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Season","publishDate":1539100803,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The length of the \u003ca href=\"https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter/\" target=\"_blank\" rel=\"noopener\">flu season\u003c/a> may vary depending on where you live, with large cities enduring longer periods of transmission and smaller cities experiencing shorter, but more explosive, spread, a new study suggests.[contextly_sidebar id=\"x5n5Lo7fgVHdWAKOVx3fr6K7JZjGLMsB\"]\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2018/10/04/flu-season-may-stretch-longer-in-big-cities/\" target=\"_blank\" rel=\"noopener\">study \u003c/a>doesn’t assert that one’s risk of contracting influenza varies depending on the size of any given community. Rather, it argues that in less populous places, flu needs the right atmospheric conditions to spread effectively.\u003c/p>\n\u003cp>In large cities, those conditions don’t matter quite as much.\u003c/p>\n\u003cp>“If there’s lots of people and transportation patterns frequently bring them together, it helps the virus find new hosts even when climate conditions aren’t at their most favorable,” explained lead author Benjamin Dalziel, an assistant professor in the department of integrative biology at Oregon State University in Corvallis.\u003c/p>\n\u003cp>The finding suggests a one-size-fits-all approach to flu season preparedness won’t work. If the study is correct, small centers should work on surge capacity — their ability to handle a lot of sick people over a short period of time — while larger cities should find ways to reduce transmission, said Jacco Wallinga, an expert on infectious diseases modeling at the National Institute for Public Health and the Environment in the Netherlands.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This is important for policymakers because it indicates that metropolitan areas should focus on reducing influenza spread, whereas small towns should focus on reducing harm,” Wallinga wrote in a \u003ca href=\"http://science.sciencemag.org/content/362/6410/29\" target=\"_blank\" rel=\"noopener\">commentary \u003c/a>on the paper, which was published alongside it Thursday in the journal Science.[contextly_sidebar id=\"Gn9g9r2BXGVHmmbiJ9A2DrWrh8ktrDcE\"]\u003c/p>\n\u003cp>Influenza is famously unpredictable. It’s not uncommon to hear people who have studied it for decades describe the virus as “humbling.”\u003c/p>\n\u003cp>Experts know there will be a surge of influenza infections at some point in the year; in the Northern Hemisphere that period typically falls in the stretch from late autumn through late winter or early spring. But some years the peak of infections will occur over Christmas and other times the sickest point in the season will come in late February or even March.\u003c/p>\n\u003cp>It’s not fully understood why flu behaves this way. Time spent indoors during the winter, when their immune systems may not be as robust, is thought to be a factor.\u003c/p>\n\u003cp>Dalziel and his co-authors set out to look at the role specific humidity levels — how much moisture there is in the air — play in flu transmission. They used a large amount of data: weekly health insurance claims from people who sought care for influenza-like illness. The researchers had data by ZIP code for six years, from 2002 to 2008, for roughly 603 cities in the United States.\u003c/p>\n\u003cp>What they saw was that in small cities, the curve of a flu season was sharp. Regardless of whether a lot of people got sick in a flu season or whether fewer were struck in a particular year, most of the infections occurred over a short period of time, making for a “spiky” epidemic curve.\u003c/p>\n\u003cp>But the pattern in large cities was different. The curve was lower and longer — more diffuse. It didn’t mean that fewer people got sick, but that infections were spread out over a longer period of time.\u003c/p>\n\u003cp>It meant that flu viruses were still able to spread from person to person in large cities even when climatic conditions weren’t ideal.\u003c/p>\n\u003cp>Dalziel, who admitted the big-city pattern wasn’t what he and his colleagues were expecting, said the small city outbreaks were “explosive” while the big city epidemics “smoldered.”\u003c/p>\n\u003cp>Their conclusion was that specific humidity didn’t matter as much in places where large numbers of people live.\u003c/p>\n\u003cp>“The flu is able to spread under a wider envelop of climatic conditions in the metropolises, because of highly organized movement patterns that put people into such close proximity that the specific humidity starts to matter less,” Dalziel said. “In metropolises, flu is able to eke out a living because there’s more highly organized close contact.”\u003c/p>\n\u003cp>Seema Lakdawala, who studies influenza transmission, described the finding as fascinating.\u003c/p>\n\u003cp>“What they’re showing is that the transmission dynamics within intense urban areas is more perpetual,” said Lakdawala, an assistant professor in the department of microbiology and molecular genetics at the University of Pittsburgh School of Medicine.\u003c/p>\n\u003cp>Lakdawala studies how the flu virus is transmitted — through droplets of saliva or mucus that can only travel short distances, or through aerosols, which can hang in the air longer. Her read of this study suggested to her that in smaller places, aerosolized viruses may play more of a role in transmission, and those may be more dependent on climatic conditions. But in large centers where people are more densely packed, transmission over short distances — which is less climate-dependent — can get the job done.[contextly_sidebar id=\"eYd72fXTu5jD6vzseb6AQMPC5fhHGdol\"]\u003c/p>\n\u003cp>“Since I’ve been thinking about the importance and the contribution of short-range versus long-range transmission for so long, to me it really fits,” said Lakdawala, who was not involved in the research.\u003c/p>\n\u003cp>“In intense urban areas, we’re indoors more often. So this idea that there is transmission occurring universally, constantly, in these environments that isn’t necessarily driven by seasonality of humidity is really fascinating,” she said. “And it really fits with what we think is happening — that these long-range transmission events may be more sensitive to humidity conditions, and they may be happening more in less populated areas.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/flu-season-may-stretch-longer-in-big-cities/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n","blocks":[],"excerpt":"A new study says large cities endure longer periods of flu transmission while smaller cities experience shorter, but more explosive, spread.","status":"publish","parent":0,"modified":1539039229,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":982},"headData":{"title":"How City Size Impacts the Severity of Flu Season | KQED","description":"A new study says large cities endure longer periods of flu transmission while smaller cities experience shorter, but more explosive, spread.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"444918 https://ww2.kqed.org/futureofyou/?p=444918","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/09/how-city-size-impacts-the-severity-of-flu-season/","disqusTitle":"How City Size Impacts the Severity of Flu Season","source":"DIY Health","nprByline":"Helen Branswell\u003cbr />STAT","path":"/futureofyou/444918/how-city-size-impacts-the-severity-of-flu-season","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The length of the \u003ca href=\"https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter/\" target=\"_blank\" rel=\"noopener\">flu season\u003c/a> may vary depending on where you live, with large cities enduring longer periods of transmission and smaller cities experiencing shorter, but more explosive, spread, a new study suggests.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2018/10/04/flu-season-may-stretch-longer-in-big-cities/\" target=\"_blank\" rel=\"noopener\">study \u003c/a>doesn’t assert that one’s risk of contracting influenza varies depending on the size of any given community. Rather, it argues that in less populous places, flu needs the right atmospheric conditions to spread effectively.\u003c/p>\n\u003cp>In large cities, those conditions don’t matter quite as much.\u003c/p>\n\u003cp>“If there’s lots of people and transportation patterns frequently bring them together, it helps the virus find new hosts even when climate conditions aren’t at their most favorable,” explained lead author Benjamin Dalziel, an assistant professor in the department of integrative biology at Oregon State University in Corvallis.\u003c/p>\n\u003cp>The finding suggests a one-size-fits-all approach to flu season preparedness won’t work. If the study is correct, small centers should work on surge capacity — their ability to handle a lot of sick people over a short period of time — while larger cities should find ways to reduce transmission, said Jacco Wallinga, an expert on infectious diseases modeling at the National Institute for Public Health and the Environment in the Netherlands.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This is important for policymakers because it indicates that metropolitan areas should focus on reducing influenza spread, whereas small towns should focus on reducing harm,” Wallinga wrote in a \u003ca href=\"http://science.sciencemag.org/content/362/6410/29\" target=\"_blank\" rel=\"noopener\">commentary \u003c/a>on the paper, which was published alongside it Thursday in the journal Science.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Influenza is famously unpredictable. It’s not uncommon to hear people who have studied it for decades describe the virus as “humbling.”\u003c/p>\n\u003cp>Experts know there will be a surge of influenza infections at some point in the year; in the Northern Hemisphere that period typically falls in the stretch from late autumn through late winter or early spring. But some years the peak of infections will occur over Christmas and other times the sickest point in the season will come in late February or even March.\u003c/p>\n\u003cp>It’s not fully understood why flu behaves this way. Time spent indoors during the winter, when their immune systems may not be as robust, is thought to be a factor.\u003c/p>\n\u003cp>Dalziel and his co-authors set out to look at the role specific humidity levels — how much moisture there is in the air — play in flu transmission. They used a large amount of data: weekly health insurance claims from people who sought care for influenza-like illness. The researchers had data by ZIP code for six years, from 2002 to 2008, for roughly 603 cities in the United States.\u003c/p>\n\u003cp>What they saw was that in small cities, the curve of a flu season was sharp. Regardless of whether a lot of people got sick in a flu season or whether fewer were struck in a particular year, most of the infections occurred over a short period of time, making for a “spiky” epidemic curve.\u003c/p>\n\u003cp>But the pattern in large cities was different. The curve was lower and longer — more diffuse. It didn’t mean that fewer people got sick, but that infections were spread out over a longer period of time.\u003c/p>\n\u003cp>It meant that flu viruses were still able to spread from person to person in large cities even when climatic conditions weren’t ideal.\u003c/p>\n\u003cp>Dalziel, who admitted the big-city pattern wasn’t what he and his colleagues were expecting, said the small city outbreaks were “explosive” while the big city epidemics “smoldered.”\u003c/p>\n\u003cp>Their conclusion was that specific humidity didn’t matter as much in places where large numbers of people live.\u003c/p>\n\u003cp>“The flu is able to spread under a wider envelop of climatic conditions in the metropolises, because of highly organized movement patterns that put people into such close proximity that the specific humidity starts to matter less,” Dalziel said. “In metropolises, flu is able to eke out a living because there’s more highly organized close contact.”\u003c/p>\n\u003cp>Seema Lakdawala, who studies influenza transmission, described the finding as fascinating.\u003c/p>\n\u003cp>“What they’re showing is that the transmission dynamics within intense urban areas is more perpetual,” said Lakdawala, an assistant professor in the department of microbiology and molecular genetics at the University of Pittsburgh School of Medicine.\u003c/p>\n\u003cp>Lakdawala studies how the flu virus is transmitted — through droplets of saliva or mucus that can only travel short distances, or through aerosols, which can hang in the air longer. Her read of this study suggested to her that in smaller places, aerosolized viruses may play more of a role in transmission, and those may be more dependent on climatic conditions. But in large centers where people are more densely packed, transmission over short distances — which is less climate-dependent — can get the job done.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Since I’ve been thinking about the importance and the contribution of short-range versus long-range transmission for so long, to me it really fits,” said Lakdawala, who was not involved in the research.\u003c/p>\n\u003cp>“In intense urban areas, we’re indoors more often. So this idea that there is transmission occurring universally, constantly, in these environments that isn’t necessarily driven by seasonality of humidity is really fascinating,” she said. “And it really fits with what we think is happening — that these long-range transmission events may be more sensitive to humidity conditions, and they may be happening more in less populated areas.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/flu-season-may-stretch-longer-in-big-cities/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444918/how-city-size-impacts-the-severity-of-flu-season","authors":["byline_futureofyou_444918"],"categories":["futureofyou_1060","futureofyou_73"],"tags":["futureofyou_1622","futureofyou_662","futureofyou_1455","futureofyou_652"],"collections":["futureofyou_1093"],"featImg":"futureofyou_444920","label":"source_futureofyou_444918"},"futureofyou_444271":{"type":"posts","id":"futureofyou_444271","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444271","score":null,"sort":[1536182430000]},"guestAuthors":[],"slug":"pediatrics-group-says-avoid-popular-flumist","title":"Pediatrics Group Urges Parents to Ditch FluMist in Favor of Shots","publishDate":1536182430,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"term":1093,"site":"futureofyou"},"content":"\u003cp>The American Academy of Pediatrics is recommending children be vaccinated with injectable flu vaccine for the coming season, rather than the nasal spray vaccine FluMist, unless a child will only be vaccinated if he or she can forgo a needle, or if a doctor runs out of flu shots.[contextly_sidebar id=\"hDOkDX1TSKq0uExbrwfmFky6j6An7v9D\"]\u003c/p>\n\u003cp>“The AAP feels that the flu shot should be the primary vaccine choice for all children,” said Dr. Henry Bernstein, a pediatrician and an ex-officio member of the AAP’s committee on infectious diseases.\u003c/p>\n\u003cp>That advice puts the AAP’s annual flu vaccine recommendations slightly at odds with \u003ca href=\"https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_w\" target=\"_blank\" rel=\"noopener\">those of the Centers for Disease Control and Prevention\u003c/a>, which state that any of the flu vaccines available for children could be used for the coming flu season.\u003c/p>\n\u003cp>Both, however, share an end goal: getting more children vaccinated.\u003c/p>\n\u003cp>Influenza can be deadly for children. In the past flu season, 180 children under the age of 18 died from the flu, making it the second most deadly flu season — after the 2009 H1N1 pandemic — since the CDC started recording pediatric flu deaths in the winter of 2005-2006.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The CDC recommends everyone over the age of 6 months be vaccinated every year against the flu, unless there is a medical reason to avoid the vaccine.\u003c/p>\n\u003cp>Yet only about 60 percent of children between the ages of 6 months and 17 years got vaccinated against flu in 2016-2017, the most recent year for which data are available. Roughly eight out of every 10 children who died from flu weren’t vaccinated, said Dr. Lisa Grohskopf, a medical officer in the CDC’s influenza division.