Tag Archives: Flu

Certain flu vaccines are not recommended for all ages


It is time for your 2013-2014 flu vaccine.  However, do take your doctor’s advice before vaccination. Certain flu vaccines are not recommended for all ages. For example, CDC recommends that one brand of inactivated flu vaccine called Affluria, should not be given to children 8 years of age or younger. A related vaccine was related with fever and fever – related seizures in young children in Australia. More about side effects below.  Young children who get inactivated flu vaccine and pneumococcal vaccine (PCV13) at the same time may be at increased risk for seizures caused by fever. Ask your doctor for more information. Tell your doctor if a child who is getting flu vaccine has ever had a seizure. You may also read “Why am I feeling fatigued after taking the flu vaccine?

Avoid Pain Reliever with Flu Vaccine
Although your first reaction would be to take a fever or pain reliever along with the flu vaccine – you may want to avoid this action. Common pain relievers dilute the effect of the vaccine. Click here to read the views of the University of Rocherster Medical Center. Quote

“What we’ve been saying all along, and continue to stress, is that it’s probably not a good idea to take common, over-the-counter pain relievers for minor discomfort associated with vaccination,” Phipps said. “We have studied this question using virus particles, live virus, and different kinds of pain relievers, in human blood samples and in mice — and all of our research shows that pain relievers interfere with the effect of the vaccine.”

Unquote.

Egg and/or latex allergy?
What if you have an egg and/or latex allergy? Consult your doctor. The answer is in this previous article.  However, there is a major update for individuals with egg allergy waiting to be vaccinated – Flublok.  In 2013, FDA has approved Flublok, for 18-49 year old, which is not developed in eggs but in insects. Hence, Flublok may be suitable for adults (but not children, teens and seniors) with egg and/or latex allergy.  Traditionally, the flu vaccine has been developed in eggs.  To learn more you may read a previous article, “Tracking the history of the development of the flu vaccine”, by clicking here.  The ability to develop the flu vaccine in insects instead of eggs is heralded as a boon to egg allergic individuals.  However, since it has been newly introduced in 2013, it remains to be clinically tested in individuals other than adults and hence, is not yet FDA approved in children, teens and seniors, since their immune system is different than a typical healthy adult.

A Flu Virus

A Flu Virus

Please, discuss with your doctor.  It is highly recommended to take the flu vaccine to avoid hospitalization and other secondary complications from a flu infection.  It is highly contagious.  Certain age groups are more susceptible than others.  The Centers of Disease Control of USA reports a total of 12,343 hospitalizations that occurred from October 1, 2012 through April 30, 2013, which translates to a cumulative rate of 44.3 influenza-associated hospitalizations per 100,000 people in the United States. The total number of influenza-associated pediatric deaths reported to CDC for 2012-2013 was 146 in USA. While the vast majority of the tested virus samples (>99%) showed susceptibility to the antiviral drugs oseltamivir and zanamivir, some varieties showed resistance. Watch an animated video of how the flu virus enters, and multiplies inside the human body.

Why do I feel fatigued after my flu vaccine?
The vaccine composition is changed every year. The WHO meets twice a year to discuss the varieties of flu strains causing flu infections and hopes to include the most “popular” strains in the flu vaccine composition (see below for for the 2013-2014 composition). However, the vaccine can accomodate a maximum of three to four flu strains. There might be a new flu strain that emerges later in the year. There might be a fifth or sixth flu strain also causing infections. The flu vaccine assists an individual in easing the “suffering from symptom” period. Therefore, a person who has the vaccine can still get the flu from a flu strain not included in the vaccine but the symptoms will be weaker. This is because the flu strains differ from each other very slightly and most of their characteristic proteins are included in the vaccine, hence “teaching” the body’s immune system to be ready to fight the flu infection.

There can be a slight fever and other side effects (see below) after the flu vaccine.  The symptoms would start right away and last 2 to 3 days. This might happen if the flu vaccine composition includes one or more flu strains that were not included in the previous year’s vaccine composition. If the individual has never been exposed to 1 or more of the flu strains in the vaccine, the immune system might react with symptoms like the flu. It is the immune system getting ready. The individual does not get flu from the inactivated flu vaccine and the live flu vaccine is too weakened to cause the flu. You may also read “Why am I feeling fatigued after taking the flu vaccine?

