children have a weaker immune system and are more susceptible to flu.

"Every pediatrician knows that influenza can strike a healthy child and have that child in the intensive care unit by the end of the day," said Dr. William Schaffner, president-elect of the National Foundation for Infectious Diseases and chairman of preventive medicine at Vanderbilt University School of Medicine.

According to figures from the CDC, 86 children died from influenza during the 2007-08 season. More than half of those deaths were in children between the ages of 15 and 17.

Baker noted there was an additional incentive to immunize children, because "children, especially the youngest ones, are such effective spreaders of the flu." By vaccinating children, the spread of flu to unimmunized parents, grandparents and other adults may be minimized.

But Baker noted that it would require widespread immunization for that to happen.

"If you only immunize half the population, you may not see an effect," she said.

One positive sign for Baker and other physicians was an earlier delivery of vaccines this year, with some arriving in August.

"Because we got the vaccine so early, there'll be more time to actually get this done."

Baker said that vaccinations were set to begin Monday, but were delayed a week because of Hurricane Ike.

Manufacturers were also prepared to get vaccines out sooner.

Birke said that Novartis received approval from the Food and Drug Administration to manufacture more of the vaccine at a plant in Rosia, Italy, "to further support our ability to deliver more vaccine earlier in the season."

Organizers also emphasized that people older than 65 should be vaccinated. Despite this recommendation in the past, roughly 70 percent of seniors get immunized each year.

"'Get your flu shot' is still an important message for older Americans," said Kerry Weems, acting administrator of the Centers for Medicare and Medicaid Services.

"Getting these shots costs nothing for people on Medicare," he said. "Free should be cheap enough."

With the increased numbers of people recommended to get the flu shot, higher numbers of immunizations are expected, though last year's vaccine did not protect against influenza as well as it had in the past.

As in years past, strains were chosen in February, based on data about the spread of flu in the Southern Hemisphere and expectations for which strains will predominate in the Northern Hemisphere in the forthcoming season.

"There's a certain amount of science and a certain amount of art to it," said Stephen Morse, an epidemiologist from Columbia University's Mailman School of Public Health, in an interview with ABC News last week.

Dr. Dan Jernigan, deputy director of the CDC's influenza division, said that the virus has matched well in 16 of the last 20 flu seasons.

But last year, two of the three strains of influenza did not match well, so the vaccine only matched the strains going around by 44 percent, as opposed to typical goals of 70 percent to 90 percent.

As a result, all three of the flu strains whose components are included in this year's vaccine are new.

But even fears of a less effective vaccine shouldn't discourage people from getting immunized, said Baker.

"We're not saying it wasn't a good vaccine, we're saying it doesn't match the way it should. We had 44 percent protection ultimately. If you don't get a flu shot, you get none."

"Even though it was a poor match, it's all relative of what you think poor is. Would I like it to be 90 percent? Sure, but I wouldn't like it to be 0 percent."

For his part, Schaffner invokes the French philosopher Voltaire who saw perfection as the enemy of the good.

"We may not have the perfect vaccine, but we have a darn good one," he said. "Partial protection is better than no protection at all."