Flu shot may be less effective this year because current virus has mutated

[YouKnowWho]

I am with you SL - they guessed wrong.

I have not found Tamiflu to be helpful in the past but by the time I must up enough energy to make it into the drs office, I am probably past the point of no return.

This year, my dr doesn't want to see anyone with the flu - if you think you have it, they will call in the Tamiflu (and she doesn't call in any meds usually, she wants to see you).  But I think they are trying to cut the exposure risk down to others.

[LinksEtc]

SL, I don't understand the details as well as a doc ... good ?.

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Tweeted by @charlesornstein

MT @tonyleys: Seriousness of flu situation hits home with picture of healthy, vaccinated Iowa 3-year-old who died. dmreg.co/1BfEfiG

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'Healthy' Iowa 3-year-old dies from flu
http://www.desmoinesregister.com/story/news/health/2015/01/02/flu-deaths-iowa-young-girl-dies/21214315/

Ayzlee McCarthy spent much of Dec. 26 playing with Christmas gifts and trying on her new "Frozen" dress-up clothes.

Three days later, the feisty 3-year-old was dead, the cause attributed to complications from influenza.

So sad.   

[momma2boys]

About Tamiflu...

It can be used for prophylactic treatment, usually when another family member has the flu. I've never heard of them using like you said Mac as preventative and would probably refuse it for that purpose.

Every.Single.Year! there is a shortage of Tamiflu. Early in the season too. We are out and cannot get it.

All doctors should go the phone route. I've had the flu and would've needed to be carried or taken by ambulance I was so sick. Don't spread it either.

Doctors need to be sure it is a probable case before prescribing though. I've had people come in, drop off a Tamiflu rx and say I'm going to run across the street to the store then I will be back. They aren't coughing, sneezing, don't look very ill. First, you probably don't have the flu if you're out shopping. Second, if you do, don't go out in public and spread it!!  Third, someone very ill with the flu could really use that Tamiflu that you don't need.

And my biggest pet peeve, a stomach virus is NOT the flu!!!

[hedgehog]

Could those people, at let some of them, be getting the rx filled for a family member? 

[momma2boys]

No, it's for them. The ones I mentioned are regular customers I know, and they were filling for themselves.

[maeve]

Every.Single.Year! there is a shortage of Tamiflu. Early in the season too. We are out and cannot get it.

That happened to us a few years ago and a compounding pharmacy (actually a local Walgreens) was able to make it.  Our doctor has always had DD come in for the flu and prescribed Tamiflu if she tested positive. Our plan before DD could be vaccinated called for us to take her into the doctor for testing at the first sign of possible flu symptoms.

A fifth-grader at our local elementary school died from flu just before Christmas. 

I think I came down with it on Christmas Eve/Christmas Day. I didn't go to the doctor for a test but the symptoms matched. It took me a solid week to feel better. I don't think I've really had the flu before. It was the achy joints I had that make me think this was my usual upper respiratory infection. I was vaccinated this year.

[2ndGenAllergyMom]

I feel very certain that the Tamiflu worked for me.  I realized I was getting the flu very early since I was with my son at the hospital.  If nobody near me had been diagnosed, I probably would've gone to bed early when it started to hurt to cough, not realizing that I had something worse than a bad cold.  Because I got the Tamiflu so quickly, I was only sick for another day or two, with asthma symptoms lasting a few more days.  Catching and medicating it early worked wonders.  DS2 never got the flu, though I can't say that was the Tamiflu he was taking preventatively, or just us being paranoid about his exposure to his brother.

I'm not trying to sound like an idiot, but didn't we discuss elsewhere that illnesses don't mutate that quickly?  (Ebola) so how does the flu mutate that much in just a few months?

I always thought the issue with the flu shot was that there are multiple flus floating around and they guess which ones are likely to be most common. And sometimes they guess wrong.

They can (and do) absolutely guess wrong.  And it's been a very long time since I studied anything resembling genetics, but why couldn't a virus mutate quickly?

[SilverLining]

but why couldn't a virus mutate quickly?

When the conversation was about Ebola, all the experts said things don't mutate quickly. But now, when it's "just the flu" they say it mutates in just a few months.

It just sounds like "they" make it up as they go along.

