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What Your Dentist Should Be Telling You About Oral Cancer and HPV

April 6, 2018 1 comment

oral-cancer-monthI had my teeth cleaned yesterday, and while I was at the dentist I remembered that April is Oral Cancer Awareness Month. 

The dentist never mentioned it, but I knew just what she was doing when she put her gloves on and started rolling her fingers around the inside of my checks, under my tongue and on the outside of my neck and jaw.  She was doing what all oral health professionals should do – a thorough examination that could help with early detection of oropharyngeal cancers (also known as cancers of the throat and tongue) which are commonly caused by the human papillomavirus (HPV). 

As someone who has been diagnosed with two different cancers in the past, I no longer think “not me”.  Quite honestly, knowing how prevalent HPV is (it’s estimated that 80% of sexually active people will contract HPV at some point in their life) it’s probably more likely that I would be diagnosed with an HPV related cancer than many other types of cancer. Although most cases of HPV resolve without incident, the fact remains that approximately 14 million new cases of HPV occur in the U.S. each year, with at least 79 million people estimated to be currently infected and about 31,500 cases of HPV related cancers diagnosed in men and women each year in the U.S.. This includes cancers in the oropharynx, cervix, vagina, vulva, penis, and anus.  

While HPV can cause up to six different types of cancer, oral cancers are on the rise.  It’s estimated that HPV-associated oropharyngeal cancer affects about 16,400 people each year, and that by year 2020, it will become the most common HPV-related cancer in the US, surpassing cervical cancer.  

Here are a few other details to consider:

While I’m pleased that my dentist took the time to closely examine my neck, throat, mouth and tongue for any abnormalities, I’m disappointed that she didn’t take the opportunity to discuss the importance of HPV vaccination with me. 

Education of the public regarding the risk factors which lead to oral cancer, recognition of the early signs and symptoms, and the development of patient awareness, are primary responsibilities of the dental community.  

In 2017, the American Academy of Pediatric Dentistry (AAPD) issued a policy statement on HPV vaccination that encourages oral health care providers to educate patients and parents on the relationship of HPV to oral and oropharyngeal cancer and to counsel them regarding the HPV vaccination, in accordance with CDC recommendations. Currently, the CDC recommends two doses of HPV vaccination for girls and boys beginning at ages 11 or 12, but vaccination can be started at age 9 and can be administered through age 26 for females and age 21 for males.

Screen Shot 2018-04-06 at 10.36.56 AMWhile oral health professionals should be recommending HPV vaccination to all age-eligible patients, it would be prudent to also provide that information to patients who are parents. Although my dentist is not a pediatric dentist, my five children are also patients and we all get our regularly scheduled dental cleanings twice each year. 

At no point has anyone at this particular dental practice ever discussed oral cancer or HPV with me or any of my children, despite the fact that all five of my children are  considered “age-eligible”. (I know this because after my appointment yesterday, I asked my kids.)

Yesterday, my dentist failed to discuss HPV vaccination as a potential way to prevent oral and oropharyngeal cancers, which I consider to be a missed opportunity. However, during our collective twelve appointments each year for the past five years, it’s actually more like 60 enormous missed opportunities!

I get it.  Dentists may not be comfortable discussing vaccines. Or HPV.  But how comfortable can it be for them to have to tell their patients they may have oral cancer? How comfortable can it be for those patients who will end up having to suffer through an oral cancer that may have been preventable?

Fortunately, there are tests that can help detect HPV in women before they develop cervical cancer.  However, the same is not true for HPV-related head and neck cancers. These cancers typically develop in the throat at the base of the tongue, in the folds of the tonsils or the back of the throat, making them very difficult to detect. That is why regular dental exams can be vital. But prevention is always preferred to treatment, and HPV vaccination represents our best chance at prevention. 

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Since my dentist didn’t provide the information I feel all parents and patients deserve to know, I plan to bring them this action guide for Dental Health Providers, created by the National HPV Vaccination Roundtable when I return next week for my daughter’s visit. 