\u003c/p>\n\u003cp>The differing advice from the CDC and the AAP on AstraZeneca’s FluMist could befuddle parents and pediatricians.[contextly_sidebar id=\"ns1NFKxqZaS66Mu22mM7Fucp2b9WmmE4\"]\u003c/p>\n\u003cp>“There’s no question that ideally we would like for the CDC and the AAP to be completely harmonized” when it comes to recommendations, said Bernstein who is also a member of the Advisory Committee on Immunization Practices, which guides the CDC on vaccine decisions.\u003c/p>\n\u003cp>“Both groups are harmonized in wanting as many children to receive flu vaccine as possible each and every year,” said Bernstein. “When recommendations are not perfectly harmonized, it does pose the possibility for confusion.”\u003c/p>\n\u003cp>But any confusion might be mitigated by the fact that finding FluMist might not be easy this flu season.\u003c/p>\n\u003cp>The decision to once again recommend it — effectively giving doctors and pharmacists a go-head to use it again — was \u003ca href=\"https://www.statnews.com/2018/02/21/flu-flumist-vaccine/\">made by the ACIP in late February\u003c/a>. By that point, though, many flu vaccine orders would already have been placed for the 2018-2019 season.\u003c/p>\n\u003cp>While dozens of lots of vaccine products made by Sanofi Pasteur, GlaxoSmithKline, and Seqirus have been given the \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Post-MarketActivities/LotReleases/ucm613863.htm\" target=\"_blank\" rel=\"noopener\">green light for distribution\u003c/a> by the Food and Drug Administration, no lots of FluMist had cleared that hurdle as of Aug. 30.\u003c/p>\n\u003cp>It has been a rocky few years for FluMist, which once was deemed more effective in children than injectable flu vaccine. But just after ACIP gave FluMist a rare preferential recommendation in 2014, performance problems came into view. By the 2016-2017 flu season, the CDC’s vaccine advisers recommended it not be used in the U.S. ACIP retained that position for the following flu season as well.\u003c/p>\n\u003cp>The problem was vaccine effectiveness studies that are done every year showed FluMist had not been offering much if any protection against the influenza A virus family H1N1.\u003c/p>\n\u003cp>It wasn’t clear why the vaccine’s performance was so poor in the U.S. during the 2013-2014 and 2015-2016 seasons. To make matters more confounding, other countries that use FluMist — Canada, Finland, and Britain among them — did not see the puzzling lack of effectiveness.[contextly_sidebar id=\"plRGl9fWXC0hyQTXcSoyNMZbRMqtlHfF\"]\u003c/p>\n\u003cp>Unlike injectable flu vaccine, FluMist contains live viruses. The viruses in the vaccine, which is puffed up a nostril of the recipient, initiate the infection process, thereby activating an immune response. But the viruses in the vaccine are weakened and don’t induce illness.\u003c/p>\n\u003cp>In response to its U.S. performance problems, AstraZeneca reformulated the H1N1 portion of the vaccine. There is some evidence that suggests the updated vaccine may be more effective — although the company hasn’t been able to do studies in children to confirm that. H3N2 viruses have dominated in the last two flu seasons here.\u003c/p>\n\u003cp>“They provided some evidence that appeared promising that the new virus that’s going to go into the vaccine this season in the U.S. is a bit more fit,” said Grohskopf. “It is promising evidence that what is at least believed to be the root cause of the problem has been fixed.”\u003c/p>\n\u003cp>Bernstein said the AAP was not as convinced by the data as the CDC. He voted against recommending FluMist for the 2018-2019 season at the February ACIP meeting.\u003c/p>\n\u003cp>Another place the CDC and AAP advice diverges slightly relates to when children should be vaccinated.\u003c/p>\n\u003cp>The AAP recommendations, published Monday in the journal Pediatrics, suggest pediatricians should start urging parents to vaccinate their children as soon as flu vaccine becomes available. That can be as early as late July or August, which — depending on when flu activity picks up — is often months ahead of when children will face a flu threat. Flu season often peaks in January or February, and influenza B viruses, which are particularly hard on children, often circulate late in the winter.[contextly_sidebar id=\"99nVOxVZDXqlh05RmfHN75NAR5MEv5RW\"]\u003c/p>\n\u003cp>There are some studies that have shown protection from flu vaccine starts to wear off as the season wears on.\u003c/p>\n\u003cp>The CDC’s recommendations, published Aug. 24, suggested people should be vaccinated by the end of October, when flu activity can start to tick up.\u003c/p>\n\u003cp>Grohskopf acknowledged the variability and unpredictability of influenza makes it tough to know when to advise people to get the vaccine. “What we can say is the best time to get vaccinated is probably a couple of weeks before flu starts circulating where you are. But we can never really tell people when that is,” she admitted.\u003c/p>\n\u003cp>One thing is clear though, she said. Parents of young children should start the vaccination process earlier. That’s because children under 8 years old who haven’t had at least two flu vaccines in their life need two doses of vaccine given at least four weeks apart. The second shot should be by the end of October, the CDC guidance said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/09/03/flumist-vaccine-recommendations/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"New recommendations urge parents to vaccinate their children as soon as flu vaccine becomes available. ","status":"publish","parent":0,"modified":1536135982,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1135},"headData":{"title":"Pediatrics Group Urges Parents to Ditch FluMist in Favor of Shots | KQED","description":"New recommendations urge parents to vaccinate their children as soon as flu vaccine becomes available. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"444271 https://ww2.kqed.org/futureofyou/?p=444271","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/09/05/pediatrics-group-says-avoid-popular-flumist/","disqusTitle":"Pediatrics Group Urges Parents to Ditch FluMist in Favor of Shots","nprByline":"Helen Branswell\u003cbr />STAT","path":"/futureofyou/444271/pediatrics-group-says-avoid-popular-flumist","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The American Academy of Pediatrics is recommending children be vaccinated with injectable flu vaccine for the coming season, rather than the nasal spray vaccine FluMist, unless a child will only be vaccinated if he or she can forgo a needle, or if a doctor runs out of flu shots.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“The AAP feels that the flu shot should be the primary vaccine choice for all children,” said Dr. Henry Bernstein, a pediatrician and an ex-officio member of the AAP’s committee on infectious diseases.\u003c/p>\n\u003cp>That advice puts the AAP’s annual flu vaccine recommendations slightly at odds with \u003ca href=\"https://www.cdc.gov/mmwr/volumes/67/rr/rr6703a1.htm?s_cid=rr6703a1_w\" target=\"_blank\" rel=\"noopener\">those of the Centers for Disease Control and Prevention\u003c/a>, which state that any of the flu vaccines available for children could be used for the coming flu season.\u003c/p>\n\u003cp>Both, however, share an end goal: getting more children vaccinated.\u003c/p>\n\u003cp>Influenza can be deadly for children. In the past flu season, 180 children under the age of 18 died from the flu, making it the second most deadly flu season — after the 2009 H1N1 pandemic — since the CDC started recording pediatric flu deaths in the winter of 2005-2006.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The CDC recommends everyone over the age of 6 months be vaccinated every year against the flu, unless there is a medical reason to avoid the vaccine.\u003c/p>\n\u003cp>Yet only about 60 percent of children between the ages of 6 months and 17 years got vaccinated against flu in 2016-2017, the most recent year for which data are available. Roughly eight out of every 10 children who died from flu weren’t vaccinated, said Dr. Lisa Grohskopf, a medical officer in the CDC’s influenza division.\u003c/p>\n\u003cp>The differing advice from the CDC and the AAP on AstraZeneca’s FluMist could befuddle parents and pediatricians.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“There’s no question that ideally we would like for the CDC and the AAP to be completely harmonized” when it comes to recommendations, said Bernstein who is also a member of the Advisory Committee on Immunization Practices, which guides the CDC on vaccine decisions.\u003c/p>\n\u003cp>“Both groups are harmonized in wanting as many children to receive flu vaccine as possible each and every year,” said Bernstein. “When recommendations are not perfectly harmonized, it does pose the possibility for confusion.”\u003c/p>\n\u003cp>But any confusion might be mitigated by the fact that finding FluMist might not be easy this flu season.\u003c/p>\n\u003cp>The decision to once again recommend it — effectively giving doctors and pharmacists a go-head to use it again — was \u003ca href=\"https://www.statnews.com/2018/02/21/flu-flumist-vaccine/\">made by the ACIP in late February\u003c/a>. By that point, though, many flu vaccine orders would already have been placed for the 2018-2019 season.\u003c/p>\n\u003cp>While dozens of lots of vaccine products made by Sanofi Pasteur, GlaxoSmithKline, and Seqirus have been given the \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Post-MarketActivities/LotReleases/ucm613863.htm\" target=\"_blank\" rel=\"noopener\">green light for distribution\u003c/a> by the Food and Drug Administration, no lots of FluMist had cleared that hurdle as of Aug. 30.\u003c/p>\n\u003cp>It has been a rocky few years for FluMist, which once was deemed more effective in children than injectable flu vaccine. But just after ACIP gave FluMist a rare preferential recommendation in 2014, performance problems came into view. By the 2016-2017 flu season, the CDC’s vaccine advisers recommended it not be used in the U.S. ACIP retained that position for the following flu season as well.\u003c/p>\n\u003cp>The problem was vaccine effectiveness studies that are done every year showed FluMist had not been offering much if any protection against the influenza A virus family H1N1.\u003c/p>\n\u003cp>It wasn’t clear why the vaccine’s performance was so poor in the U.S. during the 2013-2014 and 2015-2016 seasons. To make matters more confounding, other countries that use FluMist — Canada, Finland, and Britain among them — did not see the puzzling lack of effectiveness.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Unlike injectable flu vaccine, FluMist contains live viruses. The viruses in the vaccine, which is puffed up a nostril of the recipient, initiate the infection process, thereby activating an immune response. But the viruses in the vaccine are weakened and don’t induce illness.\u003c/p>\n\u003cp>In response to its U.S. performance problems, AstraZeneca reformulated the H1N1 portion of the vaccine. There is some evidence that suggests the updated vaccine may be more effective — although the company hasn’t been able to do studies in children to confirm that. H3N2 viruses have dominated in the last two flu seasons here.\u003c/p>\n\u003cp>“They provided some evidence that appeared promising that the new virus that’s going to go into the vaccine this season in the U.S. is a bit more fit,” said Grohskopf. “It is promising evidence that what is at least believed to be the root cause of the problem has been fixed.”\u003c/p>\n\u003cp>Bernstein said the AAP was not as convinced by the data as the CDC. He voted against recommending FluMist for the 2018-2019 season at the February ACIP meeting.\u003c/p>\n\u003cp>Another place the CDC and AAP advice diverges slightly relates to when children should be vaccinated.\u003c/p>\n\u003cp>The AAP recommendations, published Monday in the journal Pediatrics, suggest pediatricians should start urging parents to vaccinate their children as soon as flu vaccine becomes available. That can be as early as late July or August, which — depending on when flu activity picks up — is often months ahead of when children will face a flu threat. Flu season often peaks in January or February, and influenza B viruses, which are particularly hard on children, often circulate late in the winter.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>There are some studies that have shown protection from flu vaccine starts to wear off as the season wears on.\u003c/p>\n\u003cp>The CDC’s recommendations, published Aug. 24, suggested people should be vaccinated by the end of October, when flu activity can start to tick up.\u003c/p>\n\u003cp>Grohskopf acknowledged the variability and unpredictability of influenza makes it tough to know when to advise people to get the vaccine. “What we can say is the best time to get vaccinated is probably a couple of weeks before flu starts circulating where you are. But we can never really tell people when that is,” she admitted.\u003c/p>\n\u003cp>One thing is clear though, she said. Parents of young children should start the vaccination process earlier. That’s because children under 8 years old who haven’t had at least two flu vaccines in their life need two doses of vaccine given at least four weeks apart. The second shot should be by the end of October, the CDC guidance said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/09/03/flumist-vaccine-recommendations/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444271/pediatrics-group-says-avoid-popular-flumist","authors":["byline_futureofyou_444271"],"categories":["futureofyou_1060","futureofyou_73"],"tags":["futureofyou_491","futureofyou_662","futureofyou_61","futureofyou_1217","futureofyou_1488"],"collections":["futureofyou_1093"],"featImg":"futureofyou_444273","label":"futureofyou_1093"},"futureofyou_442939":{"type":"posts","id":"futureofyou_442939","meta":{"index":"posts_1591205157","site":"futureofyou","id":"442939","score":null,"sort":[1529596800000]},"guestAuthors":[],"slug":"new-flu-vaccine-only-a-little-better-than-traditional-shot","title":"New Flu Vaccine Only a Little Better Than Traditional Shot","publishDate":1529596800,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>A newer kind of flu vaccine only worked a little bit better in seniors this past winter than traditional shots, the government reported Wednesday.[contextly_sidebar id=\"KXBdyTHy0L9va48xe5z0NXt2XKlPVwbS\"]\u003c/p>\n\u003cp>Overall, flu vaccines barely worked at all in keeping people 65 and older out of the hospital, with roughly 24 percent effectiveness.\u003c/p>\n\u003cp>The best performance was by a new shot called Flucelvax; it was about 26.5 percent effective in that age group. The difference wasn’t as large as some had hoped.\u003c/p>\n\u003cp>“The big problem is still the same — we need better vaccines. But these incremental improvements are very important,” said Brendan Flannery, a flu expert at the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>The findings of the Food and Drug Administration study were presented in Atlanta Wednesday to a panel that advises the government on vaccine recommendations.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The vast majority of flu shots in the U.S. are made in chicken eggs. Seqirus’ Flucelvax is made by growing viruses in animal cells instead.\u003c/p>\n\u003cp>The U.S. just went through one of the most severe flu seasons in more than a decade, driven by a nasty flu bug that tends to cause more hospitalizations and deaths, particularly among the elderly. Researchers are finding vaccines made in eggs don’t work well against that kind of flu bug. Growing vaccines in cells is thought to provide a better match.[contextly_sidebar id=\"SIPkA9pviyI2gEn0Y0I5LPZgobNyBGYN\"]\u003c/p>\n\u003cp>In a statement, Seqirus said it was encouraged by the results and is doing additional analysis.\u003c/p>\n\u003cp>The FDA study included more than 13 million Medicare beneficiaries. It looked at what kind of flu shots they got and whether they came down with a flu that put them in the hospital. Flu diagnoses were not based on lab confirmations, though, so the results could have underestimated the vaccines’ effectiveness if other bugs had made them sick, experts noted.\u003c/p>\n\u003cp>The study also showed that a higher-dose, egg-based vaccine intended for seniors worked slightly better than the traditional dose.