[hedgehog]

Influenza viruses are said to mutate more quickly than most.  I don't know whether that is fact or just what "they" say.  But also, there are different types of mutations.  To mutate enough to make a vaccine less effective could potentially be just one "misspelling" in the DNA code.  That would be a very quick mutation.  But other things (like going from one species to another, or becoming airborne) might take multiple changes.  That would take longer. 

[SilverLining]

That makes sense. (Science and I never got along well.)

Either way, I do still feel getting the shot is beneficial. With a lesser mutation it is probably still going to offer some protection. And if I understand correctly, the shot usually covers a few different flues. So, if one mutates, you are still well covered for the others.

My son doesn't agree. But now that we get it at the pharmacy he's much happier. It seems it was the anxiety of travelling so far, and sitting and waiting, which led to him feeling sick after a shot.  The pharmacy is closer, we pop in and rarely wait even five minutes and it's done. The last two years, no issues.

[2ndGenAllergyMom]

I am curious about this, and wish I had the time to research it. What hedgehog said does make sense though.

Each flu shot covers three strains of the flu, I'm pretty sure.

[CMdeux]

There are trivalent seasonal influenza vaccinations, and also a less-common tetravalent (which is what DD got this year)-- and yes, the strains are chosen VERY late in the previous flu season, which usually provides clues as to which strains are likely to prevail the following autumn in the N. hemisphere.  Just not always.

The flu is a rapidly mutating virus because it is comprised of subunits-- which means that if ONE subunit is new, a simple recombination is all that is needed to reshuffle and make a whole library of "new" or novel flu viruses.  H1N1 is an example of this subunit thing in action-- H3N1 is a different virus, although the N portion is the same, your immune system may not be very effective at fighting it off, even if you possess antibodies for H1N1.

An emergent virus that is HIGHLY effective can create a pandemic that is rapid-moving because of a naive population (that doesn't resist infection, basically)-- it's a complete failure of herd immunity.  Swine flu was an example of what a "vaccine-free" pandemic tends to look like, for anyone that wants to know what a world without flu shots would look like now. 

Such an emergent strain also outpaces the (antiquated) method of producing the majority of the flu-vax doses, as well, since it takes MONTHS to complete. 

Getting flu jabs year after year does allow your immune system to built a "library" of subunits that are recognized, however, and buys you some insurance for a year like this one.

[guess]

Our perception of efficacy when talking about relative estimates is more of an issue than mutation.  If one's expectation that even the most perfectly matched vaccination confers absolute immunity then lesser degrees often seem pointless.  The end goal of vaccination is to prepare the body before it encounters the wild virus, allowing it some defense in order to survive, not to repel it outright.  Therefore the benefit outweighs the theoretical risk both individual and herd.
Vaccinations don't make us healthy or completely immune they only increase our likelihood of not dying from encounters with the wild virus by modifying severity. 

I have absolutely no medical background or chemistry or biology but that's what I understand from both the ped's office and reading the CDC forms.  I'm sure someone can improve upon my description and wording.

[CMdeux]

Yeah-- word on the street is that this year's trivalent jab is about 33% effective in terms of protection, as compared to 75-85% in a "good match" year.  It's still far far better than not having it at all.

[LinksEtc]

This is not medical advice ... ask your own docs if you have ?s .... but interesting ....

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Tweeted by @ivanoransky

"Questioning Medicine: Why Is Tamiflu Still Around?"
http://www.medpagetoday.com/PrimaryCare/URItheFlu/49062

Tamiflu doesn't help, so why are docs still prescribing it?

More on this topic ....


Tweeted by @foodanddruglaw

"Why The CDC And FDA Are Telling You Two Different Things About Flu Drugs"
http://fivethirtyeight.com/features/why-the-cdc-and-fda-are-telling-you-two-different-things-about-the-flu/

The discrepancy between the CDC's assertion that the flu drugs can prevent complications, hospitalizations and perhaps deaths, and the FDA's insistence that the drugs have only been shown to cut the amount of time that symptoms persist comes down to how they weigh the evidence.

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Tweeted by @HealthNewsRevu

"CDC, conflicting (conflicted?) info, Tamiflu & unquestioning news reporting"
http://www.healthnewsreview.org/2015/02/conflicting-study-reports-tamiflu-and-unquestioning-news-reporting/

Once again, I found multiple conflicts of interest. The meta-analysis, published on January 30th by The Lancet, far from being "independent" as the authors claimed and as was widely reported, was actually funded by the manufacturer of Tamiflu.