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According to the Oral Cancer Foundation, there are over 100,000 dentists in the U.S., each one seeing between 8 and 15 patients per day. If you include those patients who come to a practice and see someone other than the dentist, such as the hygienist, the number of patient visits is significantly higher. If they each did their part to educate their patients, imagine what a huge difference they could make in boosting HPV vaccination rates and reducing oral cancers.

Until we start seeing more dentist taking these types of actions,  please help spread the word about the association between HPV and oral cancers, during Oral Cancer Awareness Month and all throughout the year.

Below you will find additional resources regarding HPV vaccination and HPV-related head and neck cancers.  Here’s hoping that you never have to deal with an oral cancer diagnosis, like Jason Mendelsohn, Scott Vetter, Frank Summers and others.   


 

 


 

 


Other Resources:

Head and Neck Cancer Alliance

Oral Cancer Foundation

National HPV Vaccination Roundtable

Vaccinate Your Family Website: HPV Information

Research Article: Reduced Prevalence of Oral Human Papillomavirus (HPV) 4 Years after Bivalent HPV Vaccination in a Randomized Clinical Trial in Costa Rica

 

 

Updates from the Advisory Committee on Immunization Practices February Meeting

March 6, 2018 2 comments
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Photo Credit: James Gathany, Centers for Disease Control and Prevention

The Advisory Committee on Immunization Practices (ACIP) held its first meeting of 2018 on February 21st and 22nd.  The Committee consists of a panel of immunization experts that advise the Centers for Disease Control and Prevention (CDC).  Part of their charter is to continually evaluate new data and update or change vaccine recommendations as warranted. 

The agenda for the February 2018 meeting included presentations pertaining to several different diseases and vaccines, to include hepatitis, influenza, anthrax, HPV, pneumococcal, meningococcal and Japanese encephalitis.

A overview of the meeting is provided below, with details on presentations in the order they occurred: 

Hepatitis B

The committee voted unanimously to approve a non-preferential recommendation for a new Hepatitis B vaccine (Dynavax’s HEPISLAV-B™) to their list of recommended vaccines for adults 18 years and older against infections caused by all known subtypes of Hepatitis B.

This vote came following the presentation of data showing that the new two-dose vaccine generates a more rapid and higher antibody response than the standard 3 dose vaccine.

Hepatitis B is a viral disease of the liver that can become chronic and lead to cirrhosis, liver cancer and death. The hepatitis B virus is 50 to 100 times more infectious than HIV, and transmission is on the rise. In 2015, new cases of acute hepatitis B increased by more than 20 percent nationally and 850,000-2.2 million persons are estimated to be living with infection in the U.S.

Since there is no here is no cure for hepatitis B, vaccination is our best chance at preventing the disease. While about 90% of people are infected during infancy, in adults, hepatitis B is most often spread through contact with infected blood and through unprotected sex with an infected person. Some individuals who are especially susceptible include those who are immunosuppressed or living with diabetes. The CDC recommends vaccination for those at high risk for infection due to their jobs, lifestyle, living situations and travel to certain areas.

The Working Group summary suggested that this new vaccine option is likely to improve vaccine series completion and result in earlier protection, which is especially beneficial in persons with anticipated low adherence such as injection drug users.  Additionally, the improved immunogenicity in populations with typically poor vaccine response such as the elderly, diabetics and those on dialysis, is promising.  The ACIP will continue to review post-marketing surveillance studies and additional data to ensure safety and cost-effectiveness considerations.

Hepatitis A

The committee voted unanimously to pass three recommendations pertaining to Hepatitis A.

  • Hepatitis A vaccines should be administered for post-exposure prophylaxis for all persons 12 months of age or older.
  • Hepatitis A vaccine or immune globulin (IG) may be administered to persons 40 years of age or older, depending on the providers’ risk assessment.
  • Hepatitis A vaccine should be administered to infants age 6-11 months of age traveling outside the US when protection against hepatitis A is recommended. This recommendation takes into consideration the fact that infants under 12 months who will be traveling internationally will typically also need an MMR vaccine.  Since Hepatitis A immune globulin and MMR vaccine should not be administered simultaneously, these children should receive a single dose of HepA vaccine. It’s important to note that infants should then complete the full, 2 doses of MMR and HepA vaccines at 12 months of age as recommended.

Influenza

The Committee heard five presentations specific to influenza.