\u003c/p>\n\u003cp>For Americans of all ages, the CDC estimates that flu shots were 40 percent effective against all strains this past season. They were far less effective against the kind that made most people sick.\u003c/p>\n\u003cp>__\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Associated Press Health & Science Department receives \u003ca href=\"http://bit.ly/2G0n9w6\" target=\"_blank\" rel=\"noopener\">support\u003c/a> from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n","blocks":[],"excerpt":"Overall, flu vaccines barely worked at all in keeping people 65 and older out of the hospital, with roughly 24 percent effectiveness.","status":"publish","parent":0,"modified":1529540056,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":15,"wordCount":402},"headData":{"title":"New Flu Vaccine Only a Little Better Than Traditional Shot | KQED","description":"Overall, flu vaccines barely worked at all in keeping people 65 and older out of the hospital, with roughly 24 percent effectiveness.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"442939 https://ww2.kqed.org/futureofyou/?p=442939","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/06/21/new-flu-vaccine-only-a-little-better-than-traditional-shot/","disqusTitle":"New Flu Vaccine Only a Little Better Than Traditional Shot","source":"Health","nprByline":"Mike Stobbe\u003cbr />Associated Press","path":"/futureofyou/442939/new-flu-vaccine-only-a-little-better-than-traditional-shot","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A newer kind of flu vaccine only worked a little bit better in seniors this past winter than traditional shots, the government reported Wednesday.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Overall, flu vaccines barely worked at all in keeping people 65 and older out of the hospital, with roughly 24 percent effectiveness.\u003c/p>\n\u003cp>The best performance was by a new shot called Flucelvax; it was about 26.5 percent effective in that age group. The difference wasn’t as large as some had hoped.\u003c/p>\n\u003cp>“The big problem is still the same — we need better vaccines. But these incremental improvements are very important,” said Brendan Flannery, a flu expert at the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>The findings of the Food and Drug Administration study were presented in Atlanta Wednesday to a panel that advises the government on vaccine recommendations.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The vast majority of flu shots in the U.S. are made in chicken eggs. Seqirus’ Flucelvax is made by growing viruses in animal cells instead.\u003c/p>\n\u003cp>The U.S. just went through one of the most severe flu seasons in more than a decade, driven by a nasty flu bug that tends to cause more hospitalizations and deaths, particularly among the elderly. Researchers are finding vaccines made in eggs don’t work well against that kind of flu bug. Growing vaccines in cells is thought to provide a better match.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In a statement, Seqirus said it was encouraged by the results and is doing additional analysis.\u003c/p>\n\u003cp>The FDA study included more than 13 million Medicare beneficiaries. It looked at what kind of flu shots they got and whether they came down with a flu that put them in the hospital. Flu diagnoses were not based on lab confirmations, though, so the results could have underestimated the vaccines’ effectiveness if other bugs had made them sick, experts noted.\u003c/p>\n\u003cp>The study also showed that a higher-dose, egg-based vaccine intended for seniors worked slightly better than the traditional dose.\u003c/p>\n\u003cp>For Americans of all ages, the CDC estimates that flu shots were 40 percent effective against all strains this past season. They were far less effective against the kind that made most people sick.\u003c/p>\n\u003cp>__\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Associated Press Health & Science Department receives \u003ca href=\"http://bit.ly/2G0n9w6\" target=\"_blank\" rel=\"noopener\">support\u003c/a> from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/442939/new-flu-vaccine-only-a-little-better-than-traditional-shot","authors":["byline_futureofyou_442939"],"categories":["futureofyou_1060","futureofyou_73"],"tags":["futureofyou_952","futureofyou_662","futureofyou_664","futureofyou_61","futureofyou_1056"],"collections":["futureofyou_1093"],"featImg":"futureofyou_442941","label":"source_futureofyou_442939"},"futureofyou_440955":{"type":"posts","id":"futureofyou_440955","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440955","score":null,"sort":[1524524430000]},"guestAuthors":[],"slug":"the-vaccine-dilemma-how-experts-weigh-benefits-for-many-against-risks-for-a-few","title":"The Vaccine Dilemma: How Experts Weigh Benefits For Many Against Risks for a Few","publishDate":1524524430,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>You’ve likely seen a version of the image above. Some people observe two faces in profile. Others see a vase.\u003c/p>\n\u003cp>The same phenomenon can occur when scientists look at data, particularly when they try to weigh the benefits and risks of individual vaccines. Vaccines protect huge numbers of people, generally children, from serious diseases, but in rare cases, certain vaccines can tragically cause harm. How do those scientists figure out which to value more?[contextly_sidebar id=\"vM6M1R2zIUt7PSfniSijCNeI1SXmNMTL\"]\u003c/p>\n\u003cp>This dilemma was at the center of last week’s decision by an expert committee advising the World Health Organization to sharply scale back use of a controversial vaccine called Dengvaxia, the first to protect against dengue infection.\u003c/p>\n\u003cp>Two years ago, many of the same experts concluded the vaccine was safe to use in children 9 and older in places where dengue infection is almost unavoidable — even though there were strong theoretical concerns the vaccine might put some vaccinated kids at higher risk of developing a severe form of dengue. Severe dengue can lead to internal bleeding, shock, and even death.\u003c/p>\n\u003cp>Late last year, theory was shown to be reality. After reviewing the data, the WHO’s Strategic Advisory Group of Experts on Immunizations — knows as the SAGE — shifted its stance, recommending last week that the vaccine be given only to children who test positive for a previous dengue infection. A point-of-care blood test doesn’t currently exist, leaving the vaccine’s future in limbo for now.[contextly_sidebar id=\"j6YzLYuARPhSnQ2nKylAVpIU8wdsgIj2\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Benefits trumped theoretical risks. But real risks trumped real benefits — even though the latter outnumbered the former.\u003c/p>\n\u003cp>A variety of factors influence these decisions, according to interviews with public health experts and ethicists who have made or studied them. The severity of disease being prevented and the treatability of the side effects being caused are crucial, as are ethics, public perceptions, and politics. And critically, these days, so is the likelihood that any negative attention generated by one vaccine might stain the reputations of others.\u003c/p>\n\u003cp>Dr. Art Reingold has been involved in countless debates of this type, having served for more than a dozen years on first the SAGE, and later on the corresponding body that advises the Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, or ACIP.[contextly_sidebar id=\"xdscPdRSoRoclTtqbEFBgO7cpt3QJHtx\"]\u003c/p>\n\u003cp>“I would say that for many individuals having to vote or being on these committees and weigh in, many of them spend an awful lot of time looking at data and reviewing it and struggling with it when it’s not a slam dunk,” said Reingold, who teaches infectious diseases epidemiology at the University of California, Berkeley’s school of public health.\u003c/p>\n\u003cp>Reingold, whose term on ACIP concluded at the end of last year, noted that while many of that panel’s votes are close to unanimous, some recommendations — or decisions not to recommend a vaccine — are decided by a narrow vote. “And obviously in that instance pretty smart people have come down on different sides of the same question by weighing effectively all the same evidence,’’ he said.\u003c/p>\n\u003cp>\u003cstrong>The Vaccine Calculus\u003cbr>\n\u003c/strong>In some cases, these decisions aren’t that difficult. A flu shot can trigger Guillain-Barre syndrome, though this adverse event is very rare. But influenza infection can also provoke this disorder, a form of progressive paralysis from which most people recover.\u003c/p>\n\u003cp>In other circumstances, the position of the scales — which side is higher, which is lower — tilts over time.\u003c/p>\n\u003cp>Oral polio vaccine has saved untold millions of children from paralysis in the more than half-century it has been in use. But in rare instances the vaccine also paralyzes, a fact that became clear in the first year of its use, back in the early 1960s.\u003c/p>\n\u003cp>Sometimes the paralysis occurs in the child who got the dose of vaccine, or in a close contact of that child, as was reported in 1962. Other times the weakened viruses in the vaccine circulate among unvaccinated children, who ingest them in water or food contaminated with traces of feces. As the viruses travel from gut to gut, they can go rogue — regain the power to paralyze. That phenomenon was first observed in 2000. Yet oral polio vaccine is still used today.\u003c/p>\n\u003cp>[contextly_sidebar id=\"4xoAKYJE6AnYbA5mfYOPli4oSCgYa7Q4\"]As polio eradication efforts have driven down the polio case count to very low levels, the toll of vaccine-related paralysis can surpass the damage caused by the viruses themselves. Last year there were 22 children in the world paralyzed by polioviruses; vaccine viruses crippled 96.\u003c/p>\n\u003cp>The shifting of the risk-benefit ratio for oral polio vaccine led the United States to switch exclusively to injectable polio vaccine in 2000. In 1996, when the decision to phase out oral vaccine was made, eight or nine children a year were being paralyzed by the vaccine, though polio itself hadn’t paralyzed a child in the United States for over a decade.\u003c/p>\n\u003cp>The risk posed by the oral vaccine became intolerable, given there was a safer, albeit more expensive alternative — the injectable polio vaccine does not paralyze. “Obviously thinking on these things can change. The risks and benefits relatively speaking can change,” Reingold said.\u003c/p>\n\u003cp>In 2016, the formulation of the oral vaccines was altered to drop the component that protected against type 2 polioviruses. That part of the vaccine was the most likely to regain the power to paralyze. Type 2 viruses had disappeared in 1999; there was too little benefit and too much risk associated with keeping them in the vaccine.\u003c/p>\n\u003cp>In the case of Dengvaxia, the calculus is not as clear cut. Evidence suggests that in places where about 70 percent of people have been infected at least once with dengue, the vaccine would prevent seven children from getting sick enough to need hospital care for every additional hospitalized case it provoked. In places where 85 percent of people have been infected, there would be 18 hospitalized cases prevented for every one the vaccine created.\u003c/p>\n\u003cp>Some dengue experts have argued those benefits should not be ignored. Others argue those risks cannot ethically be incurred.\u003c/p>\n\u003cp>[contextly_sidebar id=\"YfGTYns6XDY9Onrzu1EUV5DkCwM08fCc\"]The SAGE deliberated over whether it was permissible to use rates of local dengue infection as a substitute for individual testing — in other words, could the vaccine be given, as it had previously recommended, in places where studies show most people have been infected at least once?\u003c/p>\n\u003cp>They concluded both options pose real-world challenges, given the current lack of a rapid, accurate test. But they also noted there is no evidence to date that children who have never been infected with dengue — the ones the vaccine could harm — would ever experience a benefit from Dengvaxia. They worried that wide-scale dengue vaccination programs might be “ethically problematic and have adverse implications for trust and the long-term success of public health programs.”\u003c/p>\n\u003cp>\u003cstrong>Mounting Distrust\u003cbr>\n\u003c/strong>Why have oral polio vaccine risks been tolerated, but Dengvaxia’s deemed serious enough to effectively shelve the vaccine? Here the factors named above plus timing surely play a role.\u003c/p>\n\u003cp>Experts making these types of decisions these days are doing so in a climate of litigiousness and mounting vaccine refusal and hesitancy. Headlines questioning the safety of one vaccine threaten to fuel rejection of others. The government of the Philippines, where Dengvaxia has been given to more than 800,000 children, has threatened legal action against its manufacturer, Sanofi Pasteur.\u003c/p>\n\u003cp>“The public has a whole new understanding of science, data, facts, and fake news,” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy. “We’ve surely had an anti-science movement well before the current situation, but it’s never been as acute.”[contextly_sidebar id=\"MRQx4tKZn53WSvNmnqGKkUDbBGs0RMX9\"]\u003c/p>\n\u003cp>Then there’s the issue of who gets vaccinated. Most of these products are designed to protect children, who hold a special position in discussions of the ethics of medical treatments.\u003c/p>\n\u003cp>The ethical bar must be placed higher when it comes to kids, because they cannot make an informed decision for themselves, said Art Caplan, a professor of bioethics at New York University’s school of medicine. “So I think the issue is not just: Could we accept huge benefits for small risks? Because I think the answer to that is yes. But I think it’s: Can we accept huge benefits for small risks to very vulnerable children?\u003c/p>\n\u003cp>“When you have that child population put knowingly at risk, it gets really hard from the ethics point of view to ignore that,” he said.\u003c/p>\n\u003cp>And society’s tolerance of risk has changed, Caplan argued, pointing to the so-called Cutter incident to make his case.\u003c/p>\n\u003cp>In 1955, it was discovered that children had been mistakenly injected with polio vaccine that contained live viruses. The process by which the viruses in the vaccine were supposed to be inactivated — killed — hadn’t worked. Fifty-one children in the U.S. were paralyzed and five died.\u003c/p>\n\u003cp>But in the 1950s, polio was an enormous threat. Parents lived in fear their children would end up in an iron lung. Polio vaccination resumed. The company that made the vaccine, Cutter Laboratories, didn’t even go out of business. If a similar incident were to happen today, Caplan said, “it would have shut everything down forever.”[contextly_sidebar id=\"TB4CDGkuuXqcHsBv1pEbtZgMooHhybmV\"]\u003c/p>\n\u003cp>Compare that to the case of RotaShield, the first vaccine licensed to protect against rotavirus infection. These common viruses cause devastating bouts of diarrhea in young children, who can end up in the hospital as a result. Every year some children died of these infections in the U.S., but rotaviruses did more damage in the developing world, where stricken kids didn’t have easy access to hospital care.\u003c/p>\n\u003cp>RotaShield was approved in the U.S. in 1998. A year later, Wyeth Laboratories withdrew it from the market after studies showed babies who got it were at greater risk of developing intussusception, a type of bowel blockage that can kill if it isn’t corrected in time. The CDC estimated that for every 10,000 children vaccinated with RotaShield there would be one or two additional cases of intussusception over what is normally seen.\u003c/p>\n\u003cp>Some experts argued that the vaccine should still be marketed in the developing world, where the number of lives saved would far outstrip the cases of intussusception. The WHO estimated that in 2004, more than half a million children died from rotavirus infections, the lion’s share in South Asia and sub-Saharan Africa.\u003c/p>\n\u003cp>“When you think about the risk-benefit equation in a poor country, almost certainly it would have been far better in terms of illness — preventable deaths averted, cost of care reduced — to continue to use that initial rotavirus vaccine or rather to introduce it and use it in poor countries,” Reingold said.