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Flu season 2008-2009 begins ... now

This article first appeared in the St. Louis Beacon: October 10, 2008 - This year more people than ever before should get a flu vaccination, according to new recommendations issued by the Centers for Disease Control and Prevention. Along with the usual guideposts, the CDC is now recommending that all children, ages 6 months to 18 years, get vaccinated against influenza.

"This is the largest group of people we have ever recommended get flu shots," said CDC director Dr. Julie L. Gerberding in a teleconference conducted last month. The recommendations would apply to 261 million people in the U.S. "an extension of the previous recommendation to vaccinate children up to 2 years of age and those with underlying medical conditions," Gerberding said.

The hope is that these new guidelines will help reduce the outbreak of the flu in the 2008-2009 season, particularly among school-age children who account for a high percentage of all flu cases. Others who are at high risk and targeted for vaccination include adults over age 50, people with chronic illnesses, pregnant women, and health-care workers (as well as any others likely to come in contact with the disease), according to Gerberding.

Evidence Lacking?

While the CDC calls for vaccinating more kids, a study shows that vaccinations for children 5 and younger have failed to reduce the number of flu-related pediatric hospitalizations or doctor's visits over the past two seasons. The results were published this month in the Archives of Pediatrics and Adolescent Medicine. The author called for further research noting that the vaccine in the communities studied may not have been a good match for the influenza strains circulating there.

It is also known among infectious disease clinical circles that the flu shot may not work particularly well in the younger set. The live attenuated vaccine nasal spray (FluMist) has been more effective in this demographic. Children over the age of 2 should receive the nasal flu vaccine instead of the shot. The nasal vaccine is approved for use in healthy children and adults, aged 2 to 49, who do not have respiratory conditions such as asthma.

Support in Favor

In her teleconference, Gerberding said influenza causes about 36,000 deaths and 200,000 hospitalizations. That's not to mention, the days it costs parents away from work as they care for their sick children, said Dr. George Griffing, professor of internal medicine at Saint Louis University School of Medicine. Much of this can be prevented with the flu vaccine. 

Still another October study, this in the journal Pediatrics, reveals that deaths caused by flu-related bacterial infections are increasing among children.

"Children who are at risk for influenza complications or healthy children with moderate to severe respiratory illness should be tested for influenza and, when infected, treated with [the antiviral medications] oseltamivir or zanamivir," the authors concluded.

Should You Get Vaccinated?

In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. For healthy adults, "it is optional," Griffing said. However, it is recommended by CDC and the Advisory Committee on Immunization Practices (ACIP) that certain people should make it a point to get vaccinated each year. In these folks, "vaccination goes a long way to not only prevent the disease, but also all the complications that go along with it," Griffing said.

People who are targeted for vaccination this 2008-09 flu season include:

  • Children ages 6 months-18 years
  • Pregnant women
  • Adults 50 and older
  • People with certain chronic medical conditions
  • Nursing home and other long-term care facility residents
  • Health care workers
  • Family members and close contacts of children younger than 6 months of age

"If you are healthy and want to protect yourself, get the vaccine," Griffing said. "If you're healthy and want to gamble, skip it."
But, he adds, "when you look at the low cost and low risks of getting the vaccine, why not get it?"

Dr. Cindy Haines is managing editor of Healthday-Physician's Briefing and president of Haines Medical Communications Inc., a full-service medical communications and consulting firm. As a board-certified family physician, Haines is well-versed in all areas of health care, with particular interest in fitness, nutrition, and psychological health.