The first two were reports of current season data; one detailing flu surveillance, the other providing early influenza vaccine effectiveness data.

According to the update, the majority of circulating flu strains are similar to those contained in the 2017-2018 vaccine.  The only virus clearly showing antigenic drift was the B/Victoria lineage viruses which represents less than 1% of circulating viruses.  So far this season, influenza A (H3N2) has been dominant, with influenza B activity starting to increase more recently. Activity has been the highest we’ve seen since 2009, and while final severity can’t be determined until the end of the season, hospitalization rates and mortality could be similar to or exceed those send during the severe 2014-2015 season.

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Based on data from 4,562 children and adults with acute respiratory illness enrolled during November 2, 2017–February 3, 2018, at five study sites, the overall estimated effectiveness of the 2017–18 seasonal influenza vaccine for preventing medically attended, laboratory-confirmed influenza virus infection was 36%. The percentage differs by age group and by virus.  A detailed report can be found here.

The most notable news out of the Committee last week was the vote to restore the live attenuated influenza virus (LAIV) vaccine as an option for the 2018-19 season. LAIV is commonly known as the nasal spray flu vaccine or by its brand name, FluMist This renewed ACIP recommendation offers FluMist as one of several vaccine options for non-pregnant people who are 2-49 years of age during the 2018-2019 season, but does not indicate any preference for FluMist over injectable flu vaccines.

While FluMist has not been recommended for the past two flu seasons due to reduced effectiveness against the H1N1 flu strain in children, the Committee heard three presentations specific to LAIV vaccine efficacy in children prior to taking a vote on future recommendations for LAIV.  The first reported on the efficacy of Fluarix Quadrivalent in children 6-35 month of age. Another presented the results of a randomized trial of a new H1N1 LAIV strain in U.S. children. The third was a review LAIV in children 2-17 years of age.  

The possible root cause of the poor effectiveness of LAIV against H1N1 was discussed and poor replication of the H1N1 selected strain was thought to be the likely problem. A new strain selection process is now in place in cooperation with the Food & Drug Administration (FDA) and it suggested that the antibody responses of the latest reformulated version of the quadrivalent vaccine, which includes the new 2017-18 post-pandemic 2009 H1N1 LAIV strain (A/Slovenia), will perform significantly better than what was previously observed when the vaccine included the 2015-16 post-pandemic LAIV strain (A/Bolivia).  Immunogenicity and viral shedding data in small trials supported this notion, but no efficacy data is available at this time.

The Committee was therefore forced to a vote using only the science available to date. There was a lively discussion among members who expressed various concerns. While flu vaccine effectiveness is a serious issue, some committee members expressed concern that they may be holding FluMist to a higher standard than other influenza vaccines, yet all have efficacy challenges from year to year.  Other members were concerned with how the vaccine may perform in an H1N1 dominated season. Until the vaccine is used, further effectiveness assessments are performed, and a prominent H1N1 year occurs, a certain level of uncertainty will remain.

While members voted overwhelmingly (12-2) to reinstate LAIV on the immunization schedule, a second vote to give other flu vaccines a preferential recommendation over LAIV failed (11-3).  So, while the ACIP will not indicate a preference for any one type of flu vaccine over another, the public will ultimately determine whether there will be high uptake of this particular vaccine next season. Read more…

How One Teen is Engaging Her Peers to Help Eliminate HPV Related Cancers

February 27, 2018 1 comment

By Allyson Rosenblum

What if you could save a life or prevent someone from the devastation of cancer simply be providing them with information, would you do it?  What if it was someone you knew or cared about, would you do it then? 

IMG_3767 6.17.55 PMMy name is Allyson and I am a 17 year-old high school student living in Southern California. Earlier this year, I set out to do something that I hope will make a difference in the lives of others. I would like to encourage teenagers who care about their health and the health of future generations to join me.

What I’m asking is fairly simple. I am requesting high school and college students to pass along valuable information about HPV infection and prevention to those they know and care about.  