\u003c/p>\n\u003cp>But the vaccine’s fate was sealed.\u003c/p>\n\u003cp>“The fact is that the politics around the thing — this vaccine isn’t good enough for rich white children in the United States but it’s OK for poor black children in poor countries — were a non-starter,” he said. “I mean, it just doesn’t sell. Even if that’s still the wisest thing to do.”\u003c/p>\n\u003cp>It was nearly six years before another, safer rotavirus vaccine made it to market, six years during which more than half a million children a year died from rotavirus infections.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/04/23/vaccine-dilemma-weigh-benefits-risks/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Headlines questioning the safety of one vaccine threaten to fuel rejection of others. ","status":"publish","parent":0,"modified":1524516855,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":41,"wordCount":1990},"headData":{"title":"The Vaccine Dilemma: How Experts Weigh Benefits For Many Against Risks for a Few | KQED","description":"Headlines questioning the safety of one vaccine threaten to fuel rejection of others. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"440955 https://ww2.kqed.org/futureofyou/?p=440955","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/04/23/the-vaccine-dilemma-how-experts-weigh-benefits-for-many-against-risks-for-a-few/","disqusTitle":"The Vaccine Dilemma: How Experts Weigh Benefits For Many Against Risks for a Few","source":"Health","nprByline":"Helen Branswell\u003c/BR>\u003cstrong>STAT\u003c/strong>","path":"/futureofyou/440955/the-vaccine-dilemma-how-experts-weigh-benefits-for-many-against-risks-for-a-few","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>You’ve likely seen a version of the image above. Some people observe two faces in profile. Others see a vase.\u003c/p>\n\u003cp>The same phenomenon can occur when scientists look at data, particularly when they try to weigh the benefits and risks of individual vaccines. Vaccines protect huge numbers of people, generally children, from serious diseases, but in rare cases, certain vaccines can tragically cause harm. How do those scientists figure out which to value more?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>This dilemma was at the center of last week’s decision by an expert committee advising the World Health Organization to sharply scale back use of a controversial vaccine called Dengvaxia, the first to protect against dengue infection.\u003c/p>\n\u003cp>Two years ago, many of the same experts concluded the vaccine was safe to use in children 9 and older in places where dengue infection is almost unavoidable — even though there were strong theoretical concerns the vaccine might put some vaccinated kids at higher risk of developing a severe form of dengue. Severe dengue can lead to internal bleeding, shock, and even death.\u003c/p>\n\u003cp>Late last year, theory was shown to be reality. After reviewing the data, the WHO’s Strategic Advisory Group of Experts on Immunizations — knows as the SAGE — shifted its stance, recommending last week that the vaccine be given only to children who test positive for a previous dengue infection. A point-of-care blood test doesn’t currently exist, leaving the vaccine’s future in limbo for now.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Benefits trumped theoretical risks. But real risks trumped real benefits — even though the latter outnumbered the former.\u003c/p>\n\u003cp>A variety of factors influence these decisions, according to interviews with public health experts and ethicists who have made or studied them. The severity of disease being prevented and the treatability of the side effects being caused are crucial, as are ethics, public perceptions, and politics. And critically, these days, so is the likelihood that any negative attention generated by one vaccine might stain the reputations of others.\u003c/p>\n\u003cp>Dr. Art Reingold has been involved in countless debates of this type, having served for more than a dozen years on first the SAGE, and later on the corresponding body that advises the Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, or ACIP.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“I would say that for many individuals having to vote or being on these committees and weigh in, many of them spend an awful lot of time looking at data and reviewing it and struggling with it when it’s not a slam dunk,” said Reingold, who teaches infectious diseases epidemiology at the University of California, Berkeley’s school of public health.\u003c/p>\n\u003cp>Reingold, whose term on ACIP concluded at the end of last year, noted that while many of that panel’s votes are close to unanimous, some recommendations — or decisions not to recommend a vaccine — are decided by a narrow vote. “And obviously in that instance pretty smart people have come down on different sides of the same question by weighing effectively all the same evidence,’’ he said.\u003c/p>\n\u003cp>\u003cstrong>The Vaccine Calculus\u003cbr>\n\u003c/strong>In some cases, these decisions aren’t that difficult. A flu shot can trigger Guillain-Barre syndrome, though this adverse event is very rare. But influenza infection can also provoke this disorder, a form of progressive paralysis from which most people recover.\u003c/p>\n\u003cp>In other circumstances, the position of the scales — which side is higher, which is lower — tilts over time.\u003c/p>\n\u003cp>Oral polio vaccine has saved untold millions of children from paralysis in the more than half-century it has been in use. But in rare instances the vaccine also paralyzes, a fact that became clear in the first year of its use, back in the early 1960s.\u003c/p>\n\u003cp>Sometimes the paralysis occurs in the child who got the dose of vaccine, or in a close contact of that child, as was reported in 1962. Other times the weakened viruses in the vaccine circulate among unvaccinated children, who ingest them in water or food contaminated with traces of feces. As the viruses travel from gut to gut, they can go rogue — regain the power to paralyze. That phenomenon was first observed in 2000. Yet oral polio vaccine is still used today.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>As polio eradication efforts have driven down the polio case count to very low levels, the toll of vaccine-related paralysis can surpass the damage caused by the viruses themselves. Last year there were 22 children in the world paralyzed by polioviruses; vaccine viruses crippled 96.\u003c/p>\n\u003cp>The shifting of the risk-benefit ratio for oral polio vaccine led the United States to switch exclusively to injectable polio vaccine in 2000. In 1996, when the decision to phase out oral vaccine was made, eight or nine children a year were being paralyzed by the vaccine, though polio itself hadn’t paralyzed a child in the United States for over a decade.\u003c/p>\n\u003cp>The risk posed by the oral vaccine became intolerable, given there was a safer, albeit more expensive alternative — the injectable polio vaccine does not paralyze. “Obviously thinking on these things can change. The risks and benefits relatively speaking can change,” Reingold said.\u003c/p>\n\u003cp>In 2016, the formulation of the oral vaccines was altered to drop the component that protected against type 2 polioviruses. That part of the vaccine was the most likely to regain the power to paralyze. Type 2 viruses had disappeared in 1999; there was too little benefit and too much risk associated with keeping them in the vaccine.\u003c/p>\n\u003cp>In the case of Dengvaxia, the calculus is not as clear cut. Evidence suggests that in places where about 70 percent of people have been infected at least once with dengue, the vaccine would prevent seven children from getting sick enough to need hospital care for every additional hospitalized case it provoked. In places where 85 percent of people have been infected, there would be 18 hospitalized cases prevented for every one the vaccine created.\u003c/p>\n\u003cp>Some dengue experts have argued those benefits should not be ignored. Others argue those risks cannot ethically be incurred.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The SAGE deliberated over whether it was permissible to use rates of local dengue infection as a substitute for individual testing — in other words, could the vaccine be given, as it had previously recommended, in places where studies show most people have been infected at least once?\u003c/p>\n\u003cp>They concluded both options pose real-world challenges, given the current lack of a rapid, accurate test. But they also noted there is no evidence to date that children who have never been infected with dengue — the ones the vaccine could harm — would ever experience a benefit from Dengvaxia. They worried that wide-scale dengue vaccination programs might be “ethically problematic and have adverse implications for trust and the long-term success of public health programs.”\u003c/p>\n\u003cp>\u003cstrong>Mounting Distrust\u003cbr>\n\u003c/strong>Why have oral polio vaccine risks been tolerated, but Dengvaxia’s deemed serious enough to effectively shelve the vaccine? Here the factors named above plus timing surely play a role.\u003c/p>\n\u003cp>Experts making these types of decisions these days are doing so in a climate of litigiousness and mounting vaccine refusal and hesitancy. Headlines questioning the safety of one vaccine threaten to fuel rejection of others. The government of the Philippines, where Dengvaxia has been given to more than 800,000 children, has threatened legal action against its manufacturer, Sanofi Pasteur.\u003c/p>\n\u003cp>“The public has a whole new understanding of science, data, facts, and fake news,” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy. “We’ve surely had an anti-science movement well before the current situation, but it’s never been as acute.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Then there’s the issue of who gets vaccinated. Most of these products are designed to protect children, who hold a special position in discussions of the ethics of medical treatments.\u003c/p>\n\u003cp>The ethical bar must be placed higher when it comes to kids, because they cannot make an informed decision for themselves, said Art Caplan, a professor of bioethics at New York University’s school of medicine. “So I think the issue is not just: Could we accept huge benefits for small risks? Because I think the answer to that is yes. But I think it’s: Can we accept huge benefits for small risks to very vulnerable children?\u003c/p>\n\u003cp>“When you have that child population put knowingly at risk, it gets really hard from the ethics point of view to ignore that,” he said.\u003c/p>\n\u003cp>And society’s tolerance of risk has changed, Caplan argued, pointing to the so-called Cutter incident to make his case.\u003c/p>\n\u003cp>In 1955, it was discovered that children had been mistakenly injected with polio vaccine that contained live viruses. The process by which the viruses in the vaccine were supposed to be inactivated — killed — hadn’t worked. Fifty-one children in the U.S. were paralyzed and five died.\u003c/p>\n\u003cp>But in the 1950s, polio was an enormous threat. Parents lived in fear their children would end up in an iron lung. Polio vaccination resumed. The company that made the vaccine, Cutter Laboratories, didn’t even go out of business. If a similar incident were to happen today, Caplan said, “it would have shut everything down forever.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Compare that to the case of RotaShield, the first vaccine licensed to protect against rotavirus infection. These common viruses cause devastating bouts of diarrhea in young children, who can end up in the hospital as a result. Every year some children died of these infections in the U.S., but rotaviruses did more damage in the developing world, where stricken kids didn’t have easy access to hospital care.\u003c/p>\n\u003cp>RotaShield was approved in the U.S. in 1998. A year later, Wyeth Laboratories withdrew it from the market after studies showed babies who got it were at greater risk of developing intussusception, a type of bowel blockage that can kill if it isn’t corrected in time. The CDC estimated that for every 10,000 children vaccinated with RotaShield there would be one or two additional cases of intussusception over what is normally seen.\u003c/p>\n\u003cp>Some experts argued that the vaccine should still be marketed in the developing world, where the number of lives saved would far outstrip the cases of intussusception. The WHO estimated that in 2004, more than half a million children died from rotavirus infections, the lion’s share in South Asia and sub-Saharan Africa.\u003c/p>\n\u003cp>“When you think about the risk-benefit equation in a poor country, almost certainly it would have been far better in terms of illness — preventable deaths averted, cost of care reduced — to continue to use that initial rotavirus vaccine or rather to introduce it and use it in poor countries,” Reingold said.\u003c/p>\n\u003cp>But the vaccine’s fate was sealed.\u003c/p>\n\u003cp>“The fact is that the politics around the thing — this vaccine isn’t good enough for rich white children in the United States but it’s OK for poor black children in poor countries — were a non-starter,” he said. “I mean, it just doesn’t sell. Even if that’s still the wisest thing to do.”\u003c/p>\n\u003cp>It was nearly six years before another, safer rotavirus vaccine made it to market, six years during which more than half a million children a year died from rotavirus infections.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/04/23/vaccine-dilemma-weigh-benefits-risks/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440955/the-vaccine-dilemma-how-experts-weigh-benefits-for-many-against-risks-for-a-few","authors":["byline_futureofyou_440955"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_141","futureofyou_952","futureofyou_662","futureofyou_61","futureofyou_173","futureofyou_1488","futureofyou_652"],"featImg":"futureofyou_440964","label":"source_futureofyou_440955"},"futureofyou_440049":{"type":"posts","id":"futureofyou_440049","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440049","score":null,"sort":[1520644484000]},"guestAuthors":[],"slug":"does-tamiflu-work","title":"Does Tamiflu Work? We Asked a Scientist","publishDate":1520644484,"format":"aside","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"581\" height=\"326\" src=\"https://www.youtube.com/embed/AhgM59sAMzY\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>This year’s flu season has killed nearly 100 children, and led to more than 1,100\u003ca href=\"https://gis.cdc.gov/grasp/fluview/FluHospChars.html\" target=\"_blank\" rel=\"noopener\"> hospitalizations per week\u003c/a> — a rate the U.S. has not seen in more than 15 years.\u003c/p>\n\u003cp>When the flu strikes, many rush to the doctor for Tamiflu, a popular drug \u003ca href=\"https://www.fda.gov/Drugs/DrugSafety/ucm188859.htm\" target=\"_blank\" rel=\"noopener\">approved to treat\u003c/a> influenza’s basic symptoms and keep the virus from multiplying in the body. But doctors also prescribe the drug to tackle or prevent the flu’s life-threatening complications, like pneumonia and asthma attacks.[contextly_sidebar id=\"dEWuUGFvsMLSs6WLCNtEK2hWhwTOp878\"]\u003c/p>\n\u003cp>NewsHour asked a drug safety researcher, a virologist at a children’s hospital and a medical officer at Centers for Disease Control and Prevention whether Tamiflu delivers on these claims.\u003c/p>\n\u003cp>\u003cstrong>What Does Tamiflu Do?\u003c/strong>\u003cbr>\nTamiflu is an antiviral drug that blocks an enzyme called neuraminidase, which helps the flu virus replicate and spread through your body. Most flu researchers agree on the basics — that Tamiflu will reduce symptoms, like stuffy nose, sore throat, fever and tiredness, which is something many over-the-counter medications do too.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The ideal scenarios is to start [Tamiflu] treatment as soon as possible,” said Dr. Elena Govorkova, laboratory director in the division of virology at St. Jude Children’s Research Hospital in Memphis, Tenn. “The most efficacy is received when treatment starts within 48 hours after symptoms start to appear.”\u003c/p>\n\u003cp>Govorkova said Tamiflu is clinically proven to reduce the duration of influenza symptoms by one to two days, which may not seem like much. “But when you have thousands people infected, especially if people are working, it makes, of course, a huge impact,” Govorkova said.