Bay Area Reporter - October 23, 2008
Bob Roehr

Influenza "is our number one vaccine preventable disease," Dr. Julie Gerberding told a September news conference that kicked off the annual campaign for vaccination. Gerberding, the director of the Centers for Disease Control and Prevention, said Americans suffer an estimated 32,000 deaths; 200,000 hospitalizations; and "countless days of work and school lost," most of which can be prevented.

This year the CDC is expanding its guidelines to recommend vaccination for about 84 percent of the population. Only two groups fall outside of those recommendations. One is children younger than 6 months of age, because their immune system is not sufficiently matured to develop a sufficient response to the vaccine. The second is "completely healthy adults who have no contact with someone who isn't [healthy]," she said.

"For most people, the message is, get your flu shot. It is either going to be a direct advantage for you or for someone you care about," Gerberding said.

The influenza virus mutates rapidly and the big guess each spring is which three strains emerging around the world should be put into the vaccine being manufactured for use in the fall. "This year all three strains in the human vaccine have been changed," two are from the A and one from the B strains of the virus, said Daniel B. Jernigan, with CDC's influenza division. "They are the three most likely to cause illness during this flu season."

Last year two of the three strains used in the vaccine were not good matches to the flu that hit the United States and the shots did not provide good protection. Jernigan said tracking the "genetic drift" of the virus this year suggests a much better match and a more protective vaccine.

"Children are highly susceptible to this infection. They are two to three times more likely than adults to become sick. About 1 in 3 children will get influenza," said Renee R. Jenkins, president of the American Academy of Pediatrics.

The immune system of kids under 9 years of age are not fully developed "because they haven't had a prior exposure and the opportunity to build up antibodies to it, that increases their susceptibility," Jenkins said, so they should receive two vaccinations, spaced four weeks apart, to generate sufficient antibody protection.

Jason Schneider, president of the Gay and Lesbian Medical Association and a physician at the Emory University School of Medicine in Atlanta, said the flu "affects people no matter who you are." He believes it is important to get the shot not only to protect yourself, but to protect others with whom you come in contact.

"One misconception is that a person can get the flu from the vaccine. That's impossible, it's a killed virus," Schneider said. "You can have some side effects from the vaccine, but they are not nearly as severe as getting the flu itself."

People living with HIV have a normal response to vaccination if their CD4 T-cell count is above 200, while those with a CD4 count less than 100 are less likely to generate fully protective levels of antibodies to the shot.

People over 50 and those with a weakened immune system are strongly urged to get their shots.

Recent surveys show that most patients are willing to be vaccinated if their physician recommends it, and physicians are more likely to recommend it if they use electronic medical records that have built in reminders.

Medicare, Medicaid, and private insurers all cover vaccination for influenza. Many private organizations offer free shots at street fairs, supermarkets, and other venues.

In San Francisco, Magnet, the gay men's health center in the Castro, is offering free flu shots this Friday, October 24, from 5 to 8 p.m. and October 31 from 5 to 7 p.m. Magnet officials have advised that people should not get a flu vaccine if they are allergic to eggs.

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