Don’t wait for the H1N1 vaccine before you get your flu shot

by Cole Petrochko, Staff Writer, MedPage Today

Don’t wait for the pandemic H1N1 vaccine to become available before getting an inoculation for seasonal flu, the National Foundation for Infectious Diseases warned.

medpage-today Putting off routine flu shots in hopes of one-stop-shopping would defeat the primary line of defense against a proven threat, according to a panel representing some of the nation’s top medical organizations assembled by the NFID.

Officials said they expect enough H1N1 vaccine to be available for at-risk populations later this fall, but seasonal influenza vaccine is already available.

Sneezing and coughing into a shoulder, instead of hands, and staying home from work or school are effective measures against the spread of any flu, but the panel emphasized early vaccination as the best protection.

Early vaccination ensures patients are protected for the entire season and reduces stress on doctors, they said.

Seasonal flu, which hospitalizes 200,000 Americans and kills 36,000 annually, is not a threat to be ignored, they said.

“In all our concern about the novel H1N1 influenza, we must not let our guard down against seasonal influenza,” said William Schaffner, MD, president-elect of NFID.

Last flu season, more than 70% of children 6 months to 18 years old, about 55% of adults ages 19 to 64, and nearly 30% of adults 65 and older went unvaccinated.

Roughly 60% of healthcare workers didn’t get shots, either, even though studies have suggested this can reduce the ICU mortality of their patients by up to 60%, said Gregory A. Poland, MD, of the Mayo Clinic and chair of the Adult Immunization Advisory Board at the American College of Physicians.

Patients 50 years or older, those with heart disease, diabetes, or other risk factors, and pregnant women are most susceptible to the flu, said Kathleen Sebelius, secretary of the Department of Health and Human Services.

Pregnant women and caregivers of young children are also important populations for vaccination because children less than 6 months old cannot be vaccinated. Children 6 months to 18 years old should be vaccinated annually.

Although children are the least likely to suffer serious consequences from seasonal flu, it is still important to vaccinate them, said David T. Tayloe, Jr., MD, president of the American Academy of Pediatrics.

He noted that children who have not been vaccinated before may need multiple doses at least a month apart.

For the H1N1 strain, the NFID recommended the following patient populations be vaccinated:

* People 6 months to 24 years old
* Pregnant women
* Healthcare personnel
* Adults 25 to 64 years old with chronic medical conditions
* People in close contact with infants younger than 6 months

One reason for the low immunization rates might be lack of information. A survey of 1,000 adults commissioned by the NFID found 48% of respondents had questions about seasonal influenza. Of those with questions:

* 13% were related to how to avoid catching the flu
* 12% were on vaccine effectiveness
* 11% were on the seriousness or lethality of the flu
* 9% were on how easily the flu spreads
* 8% were on the best time to get vaccinated

New flu vaccines are created annually, several months ahead of flu season. Because the disease is dynamic, new strains are fairly unpredictable, as is the duration of the flu “season.”

This season’s flu was predicted to start early, but as of two weeks ago, there was no sign of change in vaccine resistance or virus lethality, said Thomas R. Frieden, MD, MPH, director of the Centers for Disease Control.

Frieden also suggested that children and older patients get a pneumococcal vaccine.

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