\u003c/p>\n\u003cp>\u003cimg class=\"size-medium wp-image-439428 alignleft\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/02/GettyImages-89182311-800x544.jpg\" alt=\"\" width=\"800\" height=\"544\">But broader claims about Tamiflu’s effectiveness made by the Centers for Disease Control and Prevention conflict with those of the U.S. Food and Drug Administration, according to drug safety researcher Peter Doshi at the University of Maryland School of Pharmacy.\u003c/p>\n\u003cp>The CDC\u003ca href=\"https://www.cdc.gov/flu/antivirals/whatyoushould.htm\" target=\"_blank\" rel=\"noopener\"> describes Tamiflu\u003c/a> as a drug that may “reduce the risk of complications such as ear infections in children, and pneumonia and hospitalizations in adults.” The FDA’s \u003ca href=\"https://www.gene.com/download/pdf/tamiflu_prescribing.pdf\" target=\"_blank\" rel=\"noopener\">drug label\u003c/a> for Tamiflu, however, says the remedy “has not been shown to prevent such complications.”\u003c/p>\n\u003cp>Doshi, who supports the FDA’s position, said this difference of view is a public health concern.\u003c/p>\n\u003cp>But Tim Uyeki, chief medical officer for the CDC’s influenza division, disagrees with the FDA’s narrow definition. He said the two agencies are acting according to their respective missions. Whereas the FDA approves drugs based on strict “controlled trials,” Uyeki said, the CDC is not a regulatory authority.[contextly_sidebar id=\"LkP32YkNx63Kd1oVIhjfC2XPuqIHqxai\"]\u003c/p>\n\u003cp>Instead, the CDC makes recommendations for public health based on a broader, albeit less strict, body of evidence, Uyeki said. For example, it gathers “observational data,” such as years of notes on flu patients who walk into hospitals seeking treatment.\u003c/p>\n\u003cp>Based on this observational data, Uyeki said that oseltamivir — the generic name for antivirals that include Tamiflu — can improve survival against the worst flu complications, especially when the drug is compared to no treatment at all.\u003c/p>\n\u003cp>\u003cstrong>Reviewing The Evidence\u003cbr>\n\u003c/strong>But Doshi said the leap from ‘reducing symptoms’ to ‘preventing complications’ is a stretch. When asked if Tamiflu provides additional benefits against the worst of the flu, Doshi said, “That’s where the evidence gets very dicey very quickly.”\u003c/p>\n\u003cp>In 2009, Doshi’s team got a\u003ca href=\"http://www.bmj.com/content/bmj/suppl/2009/12/07/bmj.b5106.DC1/jeft726562.ww1_default.pdf\" target=\"_blank\" rel=\"noopener\"> tip from a pediatrician\u003c/a> that the data for the Tamiflu clinical trials were not publicly accessible. This pediatrician noticed the claims on Tamiflu’s effectiveness were based on manufacturer-funded studies. That discovery prompted Doshi’s three-year effort to obtain and analyze the studies behind Tamiflu’s FDA approval.\u003c/p>\n\u003cp>Doshi’s team concluded in a 2014 \u003ca href=\"http://www.bmj.com/content/348/bmj.g2545\" target=\"_blank\" rel=\"noopener\">Cochrane review\u003c/a> article that the \u003ca href=\"http://www.bmj.com/content/348/bmj.g2545\" target=\"_blank\" rel=\"noopener\">clinical trial data\u003c/a> did not support the broader claims made about Tamiflu. The team looked at clinical study reports for 83 trials and found no improvement for admission-to-hospital rates, pneumonia or bronchitis. However, they did see a more than 50 percent reduction in influenza symptoms.[contextly_sidebar id=\"UhKr6k2joqSbmBiSd5fm7An0GzEUsPyo\"]\u003c/p>\n\u003cp>Uyeki said Doshi’s review has had a tremendous influence because of the worldwide reach of\u003ca href=\"http://www.bmj.com/content/348/bmj.g2545\"> Cochrane\u003c/a>, but added that the results are misleading.\u003c/p>\n\u003cp>Uyeki called Doshi’s evidence “watered down” because it relied on patients who had influenza-like symptoms, but were not necessarily confirmed by laboratory testing to have the flu. Many different viral infections and some bacterial infections can mimic “flu-like” symptoms. So if one patient received Tamiflu and did not have the flu, then he or she may have skewed Doshi’s data, Uyeki said.\u003c/p>\n\u003cp>The Cochrane review focused on “influenza-like” illness as an outcome because that’s “the thing people want to avoid,” Doshi said, adding that the outcomes with pneumonia and hospitalizations are the same, regardless of whether you’re looking at flu-like cases or lab-confirmed cases.\u003c/p>\n\u003cp>Govorkova said that Tamiflu can reduce the chances of catching pneumonia.\u003c/p>\n\u003cp>She explains: Pneumonia is caused by bacteria, not the influenza virus. But the flu virus, in some cases, can predispose receptors on the epithelial cells lining our throats and lungs to become infected with pneumonia-causing bacteria.\u003c/p>\n\u003cp>“[Tamiflu] is not for the treatment of pneumonia — you must use antibiotics,” Govorkova said. “But because [Tamiflu] is very specific for influenza virus, if you start early, you can eliminate influenza virus from the body. And because of that, pneumonia cannot occur.”\u003c/p>\n\u003cp>Doctors may also prescribe Tamiflu in cases, she said, when another remedy isn’t available — \u003ca href=\"https://academic.oup.com/jid/article/202/8/1149/926161\" target=\"_blank\" rel=\"noopener\">such as during avian\u003c/a> H5N1 influenza outbreaks. “Vaccines were not available for prevention purposes, so they were giving Tamiflu even after 48 hours of exposure,” Govorkova said.\u003c/p>\n\u003cp>\u003cstrong>Why This Debate Matters\u003cbr>\n\u003c/strong>Doshi and Uyeki do agree that underlying chronic conditions — like asthma, obesity, diabetes and heart disease — can worsen a flu case by expanding the amount of time the virus spends multiplying.\u003c/p>\n\u003cp>…patients should consult their doctors on whether Tamiflu could be helpful. They should also make sure to take the full course of medicine.\u003c/p>\n\u003cp>But with the flood of alarming media and rising flu-related hospitalizations, Doshi worries people will begin to count on Tamiflu to save lives. He said viral stories, such as those about a Texas \u003ca href=\"http://www.bbc.com/news/world-us-canada-43039036\" target=\"_blank\" rel=\"noopener\">teacher\u003c/a> or a New Hampshire \u003ca href=\"http://www.dailymail.co.uk/health/article-5331999/Mother-four-killed-flu-refusing-Tamiflu.html\" target=\"_blank\" rel=\"noopener\">mother\u003c/a>, that link their flu-related deaths to refusing Tamiflu, lead people to believe Tamiflu is a “wonder drug” that could help the situation in the first place.\u003c/p>\n\u003cp>“[Those stories] project this sense that we’re certain that if only she had taken Tamiflu she would be alive today, and we don’t have any evidence to know that that’s the case,” Doshi said. “So it really spreads a dangerous message.\u003c/p>\n\u003cp>Govorkova said patients should consult their doctors on whether Tamiflu could be helpful. They should also make sure to take the full course of medicine.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Some people drop out early or take it once a day rather than twice a day, she said, and this should be avoided because it can cause the emergence of Tamiflu-resistant flu strains.\u003c/p>\n\n","blocks":[],"excerpt":"This year’s flu season has killed nearly 100 children, and led to over 1,100 hospitalizations per week.","status":"publish","parent":0,"modified":1520993289,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":31,"wordCount":1235},"headData":{"title":"Does Tamiflu Work? We Asked a Scientist | KQED","description":"This year’s flu season has killed nearly 100 children, and led to over 1,100 hospitalizations per week.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"440049 https://ww2.kqed.org/futureofyou/?p=440049","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/09/does-tamiflu-work/","disqusTitle":"Does Tamiflu Work? We Asked a Scientist","source":"DIY Health","nprByline":"Teresa Carey\u003cbr />Nsikan Akpan\u003cbr />PBS NewsHour","path":"/futureofyou/440049/does-tamiflu-work","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"581\" height=\"326\" src=\"https://www.youtube.com/embed/AhgM59sAMzY\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>This year’s flu season has killed nearly 100 children, and led to more than 1,100\u003ca href=\"https://gis.cdc.gov/grasp/fluview/FluHospChars.html\" target=\"_blank\" rel=\"noopener\"> hospitalizations per week\u003c/a> — a rate the U.S. has not seen in more than 15 years.\u003c/p>\n\u003cp>When the flu strikes, many rush to the doctor for Tamiflu, a popular drug \u003ca href=\"https://www.fda.gov/Drugs/DrugSafety/ucm188859.htm\" target=\"_blank\" rel=\"noopener\">approved to treat\u003c/a> influenza’s basic symptoms and keep the virus from multiplying in the body. But doctors also prescribe the drug to tackle or prevent the flu’s life-threatening complications, like pneumonia and asthma attacks.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>NewsHour asked a drug safety researcher, a virologist at a children’s hospital and a medical officer at Centers for Disease Control and Prevention whether Tamiflu delivers on these claims.\u003c/p>\n\u003cp>\u003cstrong>What Does Tamiflu Do?\u003c/strong>\u003cbr>\nTamiflu is an antiviral drug that blocks an enzyme called neuraminidase, which helps the flu virus replicate and spread through your body. Most flu researchers agree on the basics — that Tamiflu will reduce symptoms, like stuffy nose, sore throat, fever and tiredness, which is something many over-the-counter medications do too.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The ideal scenarios is to start [Tamiflu] treatment as soon as possible,” said Dr. Elena Govorkova, laboratory director in the division of virology at St. Jude Children’s Research Hospital in Memphis, Tenn. “The most efficacy is received when treatment starts within 48 hours after symptoms start to appear.”\u003c/p>\n\u003cp>Govorkova said Tamiflu is clinically proven to reduce the duration of influenza symptoms by one to two days, which may not seem like much. “But when you have thousands people infected, especially if people are working, it makes, of course, a huge impact,” Govorkova said.\u003c/p>\n\u003cp>\u003cimg class=\"size-medium wp-image-439428 alignleft\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/02/GettyImages-89182311-800x544.jpg\" alt=\"\" width=\"800\" height=\"544\">But broader claims about Tamiflu’s effectiveness made by the Centers for Disease Control and Prevention conflict with those of the U.S. Food and Drug Administration, according to drug safety researcher Peter Doshi at the University of Maryland School of Pharmacy.\u003c/p>\n\u003cp>The CDC\u003ca href=\"https://www.cdc.gov/flu/antivirals/whatyoushould.htm\" target=\"_blank\" rel=\"noopener\"> describes Tamiflu\u003c/a> as a drug that may “reduce the risk of complications such as ear infections in children, and pneumonia and hospitalizations in adults.” The FDA’s \u003ca href=\"https://www.gene.com/download/pdf/tamiflu_prescribing.pdf\" target=\"_blank\" rel=\"noopener\">drug label\u003c/a> for Tamiflu, however, says the remedy “has not been shown to prevent such complications.”\u003c/p>\n\u003cp>Doshi, who supports the FDA’s position, said this difference of view is a public health concern.\u003c/p>\n\u003cp>But Tim Uyeki, chief medical officer for the CDC’s influenza division, disagrees with the FDA’s narrow definition. He said the two agencies are acting according to their respective missions. Whereas the FDA approves drugs based on strict “controlled trials,” Uyeki said, the CDC is not a regulatory authority.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Instead, the CDC makes recommendations for public health based on a broader, albeit less strict, body of evidence, Uyeki said. For example, it gathers “observational data,” such as years of notes on flu patients who walk into hospitals seeking treatment.\u003c/p>\n\u003cp>Based on this observational data, Uyeki said that oseltamivir — the generic name for antivirals that include Tamiflu — can improve survival against the worst flu complications, especially when the drug is compared to no treatment at all.\u003c/p>\n\u003cp>\u003cstrong>Reviewing The Evidence\u003cbr>\n\u003c/strong>But Doshi said the leap from ‘reducing symptoms’ to ‘preventing complications’ is a stretch. When asked if Tamiflu provides additional benefits against the worst of the flu, Doshi said, “That’s where the evidence gets very dicey very quickly.”\u003c/p>\n\u003cp>In 2009, Doshi’s team got a\u003ca href=\"http://www.bmj.com/content/bmj/suppl/2009/12/07/bmj.b5106.DC1/jeft726562.ww1_default.pdf\" target=\"_blank\" rel=\"noopener\"> tip from a pediatrician\u003c/a> that the data for the Tamiflu clinical trials were not publicly accessible. This pediatrician noticed the claims on Tamiflu’s effectiveness were based on manufacturer-funded studies. That discovery prompted Doshi’s three-year effort to obtain and analyze the studies behind Tamiflu’s FDA approval.\u003c/p>\n\u003cp>Doshi’s team concluded in a 2014 \u003ca href=\"http://www.bmj.com/content/348/bmj.g2545\" target=\"_blank\" rel=\"noopener\">Cochrane review\u003c/a> article that the \u003ca href=\"http://www.bmj.com/content/348/bmj.g2545\" target=\"_blank\" rel=\"noopener\">clinical trial data\u003c/a> did not support the broader claims made about Tamiflu. The team looked at clinical study reports for 83 trials and found no improvement for admission-to-hospital rates, pneumonia or bronchitis. However, they did see a more than 50 percent reduction in influenza symptoms.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Uyeki said Doshi’s review has had a tremendous influence because of the worldwide reach of\u003ca href=\"http://www.bmj.com/content/348/bmj.g2545\"> Cochrane\u003c/a>, but added that the results are misleading.\u003c/p>\n\u003cp>Uyeki called Doshi’s evidence “watered down” because it relied on patients who had influenza-like symptoms, but were not necessarily confirmed by laboratory testing to have the flu. Many different viral infections and some bacterial infections can mimic “flu-like” symptoms. So if one patient received Tamiflu and did not have the flu, then he or she may have skewed Doshi’s data, Uyeki said.\u003c/p>\n\u003cp>The Cochrane review focused on “influenza-like” illness as an outcome because that’s “the thing people want to avoid,” Doshi said, adding that the outcomes with pneumonia and hospitalizations are the same, regardless of whether you’re looking at flu-like cases or lab-confirmed cases.\u003c/p>\n\u003cp>Govorkova said that Tamiflu can reduce the chances of catching pneumonia.\u003c/p>\n\u003cp>She explains: Pneumonia is caused by bacteria, not the influenza virus. But the flu virus, in some cases, can predispose receptors on the epithelial cells lining our throats and lungs to become infected with pneumonia-causing bacteria.\u003c/p>\n\u003cp>“[Tamiflu] is not for the treatment of pneumonia — you must use antibiotics,” Govorkova said. “But because [Tamiflu] is very specific for influenza virus, if you start early, you can eliminate influenza virus from the body. And because of that, pneumonia cannot occur.”\u003c/p>\n\u003cp>Doctors may also prescribe Tamiflu in cases, she said, when another remedy isn’t available — \u003ca href=\"https://academic.oup.com/jid/article/202/8/1149/926161\" target=\"_blank\" rel=\"noopener\">such as during avian\u003c/a> H5N1 influenza outbreaks. “Vaccines were not available for prevention purposes, so they were giving Tamiflu even after 48 hours of exposure,” Govorkova said.\u003c/p>\n\u003cp>\u003cstrong>Why This Debate Matters\u003cbr>\n\u003c/strong>Doshi and Uyeki do agree that underlying chronic conditions — like asthma, obesity, diabetes and heart disease — can worsen a flu case by expanding the amount of time the virus spends multiplying.\u003c/p>\n\u003cp>…patients should consult their doctors on whether Tamiflu could be helpful. They should also make sure to take the full course of medicine.\u003c/p>\n\u003cp>But with the flood of alarming media and rising flu-related hospitalizations, Doshi worries people will begin to count on Tamiflu to save lives. He said viral stories, such as those about a Texas \u003ca href=\"http://www.bbc.com/news/world-us-canada-43039036\" target=\"_blank\" rel=\"noopener\">teacher\u003c/a> or a New Hampshire \u003ca href=\"http://www.dailymail.co.uk/health/article-5331999/Mother-four-killed-flu-refusing-Tamiflu.html\" target=\"_blank\" rel=\"noopener\">mother\u003c/a>, that link their flu-related deaths to refusing Tamiflu, lead people to believe Tamiflu is a “wonder drug” that could help the situation in the first place.