This year’s flu epidemic is stretching hospitals to the limit. Every state is affected. Here is a link to the most recent map from the CDC (Jan 6, 2018). You will note that all states are reporting widespread influenza activity. The experts all seem to repeat the same messages: 1) It’s not too late to get a flu shot. 2) Even if this year’s influenza vaccine isn’t perfect protection against the flu, it will prevent severe symptoms and complications. How good is the evidence that this year’s flu shot will reduce symptom severity and complications?
This is a Doozy of a Flu Season!
This is not a mild flu season. There have already been many deaths attributed to complications of influenza. Not only did the virus spread really fast, but the dominant strain seems to be especially virulent. We predicted this might be a problem back on October 2, 2017. That’s because we were carefully monitoring the Australian experience, which precedes North America’s season by about six months. Here’s what we wrote:
“The word from Australia is that this season’s flu could be worse than usual. Their flu season is wrapping up as they move from winter into spring. Experts look to the Australian experience as an early warning for North America.
“A virulent strain of H3N2 influenza virus predominated in Australia this past winter. Australian authorities do not know yet how effective their vaccination program was. As a result, U.S. authorities can’t predict how well the flu shot will work against the strain likely to cause the most trouble here this year.”
By October 10, 2017 we were hearing that the vaccine used in Australia was disappointing. We wrote:
“One possible reason that more people in Australia caught the flu is that the vaccine might have been less effective than normal. In a typical season, the flu shot works about 40 percent of the time. But preliminary analysis suggests that this year’s vaccine was only 15 to 20 percent effective.
Americans will be depending upon the same influenza vaccine that was used in Australia. Researchers have not yet determined whether the vaccine is a good match for the circulating flu strains.”
The Influenza Vaccine: Worse Than Usual
By the end of November we were learning that the vaccine used in Australia was actually worse than the 15% to 20% initially reported. An article in the New England Journal of Medicine (Nov. 29, 2017) suggested that vaccine effectiveness was only about 10%.
We have heard the experts predict that this same vaccine will be more effective in the United States. They estimate 30% protection against the flu. They have no way of knowing that, though. It will take many months to assess the data. By May or June we should have some idea how effective the vaccine was against this nasty H3N2 virus.
Will the Influenza Vaccine Reduce Flu Symptoms?
We have also heard the talking head experts insist that even if the flu shot won’t protect you from getting the flu, it will make the infection less troublesome. In other words, the vaccine will protect you from getting really sick. Again, they have no way of knowing that until the data are analyzed months after the flu season is long past.
We searched the medical literature to see whether there was solid scientific support for the idea that a flu shot would dramatically diminish flu symptoms or prevent complications. The largest study we found came from France (Vaccine, April 11, 2017). The authors wrote:
“The purpose of influenza vaccination is to prevent influenza illness, complications and severe outcomes among subjects who come into contact with the virus. Elderly people are the main population targeted by influenza vaccination campaigns as they are a high-risk population for severe complications (like bacterial pneumonia, exacerbation of chronic obstructive pulmonary disease, or decompensation of chronic underlying conditions) that may result in hospitalization, admission to an intensive-care unit (ICU), and eventually influenza-associated death…
“Surprisingly, very few studies have addressed the question of whether the vaccine mitigates influenza severity among those who develop the illness despite being vaccinated.”
The French researchers studied 2,277 older citizens between 2003 and 2014 to see whether the flu shot reduced symptom severity. 1,293 of these older individuals received flu shots. The only statistically significant improvement in vaccinated patients was less headache. They concluded:
“Our results are consistent with previous studies reporting limited or no efficacy of the influenza vaccine in reducing illness severity at onset of symptoms.”
If You Suspect the Flu What Else Can You Do?
Because this year’s vaccine doesn’t seem to be living up to expectations many people are looking for other options. Some people are interested in prescription oseltamivir (Tamiflu). How good is this oral antiviral drug at preventing the flu or reducing the severity of symptoms? You can learn more at these posts:
The Inside Story of Tamiflu: Side Effects & Benefits
and
Does Tamiflu Speed Recovery from Influenza? What about Side Effects?
Can You Even Get Tamiflu?
Now, some areas are reporting shortages of the oral anti-viral medicine Tamiflu. A number of California pharmacies have reported that they are out. Other states may also be experiencing regional shortages, though the manufacturer says there is no nationwide shortfall. Remember, you will need a doctor’s prescription. Most physicians will not prescribe Tamiflu unless they confirm you truly have influenza. It can take days to get an appointment. The drug only really works if it is taken within 48 hours of the first symptoms.
The People’s Pharmacy Perspective on the Influenza Vaccine:
This year’s flu season reveals that the nation’s healthcare system is not ready to cope with a flu pandemic that would be even more severe. We have analyzed influenza vaccine efficacy over the years. Even when there is a good match, effectiveness is not great. And we suspect that talking heads have not really looked at the data when they repeat the mantra that a flu shot will reduce the severity of an influenza attack. The French data contradict that belief.
Many experts are calling on pharmaceutical manufacturers, public health experts and the CDC to develop better influenza vaccines and antiviral drugs. We could not agree more.
