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Centers for Disease Control and Prevention

Fewer than half in USA get flu shots, CDC says

Liz Szabo
USA TODAY
Thomas Frieden, director of the Centers for Disease Control and Prevention, gets his flu shot Thursday.

At a time when many people are preoccupied with the dangers of Ebola and a rare respiratory virus striking children, health officials announced Thursday that fewer than half of Americans are being vaccinated against the flu, which kills an average of more than 30,000 people a year.

The disparity is striking given that influenza vaccines are available more widely than ever — including at supermarkets, drugstores and many workplaces — and there are options to accommodate just about everyone's preferences, from needle-free shots to high-dose versions, said William Schaffner, a professor at the Vanderbilt University School of Medicine in Nashville. The Centers for Disease Control and Prevention recommends a flu shot for everyone older than 6 months.

The flu season could be tougher than usual this year if it follows the pattern seen in Australia, which has reported the highest number of influenza cases in five years, Schaffner said. He noted that flu is hard to predict. In many years, however, flu outbreaks in the southern hemisphere can predict flu activity in the USA.

The Centers for Disease Control and Prevention has advice on flu shots and other vaccinations aimed at keeping children, pregnant women and senior citizens healthy.

For the first time, the CDC suggests that children ages 2 to 8 receive a live intranasal flu vaccine, instead of the traditional shot, because of evidence that it's more effective for those ages. Parents shouldn't waste time shopping for the nasal mist, however, because kids are better off getting the first vaccine available than risking an illness because they waited too long.

In another new recommendation, the CDC is calling for senior citizens to get a second type of vaccine against pneumococcus, a bacteria that can cause pneumonia and that hospitalizes about 50,000 Americans a year.

Anyone 65 and older should get a one-time vaccination with the combination pneumococcal vaccine Prevnar 13, already routinely given to children, because it protects against 13 strains of the bacteria, said CDC director Thomas Frieden.

Seniors should also get a second a second, one-time-only vaccination with another pneumococcal vaccine — known as a polysaccharid vaccine — that protects against 23 strains of pneumococcus. Seniors need to get these vaccines just once — not every year — but should get the shots about six months apart to increase their effectiveness.

The vaccines can reduce the risk of pneumoccal infection in seniors by 45% and cut the risk of life-threatening infections by 75%, Schaffner said.

The Prevnar vaccine has dramatically reduced pneumococcus infections in children, cutting pneumonia cases and ear infections, according to the CDC. Because fewer children now carry the bacteria, Prevnar has indirectly reduced those infections in seniors, too, a phenomenon known as herd immunity.

A study in the New England Journal of Medicine offers more guidance for seniors, finding that a high-dose flu shot better protects those over 65 than the regular flu shot. The immune system of seniors isn't as strong as in younger people.

People have more flu shot options this year than ever, Schaffner said. In addition to nasal sprays, which are available to people ages 2 to 49, there is a new "needle-free" shot that uses a jet to force flu vaccine through the skin. There are also shorter needles that don't penetrate as far into the muscle as regular needles.

The CDC recommends a flu shot for all pregnant women at any point in pregnancy.

Influenza vaccines can prevent dangerous flu infections in pregnant women and protect newborns for the first six months of life, until they are old enough to be vaccinated themselves, said Laura Riley, director of labor and delivery at Massachusetts General Hospital in Boston. Pregnant women infected with the flu are at high risk of hospitalization in intensive care and have a risk of preterm delivery, increasing the risk of disability and death in their babies.

Flu shots are vital for children, said pediatrician Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia. At least 100 children died from the flu last year. Although half had an underlying medical condition that put them at high risk, the other half were healthy kids. About 90% of children who died from the flu were unvaccinated, according to the CDC.

Flu costs the USA more than $87 billion annually, including an estimated $10.4 billion a year in direct medical expenses and an additional $16.3 billion in lost earnings annually, according to a report released Thursday by the CDC Foundation.

In spite of these risks, only 46% of Americans got flu shots last year, Frieden said. Vaccination rates by age were:

• 34% of adults ages 18 to 64.

• 50% of pregnant women.

• 55% of children ages 5 to 17.

• 65% of those age 65 and over.

• 70% of kids under age 5.

• 90% of doctors and nurses.

As a pediatrician who has seen healthy kids die of the flu, Offit said he's frustrated that parents seem more concerned about EVD-68, the rare respiratory virus that has sent hundreds of kids to the hospital this year, than about influenza.

"Ebola and EVD-68 have collectively caused zero deaths, but flu causes thousands of deaths every year," Offit said.

The flu hospitalizes about 200,000 people a year, Schaffner said.

"Influenza is constantly evolving as a virus and it's unpredictable," Schaffner said. Last year's severe flu season "was an unfortunate reminder that no one is exempt from flu's serious consequences."

Frieden said there is plenty of flu vaccine available this year: about 150 million doses. About half of them protect against three strains of flu and half protect against four strains.

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