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Flu shot may be overrated
By Adam Hammer
 Media Credit: Christin Osgood Third-year student Sara Wilson reaches for another tissue as she tries to recover from the flu.The epidemic may not be as bad as broadcasted and the flu shot may cause more trouble than help.
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The influenza outbreak throughout the country has loosely been defined as a "pandemic" and, according to several media reports, has claimed more lives than average.
Although many of the numbers and statistics are true, some information outside the five-o-clock news can lead to evidence of why to be hesitant about getting the flu shot, especially for the young, healthy population.
"For healthy, college-aged students, it's not quite as important," said Dr. Bruce Ver Steeg, M.D., a physician at SCSU Health Services.
There is still a potential for contracting influenza because of the populous on campus and living in close quarters, but the vaccination is more necessary among children, the elderly and those with immune deficiencies.
Ver Steeg said that there was a wide spectrum of people vaccinated this year, which could have some relation to the flu vaccine shortage.
The vaccine shortage creates a concern, as this flu season has been a little different from the past three years.
"Statistically, it's been slow for a few years," Ver Steeg said. "People are waiting, wondering, 'when are we going to get hit'."
Variants
There are two types of variants: drift and shift.
A drift variant of the Panama flu, the Fujian flu, has emerged and has led to a loss of several lives, especially among children.
As a term, it seems that death is easily understood. But what is a drift variant?
According to the National Center for Disease Control (CDC), these variants arise when a large quantity of people become immune to a circulating flu virus. The variant is just different enough to be able to spread more than the original strain, or in the case of shift variants, entirely mutated.
Nearly every year a variant strain of the flu emerges.
"In fact, in almost all years, by the end of the flu season, some new strain or some new drift species will show up," said Dr. Julie Gerberding, director of the CDC, during a press conference on Nov. 17, 2003, "and so by the end of the flu season, we don't always have the same match that we do."
Shift variants change one or both of their two kinds of surface molecules, letting them entirely escape any immunity because of prior vaccination or infection. This is generally the case in mutating animal viruses such as the swine flu pandemic of 1918 and the 1957 and 1968 influenza pandemics.
Although the influenza virus has the ability to create variants due to excess immunity, the CDC backs its push for yearly flu vaccination. Its goal is to have at least 60 percent of the nation's population on a regular vaccination schedule against the flu virus by 2010.
The consideration is that once this many people are vaccinated, the population will have to receive the flu shot every year to keep up with variant strains.
Modified vaccination
In the early part of the flu season, there was a vaccine shortage. The CDC is working on solving that problem for the future.
The effects of this year's shortage could have a lot to do with media hype Ver Steeg said.
"Despite all you read and hear," Ver Steeg said, "from the CDC, Mayo Clinic and so on; check those Web sites."
The flu vaccine is modified from year to year depending on what strains of the influenza virus are predicted to be most problematic. The vaccination can protect effectively against up to three strains of the influenza virus and can lessen the severity of some variant strains.
The 2003-04 vaccination protects against H3N2 Panama, H1N1 New Caledonia and Influenza B Hong Kong.
The Fujian variant of the H3N2 Panama was detected by global surveillance in Australia early in 2003, but it was too late to include it in the current influenza vaccine. It is also reported to be responsible for most of the influenza-related deaths this flu season.
Since Oct. 1, 565 influenza A (H3N2) viruses were collected and submitted to the CDC. Of those, 106 (18.8 percent) were similar antigenically to the H3N2 Panama strain that is included in this season's vaccine. 459 (81.2 percent) were similar to the Fujian variant.
Without accurate protection from the Fujian strain of influenza, there are still steps to follow to stay influenza-free.
Other protection
The "Cover Your Cough" campaign that came out this season promoted the stop of airborne contamination, which is one way to cut down on the spread of influenza.
Other methods include washing your hands, avoid touching your face as much as possible and use a tissue and disposing of it immediately.
Promoting a healthy immune system through good hygiene, plenty of rest, exercise and good nutrition can also help.
Most importantly, stay away from anyone you know who has influenza. Those who could have influenza, stay home and rest.
"In terms of weighing vaccine versus those; it's all important," Ver Steeg said.
Mortality rate
The death factor for influenza-like illness that was reported so profoundly in the early part of the flu season, and up to mid-December, showed that pneumonia and influenza-related fatalities accounted for far less than the epidemic threshold.
So far this season, the mortality rate has been above the epidemic threshold for the last four weeks.
Zero weeks were recorded above the epidemic threshold for 2002-03, nine weeks during 2001-02, 10 weeks during 2000-01 and 15 weeks during 1999-00.
The mortality rate did not break the epidemic threshold this flu season until late-December.
For the week ending Jan. 17, the mortality rate was at 10.3 percent. The epidemic threshold for that week is 8.1 percent.
Annually, an estimated 36,000 people will die from the influenza virus and influenza-like symptoms nationwide and 114,000 will be hospitalized.
The CDC noted that influenza-associated deaths are not reportable conditions in the United States. The number of fatalities reported is linked to cases of sudden death associated with influenza in previously healthy subjects.
Many fatalities associated with influenza are matters of health complications.
Close to home
Locally, the CDC did not record influenza-like activity in Minnesota as "widespread" until December 20, when nearly the entire country was in the red.
At SCSU, there were approximately 50 cases of influenza-like illnesses reported to health services so far this season with few viral typing.
"Generally, we work with a young, healthy community," Ver Steeg said.
Minnesota remains in the widespread classification along with some of the East Coast.
The sporadic change of flu activity and this flu season's unpredictable thresholds leave many unanswered questions including: "How can we prove what has been resulted in preventative medicine?"
The CDC realizes this dilemma. The department is humble in claiming that the information they have on the nationwide success of the flu vaccination is not definitively conclusive.
"I'd be very happy if we see no or low rates of influenza this year compared to other years, and that may be because our vaccine program is successful," Gerberding said. "It could also just be because we are wrong in our predictions, but either way we win."
Troubleshooting
Due to variant strains, unique complications arise for assessing effectiveness of the influenza vaccine.
To accurately record the number of influenza illness, a viral culture needs to be taken, which takes more time,Ver Steeg said.
In its efforts, the CDC conducted an initial study of healthcare workers in Colorado. The results showed that the 2003-04 vaccine was not effective or had very low effectiveness against influenza-like illness.
Results from other studies are expected in late spring or early summer.
The test results and records from the CDC are important to read and hear about in the news, but it is also important for the population to educate themselves.
"Sometimes no information is better than misinformation," Ver Steeg said. "Sometimes, we also lose track of other immunizations that are just as important as the flu vaccination."
More information
Updates from the CDC can be found regularly on its Web site at www.cdc.gov or stop by the Student Health Services office for more information.
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