I have personally seen HPV and cancer devastate the lives and dreams of people I love. Beginning in October of last year, I witnessed my mother’s difficult battle with cancer every day as she endured three surgeries and eight months of chemotherapy. Two months later, my cousin informed me that she was diagnosed with cervical cancer resulting from an HPV infection she acquired as a teenager. At just 35 years old, she has now had to accept the fact she will never be able to have biological children of her own. Seeing all this pain and needless suffering has moved me to take action.

I decided to start a social media campaign on Facebook and Instagram, which I called “Two Shots To Beat Cancer.”

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My goal is to enlist high school and college students throughout the U.S. to help in passing along information about the importance of early HPV vaccination to other high school and college students using various social media platforms.

Let me emphasize that this campaign is not about teen sex.  Rather, it’s about prevention of HPV prior to sexual activity. If people can avoid acquiring the strains of the HPV virus that are linked to cancer, they will be less likely to suffer with an HPV related cancer later in life or pass the virus on to others.  This is why the CDC recommends the HPV vaccine to 11-12 year olds. However, if a child did not get vaccinated in their pre-teens, it’s not too late. The vaccine is recommended up to age 26 for women and age 21 for men.

Unfortunately, most people my age do not want to talk about health related issues. We’re often uncomfortable talking about such topics, especially with adults, and reticent to share private information about ourselves. As such, many of us remain unaware of the dangers and prevalence of HPV, and questions and concerns often go unaddressed. However, it is precisely the lack of education and informed knowledge that allows the HPV epidemic to persist. By sharing timely and credible information among peers, I hope to empower my generation to take responsibility for their health and to help encourage better health practices among our peers.

I started this campaign in January and through the power of social media have already been able to get 1807 high school and college students to join me in all 50 states. With an average of 600 followers per student, that gives us the potential of reaching 1,084,200 students and counting!  However, I’m not content with that. I believe we can do far better! In fact, if high school and college students were aware that there are 14 million new people acquiring HPV in the U.S. each year and over 50% of them are teens and young adults who are just becoming sexually active, than I believe they may see their important role in this mission.

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I would encourage any high school or college student who cares about their own health, or the health of future generations, to find out more by visiting my website at TwoShotsToBeatCancer.org and joining the Two Shots To Beat Cancer Facebook Page and following our Two Shots To Beat Cancer Instagram account.

By joining me in this worthwhile endeavor, we can be the generation that puts an end to HPV related cancers. By posting to social media and sending letters to politicians, newspapers and school board administrators, we can make a difference and help to stop the spread of HPV. It takes little time, costs no money and by encouraging students to engage in important and life-changing conversations, we can save lives and prevent needless suffering.

Meningitis B and Your College Student: Preventing the Call

February 14, 2018 Leave a comment

Emily was a 19-year-old college student when she called home complaining of a headache. Thirty-six hours later, she passed away due to serogroup B meningococcal disease. Emily was able to donate six of her organs, together with bones and tissue, to save the lives of five others.

Emily’s mother, Alicia Stillman, who graduated from Arizona State University, returned to Arizona after founding The Emily Stillman Foundation to honor her late daughter’s life. She shared the story of how Emily contracted Meningitis B and her family decision to donate Emily’s organs. She also explained the work she is doing to help educate others about the availability of Meningitis B vaccines in the United States and to encourage organ donation. She spoke with Debbie McCune Davis, Director of The Arizona Partnership for Immunization (TAPI), who is leading the effort to increase awareness of the approved vaccine and who is working with Arizona Universities to promote the Off to College education campaign.

Together these two women share a message of hope, as they work to save lives and prevent serogroup B meningococcal disease by educating parents, students, educators and medical professionals across Arizona and the nation.

 

 

Alicia: I always felt I was living a blessed life. I enjoyed motherhood. I had three beautiful children, a wonderful husband, and a successful career. I believed I was doing everything right to raise healthy, independent children, as I sent each one off to college.

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Emily and the Stillman family after her high school graduation.

My middle daughter Emily had a fabulous first year away at a small liberal arts college in Kalamazoo, Michigan. In 2013, she was well into the second semester of her sophomore year when she called home one evening, complaining of a headache. Thinking it was from lack of sleep, I advised her to take some ibuprofen, and to touch base with me in the morning. Little did I know that was to be the last time I would ever hear my Emily’s voice.

