Health Communication to Boost Influenza Immunization Rates Remains a Priority

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According to the Centers for Disease Control (CDC), the United States experiences epidemics of seasonal flu each year.

Image Credit: Centers for Disease Control (CDC)

Image Credit: Centers for Disease Control (CDC)

This time of year is called “flu season.” In the U.S., flu viruses are most common during the fall and winter months. Influenza activity often begins to increase in October and November. Most of the time, flu activity peaks between December and March and can last as late as May. CDC monitors certain key flu indicators (for example, outpatient visits of influenza-like illness (ILI), the results of laboratory testing and flu hospitalization and deaths). When these indicators rise and remain elevated for a number of consecutive weeks, flu season is said to have begun. Usually ILI increases first, followed by an increase in flu-associated hospitalizations, which is then followed by increases in flu-associated deaths. It’s not possible to predict what this flu season will be like. While flu spreads every year, the timing, severity and length of the season varies from one year to another.

Don’t Get “Flued” (Again)

According to the Centers for Disease Control (CDC), receiving a vaccination before flu activity begins helps protect you once the flu season starts in your community. It takes about two weeks after vaccination for the body’s immune response to fully respond and for you to be protected; so make plans to get vaccinated. CDC recommends that people receive a flu vaccine by the end of October, if possible. However, getting vaccinated later can still be beneficial. CDC recommends ongoing flu vaccination as long as influenza viruses are circulating, even into January or later. Children aged six months through eight years, who need two doses of vaccine, should receive the first dose as soon as possible to allow time to get the second dose before the start of flu season. The two doses should be given at least 28 days apart.

Influenza vaccine effectiveness does vary from year-to-year among different age and risk groups and even by vaccine type. How well the vaccine works for a particular person in a specific season can depend in part on the match between the vaccine virus used to produce the vaccine and the circulating viruses that season, their overall health condition, when they receive the immunization viz a viz their exposure to the active virus and other variables. According to the Centers for Disease Control (CDC), receiving an annual flu vaccine (inactivated influenza vaccine and the recombinant influenza vaccine) is the primary and best way to protect yourself, your family, co-workers and others with whom you come into contact with from the flu. Flu vaccination can mitigate illness, reduce the severity, additional healthcare administration, and missed work and school due to flu, as well as prevent flu-related hospitalizations. The more people who get vaccinated, the more people will be protected from flu, including older people, very young children, pregnant women and people with certain health conditions who are more vulnerable to serious flu complications. Perhaps most significantly, immunizations can save lives. Despite these facts, influenza and pneumococcal vaccination rates remain sufficiently low to warrant concerns.Communicable Illness

Anna Almendrala wrote that: “The flu can progress from congestion and fatigue to more serious symptoms, like fever, chills and muscle aches that can persist for days. Complications caused by the flu include pneumonia, blood infections, diarrhea and seizures. In worst case scenarios, the flu can lead to death, especially for the very young or the very old. While the CDC does not directly count deaths related to influenza, their analyses estimate that they can range from 3,000 to about 49,000 people per year. Vaccines can prevent this: During the 2012-13 season, over 100 children died of the flu or flu-related complications, but 90 percent of those children did not receive the flu vaccine…. There’s also evidence to show that vaccines can prevent flu-related complications, like heart attack and stroke in older populations, said Dr. Wilbur Chen, chief of adult clinical studies within the Center for Vaccine Development.”

It is also helpful to be up-to-date with your pneumococcal vaccine as well, which can prevent pneumococcal pneumonia, a serious flu-related complication.

As Robert Blancato wrote in The Huffington Post Blog: “Immunizations are a critical step toward prevention of certain diseases. Two of those vaccine-preventable diseases are pneumonia and influenza, which result in more than 600,000 annual hospitalizations with direct costs of more than $7 billion per year just for the older adult population…. We need to focus more attention on and provide more education about vaccines as we continue to have disturbingly low rates of vaccinations among those adults who need them the most. In 2012, the CDC indicated that only 20 percent of younger adults at high risk for pneumonia had even received a pneumococcal vaccine and only 59.7 percent of older adults had received one.  Adult immunization rates are generally affected by three key categories. The first is that immunizations may not be viewed as a priority health concern by patients and/or providers, with other preventive care practices being given priority over immunizations. Health systems and processes can make routine immunizations harder than necessary, with an absence of standing orders to make vaccine administration more routine. Finally, inconsistent and uncoordinated policies may discourage immunizations with factors including variable insurance coverage for immunizations across health plans.”

Receiving the vaccination does not guarantee that you won’t still get the flu but it does reduce the risk of contagion and may reduce the severity of the experience if you do catch the flu. Nonetheless, as Dr. John Treanor, an influenza vaccine expert at the University of Rochester in New York noted: “the recommendation and the message that people should be vaccinated still holds true. Because it’s clear from all these studies that although many factors can influence how well the vaccine works, getting the vaccine is always better than not getting the vaccine.

Communicating Health Recommendations

Flu Vaccination by the CDC

The scientific and medical consensus is that we need to do a better job to communicate the importance of vaccination and boost the participation rates. Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, made that message loud and clear at the annual National Foundation for Infectious Diseases press conference on flu vaccines: “If we could increase vaccination coverage in this country by just five percent more, that would prevent about 800,000 illnesses and nearly 10,000 hospitalizations, Flu vaccine is one of the best buys in public health.”

For the 2016-2017 season, CDC recommends use of the flu shot (inactivated influenza vaccine or IIV) and the recombinant influenza vaccine (RIV). The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) should not be used during 2016-2017. The 2016-2017 influenza vaccination recommendations are now available. You should review the complete list of recommendations but some highlights of CDC’s recommendations for this year’s flu season there are a number of noteworthy information points.

  • Only injectable flu shots are recommended for use this season.
  • Flu vaccines have been updated to better match circulating viruses.
  • There will be some new vaccines on the market this season.
  • The recommendations for vaccination of people with egg allergies have changed.

According to CDC, there are many flu viruses and they are constantly changing. Therefore, the composition of U.S. flu vaccines is reviewed annually and updated to best match the projected widely circulating flu viruses. Flu vaccines protect against the three or four viruses that researchers suggest will be most common. For 2016-2017, three-component vaccines are recommended to contain:

  • A/California/7/2009 (H1N1)pdm09-like virus,
  • A/Hong Kong/4801/2014 (H3N2)-like virus and a
  • B/Brisbane/60/2008-like virus (B/Victoria lineage).

Four-component vaccines are recommended to include the same three viruses above, plus an additional B virus called B/Phuket/3073/2013-like virus (B/Yamagata lineage). Here is a link to a list showing all the influenza vaccines that are FDA-approved for use in the United States during the 2016-2017 season.

Action ItemsCDC handwashing

CDC recommends a yearly flu vaccine for everyone 6 months of age and older. In addition to getting a seasonal flu vaccine, you should take everyday preventive actions like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading flu to others. In addition, there are prescription medications called antiviral drugs that can be used to treat influenza illness once you are diagnosed.

Furthermore, encourage your family members to get vaccinated. Vaccination is especially important for people at high risk for developing flu-related complications, and their close contacts. Also, if you know someone who is at high risk of flu complications and they develop flu symptoms, encourage them to get a medical evaluation for possible treatment with influenza antiviral drugs. CDC recommends that people who are at high risk for serious flu complications who get flu symptoms during flu season be treated with influenza antiviral drugs as quickly as possible.

Finally, pass the word along. It is important to communicate appropriate and beneficial health information.

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