Related Articles:
The compostion of the 2013 – 2014 trivalent and quadrivalent flu vaccine for the Northern Hemisphere
Tracking the seasonal flu, The History of the Flu Vaccine and The Flu Vaccine of 2011

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The compostion of the 2013 – 2014 trivalent and quadrivalent flu vaccine for the Northern Hemisphere


The compostion of the 2013 – 2014 trivalent and quadrivalent flu vaccine for the Northern Hemisphere:

The World Health Organization has met in Geneva Switzerland in February 2013 to decide upon the composition of the Influenza or flu vaccine composition of the upcoming 2013-2014 flu season. A quote from their decision is below:
quote

Recommended composition of influenza virus vaccines for use in the 2013-14 northern hemisphere influenza season

21 February 2013
It is recommended that trivalent vaccines contain the following:

an A/California/7/2009 (H1N1)pdm09-like virusa;
an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b*;
a B/Massachusetts/2/2012-like virus.

It is recommended that quadrivalent vaccines containing two influenza B viruses contain the above three viruses and a B/Brisbane/60/2008-like virusc.

a A/Christchurch/16/2010 is an A/California/7/2009-like virus;
b A/Texas/50/2012 is an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011;
c B/Brisbane/33/2008 is a B/Brisbane/60/2008-like virus.

* It is recommended that A/Texas/50/2012 is used as the A(H3N2) vaccine component because of antigenic changes in earlier A/Victoria/361/2011-like vaccine viruses (such as IVR-165) resulting from adaptation to propagation in eggs.

For more information

Recommended composition of influenza virus vaccines for use in the 2013-14 influenza season – full report
pdf, 229kb

Unquote
You may also want to read our follow up article, “Now is the time for your 2013 – 2014 flu vaccine“.

The Flu Virus

The Flu Virus

The 2013-2014 flu vaccine composition differs from the 2012-2013 and from the 2011-2012 flu vaccine composition. See below.

The Northern Hemisphere’s 2012-2013 seasonal influenza vaccine be made from the following three vaccine viruses:

  • an A/California/7/2009 (H1N1)pdm09-like virus;
  • an A/Victoria/361/2011 (H3N2)-like virus;
  • a B/Wisconsin/1/2010-like virus (from the B/Yamagata lineage of viruses).

While the H1N1 virus used to make the 2012-2013 flu vaccine is the same virus that was included in the 2011-2012 vaccine, the recommended influenza H3N2 and B vaccine viruses are different from those in the 2011-2012 influenza vaccine for the Northern Hemisphere.

The Northern Hemisphere’s 2011-2012 seasonal influenza vaccine contain the following three flu viruses:

  • an A/California/7/2009 (H1N1)-like virus;
  • an A/Perth/16/2009 (H3N2)-like virus;
  • a B/Brisbane/60/2008-like virus.

Related Articles:
Now is the time for the 2013-2014 flu vaccine
The History of the Flu Vaccine Development
Flu vaccine and Egg Allergy
The world’s top influenza (Flu) research laboratories decided to institute a self-imposed moratorium
Why am I feeling fatigued after the flu vaccine?

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The proportion of flu and pneumonia related deaths is now slightly above epidemic threshold

For the first time in USA, the Influenza (Flu) season of 2012 – 2013, has become an eipidemic. Which means, there is a good chance either you or somebody you know is sick from the flu. This flu season is unlike the previous year’s mild flu season and totally took the people by surprise.

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January 16, 2013 · 11:03 pm

Tracking the seasonal flu, The History of the Flu Vaccine and The Flu Vaccine of 2011


The seasonal flu of 2011 arrived with the first confirmed case in Arkansas (Read more). The vaccination of the public swung into action with the seasonal flu vaccine components of 2011, which were exactly the same as the vaccine components of 2010, and described in my previous article, entitled, “Should I get the flu vaccine this year?”. The 2011 – 2012 flu season is going to be an ordinary one, unlike the one in 2009 and the far deadlier one in 2018, all of them caused by the same deadly swine flu H1N1 strain of the flu virus. First reported death from swine flu in 2009 was a 23 month old boy in Texas (Read more). The vaccination of the public swung into action in 2009. Why was 2018 the deadliest flu season in America with over 40 million estimated to be killed world-wide, far more than by the war?  Why was the 2009 flu season pandemic by the same flu virus strain  far less deadlier? The answer is the flu vaccine, the story of which I will tell you here.