The call the next morning wouldn’t come from my Emily, but rather from the Dean of the College. She told me my daughter had been admitted to the hospital during the night with Bacterial Meningitis, that she was very sick, and I needed to get there as soon as possible. I remember insisting that this was not possible because even at that time, I knew she had received “the meningitis shot”. In fact, I even remembered that before she left for college, she had received a meningitis booster. What I did not yet know at that time was that the vaccine she had received (MenACWY) only protected her against 4 of the 5 common serogroups of Meningococcal Disease. I had no idea that there was a strain she was not protected against because a vaccine for that strain was not even available in the United States at that time.

Less than 36 hours later I said goodbye to my baby. My beautiful girl that I had promised to always protect and take care of was gone. As I said goodbye to her on that cold February morning, I told her that I would be ok…and that I would figure this out.  I would make sure this could not happen to other people.

Debbie: Stories like Alicia’s weren’t preventable in the U.S. when Emily Stillman contracted and lost her life to Meningitis B, but they are today. In October of 2014 and January of 2015, the FDA approved licensing for two different vaccinations for Meningitis B. Soon after that, the Advisory Committee on Immunization Practices (ACIP) of the Center for Disease Control and Prevention (CDC) acknowledged that college age students should talk with their doctors about Meningitis B.

In Arizona, our Board of Regents (the governing board of our state university system) took quick action to recommend all incoming freshmen get the vaccine.  There had been outbreaks in the PAC 12 schools and Arizona wanted to promote healthy campuses. We, at TAPI, worked with the Universities, their Medical Directors and all of our professional medical organizations including Osteopaths, Pharmacists, Nurses, and Pediatricians to put forth a unified message and raise awareness.

Our Off to College flyer launched an awareness campaign for parents and college age students to make certain each has the benefit of protection from all strains of meningitis.

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Alicia: I live my promise to my Emily every single day with my work at The Emily Stillman Foundation. Before the vaccine was approved in the U.S., I discovered the vaccine was available in Canada. We took busloads of families across the Detroit/Windsor border into Canada to get the MenB vaccine. We met with the FDA (Food and Drug Administration) and many members of Congress to urge the fast tracking of the licensing process. I testified at the CDC and encouraged ACIP to grant a firm recommendation to protect our adolescents and young adults. I set up vaccination clinics locally to provide the vaccine before medical practices were willing to hear about it. I speak nationally, working with colleges, medical practices, and parents to raise awareness to this hideous disease, its symptoms, and the vaccinations now available to prevent it.

I won’t stop until the MenB vaccine is on the required list, and is available to all people.  Only then will my promise to my Emily be fulfilled. 

Debbie: Today, we at TAPI are taking it a step further…we don’t want kids to wait until they’ve moved into their dorms to receive their vaccination. 

We are working with high schools, parents groups, physicians, athletic departments and more to promote Vaccinate Before You Graduate here in Arizona.  We want this to become part of the college prep routine—take your college entrance exams, turn in your transcripts, apply for scholarships, choose your school, order your cap and gown and vaccinate!

 

As mothers, and as experts – one from a heart-breaking loss, and one as a professional who works tirelessly to prevent disease – we urge you to enjoy these moments with your child.  However, as you are giving them that final send off, smoothing the bedding on their dorm bunk, stocking snacks and toiletries, telling them to study hard and have fun (but not too much fun), asking them to be safe, be sure to also give them the tools to stay healthy.

Make sure they have their boosters, that they are up to date on all vaccination and be sure your health professional has given your child protection from all strains of meningitis, including Meningitis B. If your child has already started that journey and is off to college, check with the student health services at their school for information about vaccine availability on campus.

Do it for your child, do it for yourself and do it for Emily.


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Alicia Stillman lives in West Bloomfield, Michigan with her husband of 29 years, Michael. In addition to her angel daughter Emily, she has two live children – Karly, 25, and Zachary, 21. Alicia holds an MBA in Management Accounting, and is the Accounting Director for a multi-state Law Firm. She is the Co-Founder and Director of The Emily Stillman Foundation, founded in 2014 in memory of her late daughter Emily. The Foundation has a trifold mission to raise awareness for and encourage organ and tissue donation, to educate about Meningococcal Disease as well as all vaccine preventable diseases, and to advocate globally for all health and wellness issues. Most recently, Alicia partnered with Patti Wukovits to co-found the Meningitis B Action Project.  Alicia can be reached through the Foundation at emilystillmanfoundation@gmail.com.