\u003c/p>\n\u003cp>“[Those stories] project this sense that we’re certain that if only she had taken Tamiflu she would be alive today, and we don’t have any evidence to know that that’s the case,” Doshi said. “So it really spreads a dangerous message.\u003c/p>\n\u003cp>Govorkova said patients should consult their doctors on whether Tamiflu could be helpful. They should also make sure to take the full course of medicine.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some people drop out early or take it once a day rather than twice a day, she said, and this should be avoided because it can cause the emergence of Tamiflu-resistant flu strains.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440049/does-tamiflu-work","authors":["byline_futureofyou_440049"],"categories":["futureofyou_1060","futureofyou_1"],"tags":["futureofyou_190","futureofyou_952","futureofyou_662","futureofyou_61","futureofyou_1056"],"collections":["futureofyou_1093"],"featImg":"futureofyou_440051","label":"source_futureofyou_440049"},"futureofyou_439726":{"type":"posts","id":"futureofyou_439726","meta":{"index":"posts_1591205157","site":"futureofyou","id":"439726","score":null,"sort":[1519350794000]},"guestAuthors":[],"slug":"us-panel-says-its-okay-to-use-nasal-spray-flu-vaccine-again","title":"U.S. Panel Says it's Okay to Use Nasal Spray Flu Vaccine Again","publishDate":1519350794,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"term":1093,"site":"futureofyou"},"content":"\u003cp>It's OK for doctors to start using a kid-friendly nasal spray flu vaccine again, a federal panel said Wednesday.\u003c/p>\n\u003cp>Two years ago, the advisory group pulled its recommendation for FluMist vaccine after research found it wasn't working against swine flu, the kind of flu that was making most people sick then. But the Advisory Committee of Immunization Practices voted 12-2 Wednesday to recommend the nasal spray as an option for next winter's flu season.\u003c/p>\n\u003cp>An official from AstraZeneca, the company that makes FluMist, said the problem with the vaccine has been identified and corrected. But panel members noted there's still not good proof that FluMist works well against the swine flu bug.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The AstraZeneca product was once considered the best childhood flu vaccine on the market .’\u003c/aside>\n\u003cp>\"This is not an easy decision. It's always a challenge to make a decision with incomplete data,\" said one panel member, Dr. Edward Belongia of the Wisconsin-based Marshfield Clinic Research Foundation.\u003c/p>\n\u003cp>The panel makes its recommendations to the Centers for Disease Control and Prevention, which usually accepts the advice and sends it along as guidance to doctors, hospitals and health insurers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>FluMist is the only spray-in-the-nose vaccine on the market. It was first licensed in 2003 and is approved for healthy people ages 2 to 49. Unlike shots made from a killed virus, it is made from a live but weakened flu virus.\u003c/p>\n\u003cp>The AstraZeneca product was once considered the best childhood flu vaccine on the market and accounted for about a third of all child vaccinations. But in 2016, the committee rescinded its recommendation of FluMist after federal study results showed it provided no protection from the 2009 swine flu strain that made most people sick the previous year. It remained on the market, but for the past two winters federal officials have not been recommending that doctors give it.[contextly_sidebar id=\"Hrou1Nwf7eYT3yzBWaRGfQJaw6JOSBDA\"]\u003c/p>\n\u003cp>AstraZeneca has changed the way it tests and selects strains for the vaccine, said Dr. Raburn Mallory, a company official, speaking at the panel meeting in Atlanta. It's been difficult for researchers to check how well the revised product works, in part because in the last two years another type of flu — not swine flu — has caused most of each season's illnesses.\u003c/p>\n\u003cp>Studies have suggested that while FluMist fell down against swine flu, it has been effective against other types of flu.\u003c/p>\n\u003cp>That makes it better than nothing, panel members said. And FluMist is appealing because it is easier to give to kids who fear needles.\u003c/p>\n\u003cp>Some experts at the meeting worried the panel's decision could further damage public confidence in flu vaccines. If FluMist should fail to protect children during a bad flu season in the future, \"that's a potential disaster,\" said Dr. Sean O'Leary of the Pediatric infectious Diseases Society.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Last week, a government study found the flu shot was doing a poor job this winter. The flu vaccine changes from year to year, depending on what flu bugs are going around.\u003c/p>\n\n","blocks":[],"excerpt":"FluMist was once considered the best childhood flu vaccine on the market and accounted for about a third of all child vaccinations.","status":"publish","parent":0,"modified":1519670843,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":515},"headData":{"title":"U.S. Panel Says it's Okay to Use Nasal Spray Flu Vaccine Again | KQED","description":"FluMist was once considered the best childhood flu vaccine on the market and accounted for about a third of all child vaccinations.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"439726 https://ww2.kqed.org/futureofyou/?p=439726","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/02/22/us-panel-says-its-okay-to-use-nasal-spray-flu-vaccine-again/","disqusTitle":"U.S. Panel Says it's Okay to Use Nasal Spray Flu Vaccine Again","nprByline":"Mike Stobbe\u003cbr />Associated Press","path":"/futureofyou/439726/us-panel-says-its-okay-to-use-nasal-spray-flu-vaccine-again","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's OK for doctors to start using a kid-friendly nasal spray flu vaccine again, a federal panel said Wednesday.\u003c/p>\n\u003cp>Two years ago, the advisory group pulled its recommendation for FluMist vaccine after research found it wasn't working against swine flu, the kind of flu that was making most people sick then. But the Advisory Committee of Immunization Practices voted 12-2 Wednesday to recommend the nasal spray as an option for next winter's flu season.\u003c/p>\n\u003cp>An official from AstraZeneca, the company that makes FluMist, said the problem with the vaccine has been identified and corrected. But panel members noted there's still not good proof that FluMist works well against the swine flu bug.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The AstraZeneca product was once considered the best childhood flu vaccine on the market .’\u003c/aside>\n\u003cp>\"This is not an easy decision. It's always a challenge to make a decision with incomplete data,\" said one panel member, Dr. Edward Belongia of the Wisconsin-based Marshfield Clinic Research Foundation.\u003c/p>\n\u003cp>The panel makes its recommendations to the Centers for Disease Control and Prevention, which usually accepts the advice and sends it along as guidance to doctors, hospitals and health insurers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>FluMist is the only spray-in-the-nose vaccine on the market. It was first licensed in 2003 and is approved for healthy people ages 2 to 49. Unlike shots made from a killed virus, it is made from a live but weakened flu virus.\u003c/p>\n\u003cp>The AstraZeneca product was once considered the best childhood flu vaccine on the market and accounted for about a third of all child vaccinations. But in 2016, the committee rescinded its recommendation of FluMist after federal study results showed it provided no protection from the 2009 swine flu strain that made most people sick the previous year. It remained on the market, but for the past two winters federal officials have not been recommending that doctors give it.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>AstraZeneca has changed the way it tests and selects strains for the vaccine, said Dr. Raburn Mallory, a company official, speaking at the panel meeting in Atlanta. It's been difficult for researchers to check how well the revised product works, in part because in the last two years another type of flu — not swine flu — has caused most of each season's illnesses.\u003c/p>\n\u003cp>Studies have suggested that while FluMist fell down against swine flu, it has been effective against other types of flu.\u003c/p>\n\u003cp>That makes it better than nothing, panel members said. And FluMist is appealing because it is easier to give to kids who fear needles.\u003c/p>\n\u003cp>Some experts at the meeting worried the panel's decision could further damage public confidence in flu vaccines. If FluMist should fail to protect children during a bad flu season in the future, \"that's a potential disaster,\" said Dr. Sean O'Leary of the Pediatric infectious Diseases Society.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Last week, a government study found the flu shot was doing a poor job this winter. The flu vaccine changes from year to year, depending on what flu bugs are going around.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/439726/us-panel-says-its-okay-to-use-nasal-spray-flu-vaccine-again","authors":["byline_futureofyou_439726"],"categories":["futureofyou_1060"],"tags":["futureofyou_491","futureofyou_952","futureofyou_662","futureofyou_61"],"collections":["futureofyou_1093"],"featImg":"futureofyou_439727","label":"futureofyou_1093"},"futureofyou_439690":{"type":"posts","id":"futureofyou_439690","meta":{"index":"posts_1591205157","site":"futureofyou","id":"439690","score":null,"sort":[1519315507000]},"guestAuthors":[],"slug":"okay-your-flu-symptoms-are-better-but-are-you-still-contagious","title":"Okay, Your Flu Symptoms are Better. But Are You Still Contagious? (Video)","publishDate":1519315507,"format":"aside","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>https://www.youtube.com/watch?time_continue=28&v=XOPJ5IzE0Og\u003c/p>\n\u003cp>It's shaping up to be one of the worst flu seasons in years.\u003c/p>\n\u003cp>If you are one of the thousands of Americans who are sick with the flu, this one's for you.\u003c/p>\n\u003cp>You've spent the past couple of days cooped up in your house watching bad TV, fighting the fever sweats and expelling a baffling amount of mucus. As you start to resemble a human being again, you might feel pressure to head back to work.\u003c/p>\n\u003cp>But when is it really OK to return? Many people go back as soon as their symptoms start to resolve, which could be putting your co-workers at risk.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Those unpleasant symptoms are actually the result of your immune response battling the flu virus. Take fever for example. Your body starts a fever because the flu virus \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/7069233\" target=\"_blank\" rel=\"noopener\">doesn't grow\u003c/a> as well at high temperatures, and some immune cells actually \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/21873456\" target=\"_blank\" rel=\"noopener\">work better\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The CDC says you are contagious one day before you start feeling sick and up to seven days after.'\u003c/aside>\n\u003cp>All that gooey mucus you've been coughing up is good at trapping viruses before they can infect other cells.Your body is in an all out war, you against the virus. Immune cells seek out and destroy virus-infected cells.\u003c/p>\n\u003cp>As your airways get irritated, you cough and sneeze. And that's exactly what the flu wants. That's because the flu is spread from person to person in virus-containing droplets that are produced when a sick person coughs, sneezes or even \u003ca href=\"http://www.pnas.org/content/early/2018/01/17/1716561115\">breathes\u003c/a>. When you cough, tiny droplets that fly from your mouth can travel as far as \u003ca href=\"https://www.nature.com/news/the-snot-spattered-experiments-that-show-how-far-sneezes-really-spread-1.19996\" target=\"_blank\" rel=\"noopener\">20 feet\u003c/a> at speeds ranging from 25-50 mph. Sometimes they can stay suspended for hours.\u003c/p>\n\u003cp>If someone inhales those particles, they can become infected. The flu can even be transmitted if someone touches a surface contaminated with flu and then touches her face or mouth. That's why hand-washing is so important when you're sick. But the best way to prevent spreading the flu is to stay home if you can.\u003cbr>\n[contextly_sidebar id=\"A90TDK2AFCB9ZOL4Hj4FHr3qh04zHlfs\"]\u003cbr>\nSo how long are you really contagious with the flu?\u003c/p>\n\u003cp>The CDC says you are contagious one day before you start feeling sick and up to seven days after. If you're a kid, elderly, or have a weak immune system, you can be contagious for even longer.\u003c/p>\n\u003cp>NPR's Skunk Bear gives us an inside glimpse into how your body fights the flu, and when it's a good idea to head back to work.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Madeline Sofia, Meredith Rizzo, Adam Cole and Ryan Kellman produced this video for NPR. \u003ca href=\"http://www.danielasherer.com/about\" target=\"_blank\" rel=\"noopener\">Daniela Sherer\u003c/a>\u003c/em>\u003cem> created original animations for the video.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit\u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\"> http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+Long+Are+You+Contagious+With+The+Flu%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Finally getting out from under the flu? You can spread the flu for longer than you might think.","status":"publish","parent":0,"modified":1519407834,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":468},"headData":{"title":"Okay, Your Flu Symptoms are Better. But Are You Still Contagious? (Video) | KQED","description":"Finally getting out from under the flu? You can spread the flu for longer than you might think.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"439690 https://ww2.kqed.org/futureofyou/?p=439690","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/02/22/okay-your-flu-symptoms-are-better-but-are-you-still-contagious/","disqusTitle":"Okay, Your Flu Symptoms are Better. But Are You Still Contagious? (Video)","nprByline":"Meredith Rizzo\u003cbr />NPR Shots","nprImageAgency":"Skunk Bear/NPR","nprStoryId":"585143079","nprApiLink":"http://api.npr.org/query?id=585143079&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/02/20/585143079/how-long-are-you-contagious-with-the-flu?ft=nprml&f=585143079","nprRetrievedStory":"1","nprPubDate":"Tue, 20 Feb 2018 17:31:00 -0500","nprStoryDate":"Tue, 20 Feb 2018 05:00:00 -0500","nprLastModifiedDate":"Tue, 20 Feb 2018 17:31:40 -0500","path":"/futureofyou/439690/okay-your-flu-symptoms-are-better-but-are-you-still-contagious","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/XOPJ5IzE0Og'\n title='//www.youtube.com/embed/XOPJ5IzE0Og'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>It's shaping up to be one of the worst flu seasons in years.\u003c/p>\n\u003cp>If you are one of the thousands of Americans who are sick with the flu, this one's for you.\u003c/p>\n\u003cp>You've spent the past couple of days cooped up in your house watching bad TV, fighting the fever sweats and expelling a baffling amount of mucus. As you start to resemble a human being again, you might feel pressure to head back to work.\u003c/p>\n\u003cp>But when is it really OK to return? Many people go back as soon as their symptoms start to resolve, which could be putting your co-workers at risk.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Those unpleasant symptoms are actually the result of your immune response battling the flu virus. Take fever for example. Your body starts a fever because the flu virus \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/7069233\" target=\"_blank\" rel=\"noopener\">doesn't grow\u003c/a> as well at high temperatures, and some immune cells actually \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/21873456\" target=\"_blank\" rel=\"noopener\">work better\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The CDC says you are contagious one day before you start feeling sick and up to seven days after.'