A Flu Virus

The Story of The Flu Vaccine:
This year quite different from other years in the story of the Flu Vaccine and that is because Prof. Edwin Kilbourne passed away very quietly in 2011. He had devoted his entire life to the study of the flu virus and played a leadership role in the history of the development of the flu vaccine. I could tell you about Dr Kilbourne but to tell you why he is important, I would need to tell you about the 2018 flu pandemic.

Many have wondered why the Flu pandemic of 1918 is not mentioned as a turning point in American lifestyles in the History books. The fall of 2018 began just like another fall in the middle of a chaos of a country in the midst of the a world war. Stealthier than any human enemy, arrived a tiny microbe, the flu virus strain H1N1 on a crisp New England fall day in a Boston sea port. It must have arrived with some sailors. The September of 1918, the Boston Port was busy with war shipments of machinery. The war efforts allowed the virus to spread and diffuse. It was named the “Spanish Flu” or the “La Grippe”.

The flu pandemic of 1918 devastated many towns and military cantonments by acting very strangely. It wiped out America’s young and healthy, particularly those aged 20-35 years of age. There was no cure. The ill were advised to rest lying down, get fresh air, and to take plenty of fluids. The healthy were advised to avoid crowded, public places. Many wore masks to protect themselves or to prevent infecting others.

The Contagious First Wave of the 1918 Flu Pandemic
The best recorded first case was in Fort Riley, USA. On March 11, 1918, Private Albert Gitchell, a cook at Fort Riley, came down with a cold that required isolation. Within 5 weeks, 1,127 soldiers came down with the same symptoms and 46 of them died. Soldiers trained at Fort Riley before being deployed for the war effort in Europe and unintentionally spread the flu to Europe. When the flu began to ravage the people of Spain, the Spaniards publicly announced the disease. Spain was not in World War 1 and was not censoring its news and the world first heard of the deadly flu from Spain. Hence, the name, the “Spanish Flu”. By July 1918, the “Spanish Flu” had visited Russia, India, China and Africa and appeared to be dying out. Nobody guessed that this was only the first wave of the deadly flu pandemic about to be unleashed upon an unsuspecting world of humans by a microscopic, indestructible microbe.

The Contagious and Deadly Second Wave of the 1918 Flu Pandemic
Towards the end of August, a more deadly flu struck three world cities simultaneously. Boston, USA; Brest, France; and Freeport, Sierra Leone. The overwhelmed hospitals asked for volunteers to take care of their sick, who had to be housed in tents because of their sheer numbers.

Nurses care for the sick in tents

Some died within two days of first symptoms which included coughing violently, bleeding from their ears or turning blue in color and of course, extreme fatigue, fever and headache. The Spanish flu in its second wave struck suddenly and severely, killing some within several hours or a few days, while sparing others. Not surprisingly, panic ensued. Public events were canceled. Schools and theaters closed. Masks were required by many communities. Popular homemade remedies of the past did nothing to prevent or cure this disease. The dead piled up and mass graves had to deal with the bodies. There were not enough people to dig individual graves.

The Third Wave of the 1918 Pandemic
On November 11, 1918, an Armistice brought an end to World War 1. The hugging and kissing of the returning soldiers, some carrying the flu virus helped to create yet another epidemic wave, spreading a weaker version of the “Spanish Flu”. This wave was largely ignored because people had to concentrate on rebuilding their lives, while the pandemic lingered alongside and slowly petered away. Some say the flu lingered until next year but nothing as deadly as the early fall of 1918.

Preventing Another Deadly Pandemic
In an effort to prevent another deadly pandemic in the future, the USA government allocated 1 million dollars to learn more about the “Spanish Flu”. Among many recruited towards the laboratory war against the “Spanish Flu” was a young and eager Dr Edwin Kilbourne, a medical school graduate who was well-trained in virology laboratory research.

Dr Edwin D Kilbourne and Dr D E Rogers testing the Asian Flu virus

It was particularly hard for the Alaskan Indians for whom the death rate was elevated beyond that of the non-Indians. In one Inuit village in Alaska 72 of its 80 residents  died within 5 days in November 1918. Years later in 1997, a researcher dug up remains in the permafrost to isolate the flu virus and reconstructed the fatal strain H1N1. The Spanish Flu had traveled from Boston to Alaska in 2 months, killing many in it’s path.

In 1918 children would skip to the rhyme (Source: Crawford)
I had a little bird, Its name was Enza. I opened the window, And in-flu-enza.