 

McCune_Davis_16 - Member Photo.jpgDebbie McCune Davis has served as Director for The Arizona Partnership for Immunization, better known as TAPI, since February 1996. She was an elected member of the Arizona Legislature, serving from 1979 until 1994 and again from January 2003 until her retirement in January 2017, serving in both the House of Representatives and the Arizona State Senate. In her local community Debbie serves on numerous committees and task forces, working to improve the health status of women and children in Arizona. She has established a reputation for being a knowledgeable advocate for maternal and child health and childcare issues. In 2012 she was recognized for her advocacy by the Children’s Action Alliance in Phoenix and Every Child By Two in Washington, DC. Debbie also served on the Board of Directors of the American Immunization Registry Association and she volunteers her time as a member of the planning committee of the National Conference on Immunization and Health Coalitions. She is married to Glenn Davis and has a blended family of 5 children and 3 grandchildren. More information about TAPI may be found at www.whyimmunize.org.

Young Hockey Player’s Death A Flu Warning

January 22, 2018 2 comments

By Amy Pisani, Executive Director of Every Child By Two/Vaccinate Your Family

Each of us has a tipping point; the moment when a news story becomes personal, more impactful and perhaps spurs action.

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Every Child By Two Executive Director, Amy Pisani, with her son Nicholas, a fellow hockey player from CT.

After hearing of the tragic death of 10-year-old Nico Mallozzi, an ice hockey player from a neighboring town who died Sunday from complications related to flu, I immediately reached out to our hockey league president to ask him to urge our teams to implement the same flu protocol that Nico’s team is now doing: Stay home if you have symptoms of influenza, don’t share water bottles and shake hands post game with gloves on. Thursday evening our league distributed Nico Mallozzi # 7 memorial stickers for every player’s helmet.

According to friends and family writing online, Nico was a sweet, happy, healthy child from New Canaan, CT. He had traveled to upstate New York to cheer on his team during a hockey tournament in which he did not participate because he was feeling sick.  Nico was hospitalized on his way home and died the same day, reportedly from influenza and its complications.

As the executive director of Every Child By Two, a national non-profit organization whose mission is to ensure that all families are protected from vaccine-preventable diseases, it saddens me to learn of yet another family suffering the devastating loss of a child. As a fellow hockey mom, this tragedy resonates deeply.  Anyone with a child on a team knows that hockey families are a tight group. From fall to early spring, we travel the region at all hours of the day and night in support of our children. We cherish our children’s teammates, who we watch grow up from wobbly “learn to skaters” to dedicated players who often commit five or six days a week to practice and playing games, building lifelong friendships.

Nico’s tragic death is a poignant reminder that children of any age, even those who are healthy and athletic, can be taken by flu in a heartbeat. 

Each year, the Centers for Disease Control and Prevention warns us that approximately 100 children will die from influenza every season. Sadly, as of last week, here in the U.S. there have already been 30 children who died from flu so far this season, and this number will continue to climb, as we are nowhere near the end of this outbreak. Unfortunately, these kinds of statistics don’t always resonate with the public and as a result, health advocates are challenged to find ways to spur families to take the time to vaccinate everyone 6 months and older against flu each and every year.

To make matters worse, there are mixed messages about the effectiveness of influenza vaccines and getting across the idea that some protection from the vaccine is better than none is often difficult. As with any infectious disease, community prevention is of paramount importance. Since no vaccine is 100 percent effective and not everyone is able to be vaccinated due to age or underlying medical conditions, we must provide a barrier around one another to keep diseases from taking the lives of children like Nico.

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It’s not too late to get a flu shot for yourself and your family.

While the peak of flu activity varies from year to year, it often occurs between December and February, and can last as long as until May. Although 12,000 to 56,000 people die each season, influenza vaccination has been shown to reduce the risk of flu-associated death by 65 percent among healthy children and by 51 percent among children with underlying high-risk medical conditions. Other research indicates that adults benefit from repeated flu vaccination year after year. The study found flu vaccination was 74 percent effective in preventing intensive care unit admissions in older individuals and 70 percent effective in preventing deaths among older adults.