\u003c/aside>\n\u003cp>All that gooey mucus you've been coughing up is good at trapping viruses before they can infect other cells.Your body is in an all out war, you against the virus. Immune cells seek out and destroy virus-infected cells.\u003c/p>\n\u003cp>As your airways get irritated, you cough and sneeze. And that's exactly what the flu wants. That's because the flu is spread from person to person in virus-containing droplets that are produced when a sick person coughs, sneezes or even \u003ca href=\"http://www.pnas.org/content/early/2018/01/17/1716561115\">breathes\u003c/a>. When you cough, tiny droplets that fly from your mouth can travel as far as \u003ca href=\"https://www.nature.com/news/the-snot-spattered-experiments-that-show-how-far-sneezes-really-spread-1.19996\" target=\"_blank\" rel=\"noopener\">20 feet\u003c/a> at speeds ranging from 25-50 mph. Sometimes they can stay suspended for hours.\u003c/p>\n\u003cp>If someone inhales those particles, they can become infected. The flu can even be transmitted if someone touches a surface contaminated with flu and then touches her face or mouth. That's why hand-washing is so important when you're sick. But the best way to prevent spreading the flu is to stay home if you can.\u003cbr>\n\u003c/p>\u003cp>\u003c/p>\u003cp>\u003cbr>\nSo how long are you really contagious with the flu?\u003c/p>\n\u003cp>The CDC says you are contagious one day before you start feeling sick and up to seven days after. If you're a kid, elderly, or have a weak immune system, you can be contagious for even longer.\u003c/p>\n\u003cp>NPR's Skunk Bear gives us an inside glimpse into how your body fights the flu, and when it's a good idea to head back to work.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Madeline Sofia, Meredith Rizzo, Adam Cole and Ryan Kellman produced this video for NPR. \u003ca href=\"http://www.danielasherer.com/about\" target=\"_blank\" rel=\"noopener\">Daniela Sherer\u003c/a>\u003c/em>\u003cem> created original animations for the video.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit\u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\"> http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+Long+Are+You+Contagious+With+The+Flu%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/439690/okay-your-flu-symptoms-are-better-but-are-you-still-contagious","authors":["byline_futureofyou_439690"],"categories":["futureofyou_1"],"tags":["futureofyou_662","futureofyou_61","futureofyou_652"],"featImg":"futureofyou_439691","label":"futureofyou"},"futureofyou_439106":{"type":"posts","id":"futureofyou_439106","meta":{"index":"posts_1591205157","site":"futureofyou","id":"439106","score":null,"sort":[1517599076000]},"guestAuthors":[],"slug":"flu-vaccine-this-year-was-a-dud-according-to-early-data","title":"Flu Vaccine This Year Was a Dud According to Early Data","publishDate":1517599076,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>As the country battles an especially fierce flu season, experts have struggled to explain why one family of virus — the influenza A virus H3N2 — that has infected a lot of people in recent years is causing so much damage again this winter.\u003c/p>\n\u003cp>[contextly_sidebar id=\"pMmCXaibLUwxTcHOuOXFWa0DdskcP6kV\"]Now, new data from north of the border sheds some light on the question.\u003c/p>\n\u003cp>Canadian influenza researchers reported Thursday in the online journal \u003cem>Eurosurveillance\u003c/em> that the first reckoning of how well the flu vaccine is protecting against H3N2 viruses this year in North America has a dismal answer: not very.\u003c/p>\n\u003cp>Their midseason estimate, based on data from the four provinces where roughly 80 percent of Canadians live, suggested that the H3N2 component of the vaccine is 17 percent effective at preventing infection. Last year it was estimated at 37 percent in Canada and 34 percent in the U.S.\u003c/p>\n\u003cp>Public health authorities have come to expect protection against H3N2 — the weak link of the vaccine — to be in the low-to-mid 30 percent range at best. But this estimate is half that. And the fact that it was so much lower came as a surprise to the Centers for Disease Control and Prevention’s flu experts, who have yet to analyze their midseason flu vaccine effectiveness data.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It was lower than what the Canadians or we experienced last year,” said Alicia Fry, head of epidemiology for the CDC’s influenza division. Given that there haven’t been major changes in the viruses, “it is a surprising result.”\u003c/p>\n\u003cp>Fry said the CDC surveillance network will stop collecting data for their interim analysis next week, and the agency will publish their findings mid-month. Both teams will also reanalyze their surveillance data at the end of the season, when more data typically brings a sharper focus to the findings.\u003c/p>\n\u003cp>The new research also reported that — at least in Canada — a new subgroup of the H3N2 clan has become the dominant H3N2 viruses causing illness this season. It may be that the vaccine isn’t targeting that group of viruses effectively. The U.S. is seeing a similar pattern, said Jacqueline Katz, deputy director of the CDC’s influenza division.\u003c/p>\n\u003cp>Whatever the reason, the findings confirm the fact that people who’ve been vaccinated are among those contracting flu this season.\u003c/p>\n\u003cp>“This is low protection. And the overall message is: People who have been vaccinated should not consider themselves invincible against this H3N2 virus that’s circulating,” said Dr. Danuta Skowronski, lead author of the report and an influenza epidemiologist at the British Columbia Center for Disease Control.\u003c/p>\n\u003cp>“That means getting early medical care, antiviral treatment for those at high risk of influenza complications. That’s the main value of reporting these midseason estimates.”\u003c/p>\n\u003cp>In working-age adults, the estimated protection is lower still: 10 percent. That is in line with the protection level Australia saw in its harsh winter 2017 flu season.\u003c/p>\n\u003cp>Because of the small number of people studied — 689 — the confidence intervals around the estimates are wide. You can think of them as the margins of error around a polling number that is said to be accurate within, for example, 3 percentage points up or down.\u003c/p>\n\u003cp>And in the case of the assessment of the H3N2 component, the confidence intervals cross zero, which means the researchers cannot rule out the possibility there was no benefit from that part of the vaccine. But based on statistical calculations, the 17 percent overall and 10 percent among working-age adults is more likely to be correct, Skowronski said.\u003c/p>\n\u003cp>That low protection level among working-age adults could explain why the CDC has reported unusually high flu hospitalization rates among people aged 50 to 64 this year.\u003c/p>\n\u003cp>The Canadian data may provide clues into what is happening in the United States. But flu season activity varies across geographic regions, and it will be important to see U.S. data to see if the Canadian patterns are reflective of what is happening here.\u003c/p>\n\u003cp>It’s already clear they are not a perfect match. There is considerably more influenza B illness in Canada this year than there has been in the U.S. In fact, where flu B infections make up less than 20 percent of lab-confirmed flu cases here so far this year, the corresponding figure in Canada is about 40 percent. And in this study, flu B infections made up 51 percent of the confirmed flu cases.\u003c/p>\n\u003cp>The vaccine’s performance against influenza B viruses was substantially better than it was against H3N2. The study estimated the flu shot protected about 55 percent of people who received it against influenza B viruses.\u003c/p>\n\u003cp>That’s especially interesting given that most of the flu shots given in Canada targeted the wrong flu B viruses.\u003c/p>\n\u003cp>There are two lineages of influenza B viruses. Some flu shots target both, but older products contain protection against just one. More than two-thirds of the vaccines used in Canada protect against only one B virus, and this year the virus included in those products is not the one causing the most illness.\u003c/p>\n\u003cp>Even though the two B viruses are quite different genetically, the vaccine appears to be offering cross-protection, Skowronski said.\u003c/p>\n\u003cp>More than three-quarters of flu vaccines used in the U.S. target both flu B viruses.\u003c/p>\n\u003cp>The report does not estimate how well this year’s vaccine protects against H1N1 viruses. Skowronski said there has simply been too little H1N1 disease in Canada so far this winter to make that calculation. Fry said the CDC hopes to be able to give an estimate of how well the H1N1 component of the vaccine is working.\u003c/p>\n\u003cp>Likewise, the Canadian team could not estimate how protective the vaccine has been against H3N2 in children. The end-of-season analysis should be able to answer that question, she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\"> This \u003ca href=\"https://www.statnews.com/2018/02/01/flu-vaccine-protection-h3n2/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery. \u003c/span>\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"One family of virus known as influenza A H3N2, which has infected many people in recent years, is causing a lot of illness again this winter.","status":"publish","parent":0,"modified":1517625679,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1026},"headData":{"title":"Flu Vaccine This Year Was a Dud According to Early Data | KQED","description":"One family of virus known as influenza A H3N2, which has infected many people in recent years, is causing a lot of illness again this winter.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"439106 https://ww2.kqed.org/futureofyou/?p=439106","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/02/02/flu-vaccine-this-year-was-a-dud-according-to-early-data/","disqusTitle":"Flu Vaccine This Year Was a Dud According to Early Data","source":"KQED Future of You","nprByline":"Helen Branswell\u003cbr />\u003ca href=\"https://www.statnews.com/\">STAT\u003c/a>","path":"/futureofyou/439106/flu-vaccine-this-year-was-a-dud-according-to-early-data","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>As the country battles an especially fierce flu season, experts have struggled to explain why one family of virus — the influenza A virus H3N2 — that has infected a lot of people in recent years is causing so much damage again this winter.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Now, new data from north of the border sheds some light on the question.\u003c/p>\n\u003cp>Canadian influenza researchers reported Thursday in the online journal \u003cem>Eurosurveillance\u003c/em> that the first reckoning of how well the flu vaccine is protecting against H3N2 viruses this year in North America has a dismal answer: not very.\u003c/p>\n\u003cp>Their midseason estimate, based on data from the four provinces where roughly 80 percent of Canadians live, suggested that the H3N2 component of the vaccine is 17 percent effective at preventing infection. Last year it was estimated at 37 percent in Canada and 34 percent in the U.S.\u003c/p>\n\u003cp>Public health authorities have come to expect protection against H3N2 — the weak link of the vaccine — to be in the low-to-mid 30 percent range at best. But this estimate is half that. And the fact that it was so much lower came as a surprise to the Centers for Disease Control and Prevention’s flu experts, who have yet to analyze their midseason flu vaccine effectiveness data.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It was lower than what the Canadians or we experienced last year,” said Alicia Fry, head of epidemiology for the CDC’s influenza division. Given that there haven’t been major changes in the viruses, “it is a surprising result.”\u003c/p>\n\u003cp>Fry said the CDC surveillance network will stop collecting data for their interim analysis next week, and the agency will publish their findings mid-month. Both teams will also reanalyze their surveillance data at the end of the season, when more data typically brings a sharper focus to the findings.\u003c/p>\n\u003cp>The new research also reported that — at least in Canada — a new subgroup of the H3N2 clan has become the dominant H3N2 viruses causing illness this season. It may be that the vaccine isn’t targeting that group of viruses effectively. The U.S. is seeing a similar pattern, said Jacqueline Katz, deputy director of the CDC’s influenza division.\u003c/p>\n\u003cp>Whatever the reason, the findings confirm the fact that people who’ve been vaccinated are among those contracting flu this season.\u003c/p>\n\u003cp>“This is low protection. And the overall message is: People who have been vaccinated should not consider themselves invincible against this H3N2 virus that’s circulating,” said Dr. Danuta Skowronski, lead author of the report and an influenza epidemiologist at the British Columbia Center for Disease Control.\u003c/p>\n\u003cp>“That means getting early medical care, antiviral treatment for those at high risk of influenza complications. That’s the main value of reporting these midseason estimates.”\u003c/p>\n\u003cp>In working-age adults, the estimated protection is lower still: 10 percent. That is in line with the protection level Australia saw in its harsh winter 2017 flu season.\u003c/p>\n\u003cp>Because of the small number of people studied — 689 — the confidence intervals around the estimates are wide. You can think of them as the margins of error around a polling number that is said to be accurate within, for example, 3 percentage points up or down.\u003c/p>\n\u003cp>And in the case of the assessment of the H3N2 component, the confidence intervals cross zero, which means the researchers cannot rule out the possibility there was no benefit from that part of the vaccine. But based on statistical calculations, the 17 percent overall and 10 percent among working-age adults is more likely to be correct, Skowronski said.\u003c/p>\n\u003cp>That low protection level among working-age adults could explain why the CDC has reported unusually high flu hospitalization rates among people aged 50 to 64 this year.\u003c/p>\n\u003cp>The Canadian data may provide clues into what is happening in the United States. But flu season activity varies across geographic regions, and it will be important to see U.S. data to see if the Canadian patterns are reflective of what is happening here.\u003c/p>\n\u003cp>It’s already clear they are not a perfect match. There is considerably more influenza B illness in Canada this year than there has been in the U.S. In fact, where flu B infections make up less than 20 percent of lab-confirmed flu cases here so far this year, the corresponding figure in Canada is about 40 percent. And in this study, flu B infections made up 51 percent of the confirmed flu cases.\u003c/p>\n\u003cp>The vaccine’s performance against influenza B viruses was substantially better than it was against H3N2. The study estimated the flu shot protected about 55 percent of people who received it against influenza B viruses.\u003c/p>\n\u003cp>That’s especially interesting given that most of the flu shots given in Canada targeted the wrong flu B viruses.\u003c/p>\n\u003cp>There are two lineages of influenza B viruses. Some flu shots target both, but older products contain protection against just one. More than two-thirds of the vaccines used in Canada protect against only one B virus, and this year the virus included in those products is not the one causing the most illness.\u003c/p>\n\u003cp>Even though the two B viruses are quite different genetically, the vaccine appears to be offering cross-protection, Skowronski said.\u003c/p>\n\u003cp>More than three-quarters of flu vaccines used in the U.S. target both flu B viruses.\u003c/p>\n\u003cp>The report does not estimate how well this year’s vaccine protects against H1N1 viruses. Skowronski said there has simply been too little H1N1 disease in Canada so far this winter to make that calculation. Fry said the CDC hopes to be able to give an estimate of how well the H1N1 component of the vaccine is working.