The “Spanish Flu” of 1918 killed over 40 million people worldwide that flu season, while the World War 1 claimed about 16 million. Archives of photos here describe how the public and the government reacted to a situation of panic in the midst of a world war. These archives will help guide future leaders when faced with a similar crisis in the future. The Flu virus mutates over the years and has a habit of returning every few decades to cause epidemics or pandemics, that kill many. A cryptic, well-researched PBS movie (click here to watch) entitled, “1918 Spanish Influenza”, follows the story of the 1918 flu virus pandemic.

Native American death rate from the flu

on
swine flu death rates elevated for alaska natives and american indians

http://www.washingtonpost.com/wp-dyn/content/article/2009/12/10/AR2009121003937.html

The “Spanish flu” of 1918-19 devastated Inuit villages in Alaska. In one, Brevig Mission, 72 out of 80 residents died over five days in November 1918. A researcher extracted tissue samples in 1997 from a body buried there in a mass grave in the permafrost, allowing scientists to reconstruct that fatal strain of influenza.

CDC brochure advising that antibiotics will not work against the flu

http://www.cdc.gov/getsmart/campaign-materials/print-materials/Brochure-NativeAmerican.html

Arkansas has confirmed the first case of seasonal flu for 2011 in America   http://nwahomepage.com/fulltext-news/?nxd_id=276457

First reported death from swine flu in 2009 was a 23 month old boy in Texas    http://www.chron.com/news/health/article/Swine-flu-s-spread-pushes-Texas-to-cut-high-1744879.php

Tracking swine flu worldwide   http://www.nytimes.com/interactive/2009/04/27/us/20090427-flu-update-graphic.html

The United States Department of Health and Human Services  – a one stop to flu   http://1918.pandemicflu.gov/

The flu season that should be in history books    http://virus.stanford.edu/uda/   http://virus.stanford.edu/uda/

In 1918 children would skip to the rhyme (Crawford)  (source  http://virus.stanford.edu/uda/  )     I had a little bird,Its name was Enza.I opened the window,And in-flu-enza.     It first arrived in Boston in September of 1918 through the port busy with war shipments of machinery and supplies. The war also enabled the virus to spread and diffuse.  

Watch the PBS movie on the 1918 Spanish Influenza  http://www.pbs.org/wgbh/americanexperience/films/influenza/

Watch an archive of photos of the 1918 flu that killed an estimated excess of 40 million people worldwide while the world war 1 during the same time claimed an estimated 16 million lives  http://www.archives.gov/exhibits/influenza-epidemic/

For the federal government answers to frequent questions go to   http://www.flu.gov/general/

For a brief history of the Flu vaccine in The Times in 2008   http://www.time.com/time/nation/article/0,8599,1864920,00.html

The CBS documentary by Norman Gorin on the 1976 flu vaccine that caused 4000 people to claim damages, two thirds of them neurological   http://www.dailymotion.com/video/x9nnh6_swine-flu-1976-propaganda_news#rel-page-1

Natural questions followed on how to deal with the 2009 flu pandemic heeding the lessons of the 1976 mass flu vaccination  http://www.time.com/time/health/article/0,8599,1894129,00.html

Looking back it is not difficult to see why the 1976 flu vaccination decisions were taken.  http://www.haverford.edu/biology/edwards/disease/viral_essays/warnervirus.htm  but with the knowledge now, that the 1976 vaccine had the trigger that could make 8.3 per million people with most likely no prior illness sick from GBS versus 0.7 per million people with most likely a prior illness sick from GBS. Rationale for future vaccination programs.

Dr Edwin Kilbourne was the virologist who convinced the US Public Health Service to mass vaccinate. His was a stellar career, devoted to outwitting the Flu Virus. 1920 – 2011.  http://www.virology.ws/2011/02/25/edwin-d-kilbourne-md-1920-2011/    The New York Times only featured a miniscule portion of his career and his role in the 1976 flu vaccine fiasco and ignored his tremendous contribution to the modern flu vaccine.

Palese and Garcia-Sastra continue the search for a diagnostic, preventive and curative agent for all strains of Influenza. http://www.freepatentsonline.com/y2011/0027270.html  and http://en.wikipedia.org/wiki/Peter_Palese  and the team at Mt Sinai

Towards a broadly protective flu vaccine  http://www.jci.org/articles/view/37232  The team at St Judes Medical center  with the goal to define the role of cross reactive lymphocytes. Webster’s article on flu history with photo of little girls skip roping to the poem above  http://people.scs.carleton.ca/~soma/biosec/readings/influenza/influenza.html   Also has great related internet sources.

