Flu Shots: What's Your Excuse?

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Despite Huge Supply, Too Few Kids & Adults Get Flu Vaccine

By Daniel J. DeNoon
WebMD Health News

Reviewed By Louise Chang, MD

Sept. 25, 2008 - More Americans are getting flu shots -- but still far too few, the CDC reports.

About one in five babies aged 6 to 23 months gets both of the flu shots needed for full protection. Young children are highly vulnerable to serious flu complications.

So are elderly adults. Vaccination rates are better for those over 65: Overall, 72% of seniors get their flu shots, ranging from 63.7% in Florida to 81% in Rhode Island. Yet even Rhode Island falls short of the CDC's 2010 goal of vaccinating 90% of seniors.

The numbers reflect the 2006-2007 flu season, the CDC's most recent full data set, collected in a telephone survey of 400,000 randomly selected U.S. adults.

More recent data, collected from eight sentinel sites, suggest that there wasn't much improvement among children aged 6 months to 5 years between the 2006-2007 and 2007-2008 flu seasons.

This year, the CDC has expanded its recommendations to include kids aged 5 to 18 years. That means 86% of Americans are now supposed to get yearly flu shots (or sniffs of the newer intranasal flu vaccine).

And the rest of us, except those who can't take the vaccine due to egg sensitivity or health conditions, are supposed to get the vaccine if we simply want to avoid the flu.

The U.S. has 145 million doses of flu vaccine on hand this year. That wouldn't be enough if the 261 million people who are supposed to get flu shots actually got them. But it's far more than Americans have ever used before. Last year, we used 113 million of 140 million available doses.

Flu vaccination is particularly recommended for pregnant women, people 50 and older, younger adults with chronic illnesses such as diabetes or asthma, health-care workers, people who come into contact with infants younger than 6 months, and people in contact with others at high risk of flu complications.

Vaccination of women who will be pregnant during flu season has a two-for-one effect. It protects the woman and her fetus during pregnancy, and it protects the infant in its first months of life. Before the age of 6 months, children are too young to be vaccinated.

To warn parents about the risk of flu for young children, the CDC has posted a heart-wrenching video on YouTube. The video features interviews with parents who did not vaccinate their children -- and then watched them die of the flu.

"How does this happen? It's not supposed to," says Julie, one of the parents in the video. "Here we had this beautiful, perfect, healthy baby boy, and all of a sudden within a day he's gone."

The CDC finds that parents usually don't start looking for flu shots for their kids until late October. Children who haven't had a flu shot before need two doses four weeks apart for full immunity. Most parents who do this come in for their kids' second shot after Thanksgiving and before Dec. 10.

A lot of parents think they've gotten through flu season by Christmas and don't bring their kids in for a second shot. That's a mistake. CDC data show that over 80% of the time, peak flu season doesn't arrive until January or later. And over 60% of the time, peak flu season doesn't hit until February or later.

How well does flu vaccination work? The CDC says that in terms of preventing lab-confirmed influenza, the vaccine is nearly always over 50% effective, and as much as 90% effective in healthy adults.

Last year, two of the three flu strains in the vaccine did not match the flu viruses that actually circulated. Yet early data suggest the vaccine was 44% effective.

Analysis of flu strains circulating at low levels in the U.S. and at higher levels in the Southern Hemisphere suggest this years flu vaccine has exactly the right match for all three flu strains. The only possible sign of trouble is a small number of influenza B strains that don't match the vaccine strain, but far more of the circulating B flu bugs are a good match.

The CDC data appear in three separate reports in the Sept. 26 issue of Morbidity and Mortality Weekly Report.

SOURCES: CDC, Morbidity and Mortality Weekly Report, Sept. 26, 2008; vol 57: pp 1033-1049. CDC National Center for Immunization and Respiratory Diseases, "Video Portrait of Families Affected by Influenza," transcript provided by CDC. WebMD Medical News: "Flu Vaccine Recommended for More Children." WebMD Medical News: "Pregnant Mom's Flu Shot Protects Baby."

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