Author Topic: 2017-18 flu vaccine recommendations from CDC  (Read 133 times)

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Offline agate

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2017-18 flu vaccine recommendations from CDC
« on: August 25, 2017, 10:56:34 am »
From the New England Journal of Medicine Journal Watch, August 25, 2017--a summary of recommendations for administration of flu vaccine for the 2017-18 season:

http://www.jwatch.org/fw113253/2017/08/25/2017-18-flu-vaccine-recommendations-issued?query=pfwTOC&jwd=000100983645&jspc=US
MS Speaks--online for 13 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

Offline agate

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Re: 2017-18 flu vaccine recommendations from CDC
« Reply #1 on: September 09, 2017, 03:39:00 pm »
More on flu shots--from Berkeley Wellness, August 31, 2017:

"Is it too early to get a flu shot?"
MS Speaks--online for 13 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

Offline agate

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Flu vaccine far from perfect but still highly recommended
« Reply #2 on: December 05, 2017, 04:39:38 pm »
From NEJM Journal Watch, December 3, 2017:

Quote



Image from “Ferrets : their management in health and disease with remarks on their legal status”, 1897.

HIV and ID Observations

An ongoing dialogue on HIV/AIDS, infectious diseases,
all matters medical, and some not so medical.



Why, Even With Depressing Predictions About Flu Vaccine Effectiveness, We Should Still Recommend and Get It




Each year the print and broadcast media round up a bunch of experts on influenza and ask them to predict the severity of the upcoming flu season.

Most of the time their responses are non-committal — predicting how bad the flu season will be year-to-year is tricky business, akin to picking stocks, making 12-month weather forecasts in an almanac, or naming the winner of the World Series during spring training.

But this year is different. A particularly bad flu season in Australia, mostly due to H3N2 influenza A, has public health officials concerned we’re going to see the same thing here in the northern hemisphere.

And our flu vaccine’s estimated effectiveness against the H3N2 strain?

A dismal 10%.

This low effectiveness isn’t due to a strain-vaccine mismatch. The problem appears to be related to alterations in key flu vaccine proteins during egg-based vaccine production. Or, if you prefer a more technical explanation, here’s a quote from an excellent perspective on challenges in the flu vaccine published last week in the NEJM:

Antigenic characterization using ferret reference antiserums indicates that egg-propagated vaccine viruses acquired changes in the hemagglutinin that subsequently altered antigenicity against circulating strains.

(You have to love that sentence.)

Regardless of the mechanism, even by the meager standards we hold the flu vaccine, this 10% number is a disappointment.

But this low efficacy notwithstanding, you might note that the CDC, public health officials, and the vast majority of ID doctors still strongly recommend the vaccine. They/we do so for several reasons:

The Australia experience with H3N2 may not be recapitulated here. Although H3N2 is widespread in the USA early in the flu season, circulating flu strains change even within an individual year. In this terrific summary, read how even flu experts grapple with the vagaries and unpredictability of seasonal flu activity. And that person next to you in the subway with the cough and drippy nose may have influenza B, against which our vaccine provides much better protection.

Even partial protection is better than none. A recent paper found that the flu vaccine prevented influenza-related hospitalizations, suggesting attenuation of severe illness. It adds to existing data supporting that the vaccine provides benefit even when it doesn’t completely prevent the illness.

If you’re a healthcare provider, you owe it to your patients. This is especially the case if your patient population includes babies, or pregnant women, or the elderly, or people with cardiopulmonary disease, or individuals struggling with obesity, or immunocompromised hosts.  Good chance this covers 100% of clinicians!

It’s the only thing we’ve got. At least on the vaccine front, this is sad but true. There are various common-sense activities we can educate our patients about, but the adherence to these practices won’t be high.

It’s safe. The vaccine does not cause the flu. Furthermore, the vaccine does not cause the flu. Finally, the vaccine does not cause the flu. Got it?

We doctors, nurses, PAs, and pharmacists can be forgiven if the the weak efficacy data might take some of the energy out of our annual recommendation. But let’s try to keep giving the vaccine.

And hey, you smart vaccine researchers working on that “universal” flu vaccine — we’re rooting for you!

So is the ferret.

MS Speaks--online for 13 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

Offline agate

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Flu vaccine effectiveness estimated at 36%
« Reply #3 on: February 17, 2018, 09:53:31 am »

"Flu vaccine effectiveness estimated at 36%"--from NEJM Journal Watch, February 16, 2018: :(

https://www.jwatch.org/fw113856/2018/02/16/flu-vaccine-effectiveness-estimated-36?query=pfwRSTOC&jwd=000100983645&jspc=
MS Speaks--online for 13 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

 

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