These statistics matter and they all say the same thing; protect your entire family from flu by getting vaccinated against this potentially deadly disease every year.

For more information on this year’s flu season, visit:

 


This editorial was originally published in the Hartford Courant.

 

Is This Season’s Flu More Severe Than Usual or Just Highly Active?

January 13, 2018 10 comments

At this point in the flu season people often wonder if all the media hype is part of an orchestrated effort to panic people about flu, or if it is really signaling serious concern.

There are lots of flu stories in the news these days.  From reports of  74 Californian’s who’ve died from flu – five times the number seen at this point last year – to 13 school districts in TX closing due to the high number of flu cases among students, we’re left to wonder….

Is this year’s flu season more severe than usual or just highly active at the moment?

A recent CDC media briefing has helped clarify the following concerns regarding the latest flu activity in the U.S.: 

Right now, flu is widespread everywhere.  

One of the most notable differences between this season and others is in relation to the geographic spread of flu. This is the first time over the course of 13 years of surveillance data that the entire nation is experiencing widespread flu at the exact same time, as can be noted by the color of CDC’s flu surveillance map below.

FluWeeklyReportActivity is severe right now.

 

One of the ways the CDC tracks influenza activity is to record the number of lab confirmed cases of flu and hospitalizations by week. What they’ve noted is a very rapid increase in the number of people seeing their healthcare providers for flu diagnosis, along with a rapid rise in the numbers of people being hospitalized with lab confirmed flu. For instance, this week’s surveillance data indicates that there’s been 22.7 hospitalizations per 100,000 people in the U.S., which is up considerably from the 13.7 number recorded last week.

So far this season, influenza A (H3N2), has been the most prevalent strain in circulation. Unfortunately, historically it is often the strain linked to more severe illness, especially among children and older individuals above the age of 65. Interestingly enough, the current flu surveillance observations seem to be in line with two more previous H3N2 dominant seasons; the 2014-2015 and 2012-2013 seasons.WHOPHL02_small

Additionally the hospitalizations so far this season seem to be in line with other H3N2 predominant seasons, with the highest rates among those over the age of 65, those between 50-64, and children under 5 years of age.

Flu can cause mild disease in some, but severe disease and death in others.

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Sadly, there have been as many as 30 pediatric deaths so far this season. While children are at great risk, there are plenty of reports of otherwise healthy adults who have been hospitalized or died from flu this season.

Peak season may have started early, but there are many more weeks to go.

Speaking to the media on behalf of the CDC on Friday, Dr.  Jernigan explained,

“If we look at the timing of the season, even if we have hit the top of the curve or the peak of the seasonal activity, it still means we have a lot more flu to go.”

He went on to suggest that there will likely be at least 11 to 13 more weeks of elevated influenza activity this season, before activity begins to subside. Even though it can take about two weeks for protection from vaccination to set in, Dr. Jernigan explained that we still have a lot of flu season to get through and that vaccination efforts should continue as long as influenza viruses are circulating.

While we are seeing a lot of H3N2 circulating now, we are also seeing H1N1 show up in states that have already had H3N2 activity. And we know that B viruses also tend to show up later in the season. Each of these strains are covered in the vaccine, so flu vaccination now can still help to prevent, or lessen the severity of flu throughout the remainder of the season.

Vaccination is our best defense.  

While flu vaccination is far from perfect, it remains our best defense. Not only can it help prevent flu, but it can also help lessen the severity of symptoms if a vaccinated person does end up getting infected.  This can reduce the chances of an individual being hospitalized or dying from flu.

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In fact, a recent study showed that influenza vaccination reduced the risk of flu-associated death by 65% among healthy children and by 51% among children with underlying high-risk medical conditions. Another study indicated that many older adults benefit from repeated flu vaccination. When getting vaccinated in both the current and previous seasons, the study found flu vaccination was 74% effective in preventing ICU admissions in older individuals and 70% effective in preventing deaths among older adults.