Egg free vaccine – my earlier article

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Why am I feeling fatigued after getting my flu vaccine?


Are you or someone you know feeling fatigued or feeling unwell after getting the flu vaccine?

The needle method of delivery of Flu Vaccine

The needle method of delivery of Flu Vaccine

Some vaccines are not for all people. The flu vaccine comes in various delivery formats.  The clear choices are between a needle delivery and a nasal spray delivery. However, discuss with your doctor which option may not be suitable for the very young under 8 and the elderly, whose immune systems cannot handle the live virus in some flu vaccines versus the attenuated virus in other flu vaccines. You may also read “Certain flu vaccines are not recommended for all ages“.

Also, avoid taking a pain killer along with your flu vaccine since they dilute the effect of the vaccine.

The Centers of Disease Control lists the following common reasons for feeling unwell after getting the flu vaccine:

1. People may be exposed to one of the influenza viruses in the vaccine shortly before getting vaccinated or during the two-week period that it takes the body to gain protection after getting vaccinated. This exposure may result in a person becoming ill with flu before protection from the vaccine takes effect.
2. People may become ill from non-flu viruses that circulate during the flu season, which can also cause flu-like symptoms (such as rhinovirus). Flu vaccine will not protect people from respiratory illness that is not caused by flu viruses.
3. A person may be exposed to an influenza virus that is very different from the viruses included in the vaccine. The ability of a flu vaccine to protect a person depends largely on the similarity or “match” between the viruses or virus in the vaccine and those in circulation. There are many different influenza viruses. For more information, see Influenza (Flu) Viruses.
4. Unfortunately, some people can remain unprotected from flu despite getting the vaccine. This is more likely to occur among people that have weakened immune systems or the elderly. However, even among these people, a flu vaccine can still help prevent complications.

What about people who get a seasonal flu vaccine and still get sick with flu-like symptoms? How about an allergic reaction to egg or latex?
Have you considered an allergy to egg in which the flu virus is traditionally grown? Discuss with your doctor egg free options available this year. If egg allergy is a concern, then you may also read:
Egg Allergy and Flu vaccine : egg free options are available in Europe but not in USA until 2012. Check with your doctor on latest 2013 egg-free flu vaccine options.
Latex Allergy : some needle tips are coated with latex, eg., intradermal delivery of flu vaccine. Please, confirm about absence of latex coated needle tips on package insert. See video on Intradermal Flu vaccine technology  by Fluzone  microneedle, the first intradermal flu vaccine approved using the microneedle technology and available for 2011-2012 flu season.

A Flu Virus

Seasonal influenza vaccine provides the best protection available from seasonal flu—even when the vaccine does not exactly match circulating seasonal flu strains, and even when the person getting the vaccine has a weakened immune system. Vaccination can lessen illness severity and is particularly important for people at high risk for serious flu-related complications

Dual flu infections:
Australian scientists have discussed a “dual flu infection” phenomenon reported by Japanese scientists in 16 students.
1) They reported that vaccination with the regular flu season vaccine resulted in a higher risk of infection with H1N1 and they give their scientific opinion on why that happened in some areas of the world and not in others.
2) They hypothesize that a strand-transcending short-term immunity results. In other words, it is usually rare that two strains of influenza A attack in the same year and so close to the infection by the other strain. If the second strain attacks quickly after the first strain infects, then there is some transient immunity which protects; however, longer this gap this immunity wanes. So, by their theory, dual infections have a gap.

Super immunity:
This is the “holy grail” of flu scientists – to discover the one vaccine that will prevent all strains of flu. Apparently, natural survivors of the H1N1 infection may have a “super immunity” to all known Influenza A strains of the flu virus. A BBC article. describes Dr Patrick Wilson and his colleagues work on this. In my opinion, lets see what happens in the next few flu seasons.However, scientists caution that a vaccine developed to achieve similar “super immunity” results will have to undergo several years of clinical trials before being eligible to be marketed.

Related Articles:
Flu Vaccine
Now is the time for your 2013 – 2014 flu vaccine
The compostion of the 2013 – 2014 trivalent and quadrivalent flu vaccine for the Northern Hemisphere
Should my baby get the flu vaccine?
Should I get the flu vaccine this year?
Flu vaccination and egg allergy – do check with your doctor on update 2013 there are egg-free flu vaccine options today. This article shows you the procedure of traditional flu vaccine development

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