Flu vaccines could break transmission cycle

CORVALLIS, Ore. – The value of vaccinating more children and young adults for influenza is being seriously underestimated, experts say in a new report. Conventional wisdom and historic vaccine programs previously concentrated on the elderly and those at higher risk of death and serious complications.

An analysis, conducted in cooperation with Oregon State University, was just published in the journal Vaccine, in work supported by the National Institutes of Health. The study suggests that children in school and young adults at work are responsible for the vast majority of flu transmission.

Programs that effectively increase vaccination in those groups would have the best payoff, the research concluded.

The key point: If you don’t catch the flu, you can’t die from it.

Breaking the cycle of transmission benefits everyone from infants to the elderly, the researchers said. And at stake are thousands of lives and billions of dollars a year.

“In most cases, the available flu vaccine could be used more effectively and save more lives by increasing the number of vaccinated children and young adults,” said Jan Medlock, a co-author of the study and researcher with the Department of Biomedical Sciences in OSU’s College of Veterinary Medicine.

“That approach could really limit the cycle of transmission, preventing a great deal of illness while also reducing the number of deaths among high-risk groups,” he said. “Approaches similar to this were used in Japan several decades ago, and they accomplished just that. Our new analysis suggests we should reconsider our priorities for vaccination.”

In a perfect world and in accord with recommendations from the Centers for Disease Control and Prevention, researchers agree that almost everyone over the age of 6 months should get the flu vaccine, unless they were allergic to the shot or had other reasons not to take it. But in the United States, only about one-third of the population actually gets a flu vaccine each year.

Historic efforts have been focused on people at higher risk of death and severe disease — often the elderly, and those with chronic illness, weakened immune systems, health care workers or others.

With existing patterns of vaccine usage, the problem is enormous. Seasonal influenza in the U.S. results each year in an average of 36,000 deaths, more than 200,000 hospitalizations, an $87 billion economic burden, and millions of hours of lost time at school and work — not to mention feeling sick and miserable.

The flu vaccine, up until 2000, was only recommended for people over 65, Medlock said. Other age groups were added in the past decade as it became clear they also were at high risk of death or complications — children from age 6 months to 5 years, and adults over 50. Just recently, age was taken completely out of the equation.

“Clearly we would want people at high medical risk to get a flu vaccine as long as it is abundant,” Medlock said. “But what we’re losing in our current approach is the understanding that most flu is transmitted by children and young adults. They don’t as often die from it, but they are the ones who spread it to everyone else.”

The population-disease transmission modeling done in the new study outlines this, and concluded that a 25-100 percent reduction in deaths from flu or its complications could be achieved if current flu vaccine usage were shifted to more efficiently include children and young adults, as well as those at high risk.

One obstacle, experts say, is the historic reluctance to add even more vaccines to those already received and often mandated for school-age children.

“A simple program we could consider in our K-12 schools would be to have the school nurse, or other local professional, give every child an annual flu shot, with the parents being informed about it in advance and having the option to decline,” Medlock said.

“Vaccinating children could prevent a great deal of illness and save many lives at all ages, not just the children,” he said. “More aggressive educational campaigns to reach young adults would also be helpful.”

Collaborators on this research include scientists from Yale University and the University of Texas, supported by the National Institute of General Medical Sciences.

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Parkdale third graders sing "12 Disaster Days of Christmas"

Welcome to your sing-able Christmas gift list. What follows is an emergency rendition of “12 Days of Christmas” – for outfitting your home or car in case of snow storm, earthquake, flood or other emergency. Read it as a simple list, or sing it to the tune of “12 Days” – you know, as in “ … and a partridge in a pear tree…” Not to make light of it, but the song is a familiar framework for a set of gift ideas that you could consider gathering together, even if the recipient already owns items such as a bunch of coats, tire chains and flashlights. Stores throughout the Gorge are stocked up on all these items. Buying all 12 days might be prohibitive, but here are three ideas for checking any of the dozen off your list (notations follow, 1-12.) The gift items needed to stay warm, dry and safe are also coded to suggest items in your abode (A) in your car (C) or both (B). 12 Gallons of Water (A) 11 Family meals (B) 10 Cans of propane (A) 9 Hygiene bags (B) 8 Packs of batteries (A) 7 Spare coats (B) 6 Bright red flares (C) 5 Cozy blankets (B) 4 Tire chains (C) 3 Flashlights (B) 2 cell phone chargers (B) 1 And a crush-proof first aid kit (B) Price ranges? Here’s a few quotes for days Three, Two, Four and Nine: n A family gift of flashlights (three will run $15-30, Hood River Supply, Tum-A-Lum) n Cell phone chargers (two will run $30-60) n Tire chains (basic set, $30, Les Schwab, returnable if unused for the winter) n Family meals ($100 or so should cover the basics for three or four reasonably well-fed days) n The home kit should be kept in a handy place near an exit, and remember that water needs to be replenished every few months. If you have a solid first aid kit already, switch out the gift idea with “and-a-sto-o-u-t- tub-for it-all …” Otherwise, it’s a case of assembling your home or car kits and making sure all members of the family know what the resources are and how to use them (ie flares and propane). Emergency situations are at worst life-threatening, at best deeply uncomfortable if you and your family are left without power for an extended period, or traveling and find yourself in a situation where you need to wait out a storm, lengthy traffic delay, or other crisis. Notes on the 12 gift ideas: 12 – Gallons of water: that’s one per person in a four-member family to last for three days, the recommended minimum to be prepared for utility outages. 11 – Easy-open packaged goods, energy bars, dried food and nuts are good things to include for nutrition. Think of what your family of four needs for three days to stay fortified and hydrated (see number 12). Can-opener also recommended 10 – If you have a propane camping stove, keep extra fuel handy. 9 – Hygiene bags: put packaged moistened towelettes, toilet paper, and plastic ties in large garbage bags (for personal sanitation) Resource list courtesy of Hood River County Emergency Management, Barbara Ayers, manager/ 541-386-1213. The county also reminds residents to Get a Kit, Make A Plan to connect your family if separated, and Stay Informed. See www.co.hood-river.or.us to opt-in for citizen alerts. Enlarge



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