Manufacturers are reporting that they’ve shipped more than 151 million doses of flu vaccine this season, so there shouldn’t be a problem finding a flu vaccine in your area.  Simply refer to the flu vaccine finder for assistance.

We won’t know preliminary flu vaccine effectiveness until February.  

Read more…

What Signals the Start of Flu Season?

October 2, 2017 1 comment

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One might think that flu season starts with the arrival of vaccine in the local pharmacy or provider’s office.  Others might believe that flu season in the U.S. begins with the first case of lab verified flu.  While flu viruses are most common during the fall and winter months,  influenza activity can begin as early as September or October and last as late as May.

The CDC monitors certain key flu indicators (like outpatient visits of influenza-like illness, lab results and reports of flu hospitalizations and deaths). When these indicators rise and remain elevated for a number of consecutive weeks, than “flu season” is said to have begun.

In preparation for flu season, the Centers for Disease Control and Prevention (CDC) and the National Foundation for Infectious Diseases (NFID) kick off their annual flu vaccine campaign each September with a special press conference which emphasizes the importance of flu vaccination.

The reality is that influenza is difficult to predict. No one knows when it will peak, how many people will suffer or die, or even how effective the flu vaccine will be.

However, what experts do know is that the flu is inevitable, yet preventable.  Every year there is suffering, hospitalizations and even deaths, but much of that could be prevented if more people were protected through annual vaccination.  2017 Flu News LBE

 

Flu is a fickle and unpredictable virus. 

This was the message Dr. Bill Schaffner delivered during the news conference last week.  Since 2010, flu-related hospitalizations in the U.S. typically range from 140,000 to 710,000 each year, killing between 12,000 and 56,000 people each year.  While the exact number may differ drastically from year to year, this just highlights how dangerous and unpredictable influenza is.

Now is the ideal time to get a flu shot. You want to be vaccinated weeks before possible exposure, because it can take about two weeks post-vaccination for your body to build the proper immune response from the vaccine.

Everyone should consider flu vaccination – even healthy individuals.

Flu Fact of the Week

The flu vaccine is recommended for everyone 6 months and older.  It not only helps to reduce the risk of flu illness and serious complications for the person getting vaccinated, but it also helps to reduce the amount of flu circulating in the community.  By reducing the incidence of flu, we can help protect those who might be more susceptible to serious flu illness, such as young infants too young to get vaccinated, pregnant women and older individuals who may be more susceptible to flu infection, and individuals with certain medical conditions, like heart disease, asthma and diabetes, who are at increased risk of complications from flu.

Too often people mistakenly believe that if they are healthy they don’t need a flu vaccine.  Or, they don’t realize how dangerous the flu can be and consider it akin to a bad cold.  However, influenza is a contagious respiratory illness with no cure.  Once the virus takes hold, all we can do is treat the symptoms.  While antiviral drugs are recommended to try to lessen symptoms and shorten the time one is stick by a day or two, the reality is that influenza must run it’s course.  This is why Dr. Northrop could do nothing but watch while his otherwise healthy adult sister succumbed to influenza and died.

Why choose vaccination if it can’t guarantee you won’t get flu?  

We often hear people explain that they won’t get a flu shot because it doesn’t guarantee that they won’t get the flu.  While it is true that the flu vaccine isn’t a 100% guarantee, the annual flu vaccine is  typcially about 40-60% effective.  Therefore, getting your annual flu vaccine means you will reduce your chances of getting the flu by 40% to 60% as compared to someone who does not get vaccinated. It also means that flu vaccination can significantly reduce the risk of flu-associated hospitalization and death (especially among children and older adults).

As an example, last year’s flu vaccine effectiveness was deemed to be approximately 42% effective overall.  While that may not sound overly impressive, it is estimated that flu vaccination last year prevented about 5.4 million cases, 2.7 million flu-related doctor’s visits and 86,000 hospitalizations last season.  But last year only about 46.8% of the U.S. population 6 months and older received a flu vaccine. Now imagine if more people had been vaccinated. The CDC estimates that if overall flu vaccination coverage had been just 5 percentage points higher, another 490,000 illnesses and 7,000 hospitalizations could have been prevented.

What determines flu vaccine effectiveness?  

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