Doc's Tips

Walter Williams, M.D.: ‘Tis Flu Season Again

The message remains the same: Get your flu shot

It’s that time of year again: sniffles, body aches, fever and sore throat. And we repeat the message we share every year: Get your flu shot. Last year’s flu vaccine wasn’t quite as effective, which might lead some people to think they don’t need it. Walter Williams, M.D., a medical epidemiologist at the Centers for Disease Control and Prevention (CDC), explains why they’re wrong and shares why this is such an important issue every fall.

Black Health Matters: People still think the flu is no big deal. Every year we have to remind them that it is. Why is it a big deal?

Walter Williams, M.D.: Influenza, or the “flu,” is a potentially serious disease that can be spread through coughs, sneezes and even talking. The flu also can spread by touching a surface or object contaminated by the virus and then touching your mouth, nose or eyes. Anyone can get the flu, even healthy people. In fact, people can spread the flu one to two days before they show symptoms. Each year thousands of people in the United States die from flu, and many more are hospitalized.

Flu is more dangerous for some people. Infants and young children, older adults (ages 65 and older), pregnant women and people with certain health conditions or a weakened immune system are at higher risk for serious flu-associated complications if they get sick with the flu. Pneumonia, bronchitis and a worsening of existing health conditions are examples of flu-related complications, which can also lead to hospital stays and sometimes death.

Flu illness strikes suddenly and can last several days. Symptoms vary by age and health status, but can include: fever/chills; cough; sore throat; runny or stuffy nose; muscle or body aches; headaches; fatigue; and sometimes vomiting and diarrhea, though this is more common in children than adults.

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Last year’s flu vaccine was only 23 percent effective. Why was that? And how effective are flu vaccines on average?

Dr. Williams: Unfortunately, the H3N2 virus that was most common last season was very different from the H3N2 virus the 2014-15 seasonal flu vaccine was designed to protect against. This resulted in lower vaccine effectiveness and less benefits than during a season when the vaccine is well-matched to the flu viruses spreading and causing illness. The flu vaccines for this season have been updated and are anticipated to better match the circulating flu viruses causing illness this season. CDC is hopeful that this season’s vaccine will provide better protection as a result. During seasons when vaccine viruses and circulating viruses are similar (i.e., “well-matched”), flu vaccine is about 50 percent to 60 percent effective. This means that the flu vaccine reduces a person’s risk of flu illness by 50 percent to 60 percent.

Even a less effective flu vaccine saves lives, right? Roughly how many hospitalizations did flu vaccination prevent during the 2013-2014 season?

Dr. Williams: Yes. During 2013-14, an estimated 46 percent of the U.S. population got vaccinated, helping to prevent an estimated 7.2 million flu-related illnesses, 3.1 million flu-related medical visits and 90,000 hospitalizations. CDC estimates that flu vaccines prevent flu-associated hospitalizations in people 65 years and older, even during seasons when vaccine effectiveness is low. CDC recommends annual vaccination for everyone 6 months and older. Annual vaccination is especially important for adults 65 years and older and others that are at high risk for serious flu-related complications.
Why is it hard to predict how well the flu vaccine will work?

Dr. Williams: At least two factors play an important role in determining the likelihood that flu vaccine will protect a person from illness: 1) characteristics of the person being vaccinated (such as their age, health and immune status), and 2) the similarity or “match” between the vaccine viruses and the flu viruses spreading in the community. The effectiveness of a vaccine can be reduced during seasons when one or more of the viruses the vaccine protects against are very different from the flu viruses that spread during the flu season. During seasons when vaccine viruses and the flu viruses spreading in people are similar, overall vaccine effectiveness of 50 percent to 60 percent has been measured. Even during seasons when the vaccine match is good, the benefits of vaccination will vary across the population, depending on characteristics of the person being vaccinated and even, potentially, which vaccine was used.

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Should some people get more than one dose of flu vaccine in a season?

Dr. Williams: Everyone 6 months of age and older should get a flu vaccine every season. Some children 6 months through 8 years of age will require two doses of flu vaccine to receive protection from flu. Children in this age group who are getting vaccinated for the first time will need two doses of flu vaccine, spaced at least 28 days apart. Some children who have received flu vaccine previously also may need two doses. Your child’s doctor or other health-care professional can tell you if your child needs two doses. Everyone else needs one dose of flu vaccine every flu season.

What flu vaccination coverage disparities exist among African Americans?

Dr. Williams: Among people older than 6 months, coverage for non-Hispanic whites (48.5 percent) was higher than that of non-Hispanic blacks (43.8 percent), Hispanics (44.3 percent), and people of other or multiple races (44.3 percent).

Where can someone go to get more information?

Dr. Williams: Visit CDC’s flu website or call (800) CDC-INFO.

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