\u003c/p>\n\u003cp>Likewise, the Canadian team could not estimate how protective the vaccine has been against H3N2 in children. The end-of-season analysis should be able to answer that question, she said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\"> This \u003ca href=\"https://www.statnews.com/2018/02/01/flu-vaccine-protection-h3n2/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery. \u003c/span>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/439106/flu-vaccine-this-year-was-a-dud-according-to-early-data","authors":["byline_futureofyou_439106"],"categories":["futureofyou_452","futureofyou_1","futureofyou_73"],"tags":["futureofyou_1275","futureofyou_662","futureofyou_1455"],"featImg":"futureofyou_439123","label":"source_futureofyou_439106"},"futureofyou_438569":{"type":"posts","id":"futureofyou_438569","meta":{"index":"posts_1591205157","site":"futureofyou","id":"438569","score":null,"sort":[1516321510000]},"guestAuthors":[],"slug":"another-reason-why-you-still-need-a-flu-shot-this-year","title":"Another Reason Why You Still Need a Flu Shot This Year","publishDate":1516321510,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>\u003cspan style=\"font-weight: 400\">It could be a whole lot easier to get the flu than you thought: A new study finds it doesn't take someone coughing or sneezing near you -- just breathing may be enough.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The study from San Jose State University, UC Berkeley and others looked for infectious virus in coughs, sneezes and exhaled air from people with the flu, and found 35 percent of samples of exhaled air contained it.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"So when someone is coming down with influenza, they should go home,\" says Dr. Donald Milton of the University of Maryland School of Public Health, \"and not remain in the workplace and infect others.\"\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'We're not sure we've seen the peak of flu season yet.'\u003ccite>Dr. Richard Webby,\u003cbr>\nSt. Jude Children's Research Hospital and WHO\u003c/cite>\u003c/aside>\n\u003cp>This is a particularly bad year for influenza. Flu cases are continuing to rise in California, and are\u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/Immunization/Week2017-1801_FINALReport.pdf\">\u003cspan style=\"font-weight: 400\"> higher for this time of year\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> than in the previous five years. During the first week of 2018, the California Department of Public Health reported 15 deaths of people under the age of 65, bringing the state’s total deaths this flu season to 42.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“With the increase in influenza impacting many communities across the entire state, it is important to get a flu shot now if you have not done so already,” CDPH Director Karen Smith said in a\u003c/span>\u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/NR18-003.aspx\"> \u003cspan style=\"font-weight: 400\">statement\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Adults ages 18 through 49 get a flu shot at much lower rates than others. If you're thinking that a flu shot won't really help you, because you've heard it's only 30 percent effective, think again. There are many strains of flu, and the shot can protect you against three or four of them. The 30 percent figure applies only to the dominant strain this year -- your shot might protect you from completely different strains.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/ww2.kqed_.orgflu-1-d94c6f6333c37ebdfc7-2a73434118befd5f08e2e6b0395e6ae543930c27.jpg\">\u003cimg class=\"alignright wp-image-438276\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/ww2.kqed_.orgflu-1-d94c6f6333c37ebdfc7-2a73434118befd5f08e2e6b0395e6ae543930c27.jpg\" alt=\"\" width=\"390\" height=\"292\">\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">It’s possible, for example, that later in the flu season influenza B could become active -- that's a strain that the current vaccine is effective against, says Dr. Richard Webby, a member of the Department of Infectious diseases at St. Jude Children’s Research Hospital, and of the World Health Organization team that formulates the flu vaccine. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Also, it isn't just about you, points out Aaron E. Carroll, a professor of pediatrics at Indiana School of Medicine, in a recent\u003c/span>\u003ca href=\"https://www.nytimes.com/2018/01/15/upshot/flu-shot-deaths-herd-immunity.html\"> \u003cspan style=\"font-weight: 400\">New York Times\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> post.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"You don’t get immunized just to protect yourself,\" Carroll writes. \"You also get immunized to protect those who can’t protect themselves.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">That means people like babies who are too young to get the shots and people with compromised immune systems.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Carroll says in the 2015 to 2016 season, flu shots prevented an estimated 3,000 deaths. Yet, in that same season:\u003c/span>\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">\"If just 5 percent more people had been immunized, we could have probably avoided 500,000 illnesses, 230,000 medical visits and 6,000 hospitalizations … Less than 50 percent of children are immunized against the flu. About two-thirds of people 65 and older are. But only a third of adults 18 to 49 are.\"\u003c/span>\u003c/p>\u003c/blockquote>\n\u003cp>\u003cb>Why the Vaccine Isn't Perfect\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Currently, flu cases are dominated by a strain of influenza A called H3N2. And the problem this year is not that the WHO scientists got the strains wrong in the vaccine -- H3N2 is covered by the flu shot.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[contextly_sidebar id=\"be2kMFKFzFOLuQbbG0h32DXxbUQVd8FH\"]The problem is that the virus changes during the production of the vaccine.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Twice a year, WHO scientists meet to develop a flu vaccine: once for the world’s northern hemisphere and once for the southern. They do this about six months before the flu hits a given hemisphere, and they choose which viruses to include based on disease trends identified from laboratories worldwide.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Next, the viruses\u003c/span> \u003cspan style=\"font-weight: 400\">get injected into chicken eggs. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Sometimes the flu virus doesn’t like to grow in eggs that much,” Webby says. So it mutates to adapt to its new home.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The result is that the lab-grown H3N2 used in this season’s flu shot doesn’t quite match the H3N2 currently being spread in people. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We're really having a few difficulties getting the perfect match between these H3N2 viruses and the vaccine,” Webby says.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He adds that in the future, there are some ways scientists could improve the vaccine. It could be grown in a different medium instead of eggs, for example, to prevent the virus from mutating as much. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Meanwhile, Webby says flu activity this year could continue to increase. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We’re not sure we’ve seen the peak of flu season yet.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"The flu is a lot easier to get than you might think, and your immunity protects those you love.","status":"publish","parent":0,"modified":1517625736,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":782},"headData":{"title":"Another Reason Why You Still Need a Flu Shot This Year | KQED","description":"The flu is a lot easier to get than you might think, and your immunity protects those you love.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"438569 https://ww2.kqed.org/futureofyou/?p=438569","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/01/18/another-reason-why-you-still-need-a-flu-shot-this-year/","disqusTitle":"Another Reason Why You Still Need a Flu Shot This Year","nprByline":"Ula Chrobak\u003cbr />KQED Future of You","path":"/futureofyou/438569/another-reason-why-you-still-need-a-flu-shot-this-year","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">It could be a whole lot easier to get the flu than you thought: A new study finds it doesn't take someone coughing or sneezing near you -- just breathing may be enough.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The study from San Jose State University, UC Berkeley and others looked for infectious virus in coughs, sneezes and exhaled air from people with the flu, and found 35 percent of samples of exhaled air contained it.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"So when someone is coming down with influenza, they should go home,\" says Dr. Donald Milton of the University of Maryland School of Public Health, \"and not remain in the workplace and infect others.\"\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'We're not sure we've seen the peak of flu season yet.'\u003ccite>Dr. Richard Webby,\u003cbr>\nSt. Jude Children's Research Hospital and WHO\u003c/cite>\u003c/aside>\n\u003cp>This is a particularly bad year for influenza. Flu cases are continuing to rise in California, and are\u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/Immunization/Week2017-1801_FINALReport.pdf\">\u003cspan style=\"font-weight: 400\"> higher for this time of year\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> than in the previous five years. During the first week of 2018, the California Department of Public Health reported 15 deaths of people under the age of 65, bringing the state’s total deaths this flu season to 42.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“With the increase in influenza impacting many communities across the entire state, it is important to get a flu shot now if you have not done so already,” CDPH Director Karen Smith said in a\u003c/span>\u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/NR18-003.aspx\"> \u003cspan style=\"font-weight: 400\">statement\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Adults ages 18 through 49 get a flu shot at much lower rates than others. If you're thinking that a flu shot won't really help you, because you've heard it's only 30 percent effective, think again. There are many strains of flu, and the shot can protect you against three or four of them. The 30 percent figure applies only to the dominant strain this year -- your shot might protect you from completely different strains.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/ww2.kqed_.orgflu-1-d94c6f6333c37ebdfc7-2a73434118befd5f08e2e6b0395e6ae543930c27.jpg\">\u003cimg class=\"alignright wp-image-438276\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/ww2.kqed_.orgflu-1-d94c6f6333c37ebdfc7-2a73434118befd5f08e2e6b0395e6ae543930c27.jpg\" alt=\"\" width=\"390\" height=\"292\">\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">It’s possible, for example, that later in the flu season influenza B could become active -- that's a strain that the current vaccine is effective against, says Dr. Richard Webby, a member of the Department of Infectious diseases at St. Jude Children’s Research Hospital, and of the World Health Organization team that formulates the flu vaccine. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Also, it isn't just about you, points out Aaron E. Carroll, a professor of pediatrics at Indiana School of Medicine, in a recent\u003c/span>\u003ca href=\"https://www.nytimes.com/2018/01/15/upshot/flu-shot-deaths-herd-immunity.html\"> \u003cspan style=\"font-weight: 400\">New York Times\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> post.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"You don’t get immunized just to protect yourself,\" Carroll writes. \"You also get immunized to protect those who can’t protect themselves.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">That means people like babies who are too young to get the shots and people with compromised immune systems.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Carroll says in the 2015 to 2016 season, flu shots prevented an estimated 3,000 deaths. Yet, in that same season:\u003c/span>\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">\"If just 5 percent more people had been immunized, we could have probably avoided 500,000 illnesses, 230,000 medical visits and 6,000 hospitalizations … Less than 50 percent of children are immunized against the flu. About two-thirds of people 65 and older are. But only a third of adults 18 to 49 are.\"\u003c/span>\u003c/p>\u003c/blockquote>\n\u003cp>\u003cb>Why the Vaccine Isn't Perfect\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Currently, flu cases are dominated by a strain of influenza A called H3N2. And the problem this year is not that the WHO scientists got the strains wrong in the vaccine -- H3N2 is covered by the flu shot.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003cp>\u003c/p>\u003cp>The problem is that the virus changes during the production of the vaccine.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Twice a year, WHO scientists meet to develop a flu vaccine: once for the world’s northern hemisphere and once for the southern. They do this about six months before the flu hits a given hemisphere, and they choose which viruses to include based on disease trends identified from laboratories worldwide.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Next, the viruses\u003c/span> \u003cspan style=\"font-weight: 400\">get injected into chicken eggs. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Sometimes the flu virus doesn’t like to grow in eggs that much,” Webby says. So it mutates to adapt to its new home.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The result is that the lab-grown H3N2 used in this season’s flu shot doesn’t quite match the H3N2 currently being spread in people. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We're really having a few difficulties getting the perfect match between these H3N2 viruses and the vaccine,” Webby says.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He adds that in the future, there are some ways scientists could improve the vaccine. It could be grown in a different medium instead of eggs, for example, to prevent the virus from mutating as much. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Meanwhile, Webby says flu activity this year could continue to increase. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We’re not sure we’ve seen the peak of flu season yet.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/438569/another-reason-why-you-still-need-a-flu-shot-this-year","authors":["byline_futureofyou_438569"],"categories":["futureofyou_1"],"tags":["futureofyou_1275","futureofyou_662","futureofyou_80"],"featImg":"futureofyou_434648","label":"futureofyou"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. Plus, KQED’s Bianca Taylor brings you the local KQED news you need to know.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Consider-This-Podcast-Tile-703x703-1.jpg","imageAlt":"Consider This from NPR and KQED","officialWebsiteLink":"/podcasts/considerthis","meta":{"site":"news","source":"kqed","order":"7"},"link":"/podcasts/considerthis","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1503226625?mt=2&at=11l79Y&ct=nprdirectory","npr":"https://rpb3r.app.goo.gl/coronavirusdaily","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM1NS9wb2RjYXN0LnhtbA","spotify":"https://open.spotify.com/show/3Z6JdCS2d0eFEpXHKI6WqH"}},"forum":{"id":"forum","title":"Forum","tagline":"The conversation starts here","info":"KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.","airtime":"MON-FRI 9am-11am, 10pm-11pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED Forum with Mina Kim and Alexis Madrigal","officialWebsiteLink":"/forum","meta":{"site":"news","source":"kqed","order":"8"},"link":"/forum","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz","npr":"https://www.npr.org/podcasts/432307980/forum","stitcher":"https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast","rss":"https://feeds.megaphone.fm/KQINC9557381633"}},"freakonomics-radio":{"id":"freakonomics-radio","title":"Freakonomics Radio","info":"Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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