This is THE question this time of year. It is estimated that this year there will be approximately 42 million people in the U.S. effected by influenza and as many as 40,000 deaths to the flu (1).
The virus comes in several forms based on its structure; influenza A, influenza B, H1N1 and H3N2. The vaccine is designed to cover all strains. Influenza is a virus that causes body aches, fever, cold-symptoms and for some patients can be devastating. Those with the greatest risk of difficulties are patients who are immune compromised (severe asthma, cancer patients, auto-immune patients undergoing immune suppression treatment) and the elderly. Majority of us will experience the flu virus with its common symptoms lasting 7 to 10 days and then recover completely. Anti-viral treatments listed below can shorten this duration of the flu to 3 days.
What do we know about the vaccine?
The flu vaccine is created every year, prior to vaccine season, since the influenza virus is constantly mutating and changing. Scientists use date from previous strains to try and predict the best flu vaccine for the next year. As a result, The CDC recommends annual flu shots to anyone over the age of 6 months. Several forms of the vaccine exist. There is a Live-Attenuated Version (LAIV), which is given as a nasal spray. Some of you may recall this was briefly taken off the market a few years ago and is back this year. It is only approved now for ages greater than 2. The live version should never be given to anyone with a low-immune system. The Inactive form (IIV) is approved for as young as 6 months of age. The vaccine is created from surface proteins of the virus. The Influenza vaccine is the only vaccine today that still uses mercury as an adjuvant. This is used to both preserve the vaccine and to act as an immune stimulant to help your body form a memory against the flu.
The vaccine is creating by first growing the virus in chicken eggs and should be avoided in those with egg allergies. Anyone with heavy metal poisoning, particularly mercury exposure should also speak to their physician before getting the vaccine.
Will the vaccine be effective this year?
Australia has the opposite seasons to us here in the U.S.. As we finish our summer, they are ending their winter and cold season. As a result, we can look at influenza data coming from Australia to estimate the impact here in the United States. In general, the data demonstrates a more virulent strain with more than 300,000 confirmed cases this year compared to last. The past several years, the influenza vaccine has had very poor coverage, ranging from 20% to 40%. This means that despite getting the vaccine, if exposed you were significantly likely to get sick. Data from Australia indicate that most of the hospitalizations have been with Influenza type A (2). Furthermore, data suggests that the Influenza B vaccine has undergone mutations mid-season making the vaccine mostly ineffective to this strain. The vaccine effectiveness in population older then 65 was 17%. In the young adult population it is ranging from 30-40%.
What should you do?
All the data aside, I recommend arming yourself for this cold season. Increase your vitamin C intake, wash your hands regularly and take your vitamin D. In terms of supplements, Elderberry has shown some clinical benefit against the flu and I recommend having this at home or adding it to your daily regimen. Those who live with someone who is at risk for becoming seriously ill due to the flu should consider the vaccine.
3. Wadstein J, et al. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Research. 2004