This article was originally featured in Brigham Health Hub.
Paul Edward Sax, MD, Clinical Director of the Division of Infectious Diseases at Brigham and Women’s Hospital
Following the most dangerous flu season in decades, physicians are encouraging flu vaccination as the best way to prevent winter misery—especially for people who are most at risk.
The 2017-2018 flu season was one of the most lethal, longest and widespread, according to the US Centers for Disease Control and Prevention. Preliminary estimates suggest that influenza was responsible for an estimated 80,000 deaths, some caused by fatal complications such as stroke, pneumonia and heart attacks that can result from the illness.
“The important thing to know is that many of the flu deaths were people who were never vaccinated at all. We want to encourage people to get their flu vaccine,” said Paul E. Sax, MD, Clinical Director of the Division of Infectious Diseases at Brigham and Women’s Hospital (BWH).
Despite yearly fluctuations in effectiveness, vaccination is still regarded as the best prevention against the flu.
Of the 180 flu-associated deaths among children (the highest number reported in a season since tracking began), 80 percent of these children had not received the seasonal flu vaccine, the CDC reported. People age 65 years and older, children under age 5, and people with certain chronic conditions are more at risk of developing serious complications if they get the flu.
During the 2017-18 flu season, the vaccine was about 40 percent effective, meaning that it reduced a person’s risk of needing to seek medical care for flu illness by 40 percent. This is a lower-than-usual effectiveness rate. But it is likely due to a lower-than-expected response from the body’s immune system, Dr. Sax explains, and did not reflect a mismatch between the vaccine and the type of virus circulating. Each year, experts study outbreaks as they occur around the world and adjust the vaccine based on which strain of influenza virus they expect to be most likely.
Despite yearly fluctuations in effectiveness, vaccination is still regarded as the best prevention against the flu, with its potential for serious complications and hospitalization.
Who is Most at Risk for Influenza?
Those most at risk for complications and serious illness from influenza include:
- People with chronic conditions such as asthma (and other respiratory conditions) and diabetes
- People with heart disease and those who have had a stroke
- Adults age 65 and older
- Pregnant women
- Anyone whose immune system is compromised for any reason, including cancer
A survey during last year’s flu season suggested that only half of pregnant women received the vaccine. Dr. Sax urges pregnant women to get the vaccine, for themselves and their unborn babies. “As an infectious disease doctor, I’ve seen pregnant women who are terribly sick with flu, and it’s such a difficult situation because they’re obviously trying to care for themselves and their unborn child,” Dr. Sax says. “Pregnant women really need to get the flu vaccine.”
Over Age 65? Opt for the High Dose
There are now a number of types of flu vaccines. For most people, any of the options is fine. But Dr. Sax strongly recommends that people over 65 receive the “high-dose” shot that has been available in recent years. “The data are growing stronger that the high-dose vaccine is actually a better vaccine for older patients—that they get higher protective levels of antibodies and it correlates with reduced clinical events,” he says. “That’s what I do in my practice.”
People over age 65 made up more than half of all influenza hospitalizations during the 2017-2018 flu season. In a typical flu season, between 140,000 and 710,000 people in the US are hospitalized due to influenza; experts think that number was exceeded last year.
Be Prepared Before Flu Starts Spreading
Last year was the first flu season that was classified as high-severity across all age groups. Reports of flu-like illness began to climb in November, peaked for an extended period during January and February, and remained high through the end of March. The flu season lasted a full 19 weeks, the longest in recent years. It is not possible to predict just when a flu season will begin or peak, Dr. Sax says. The vaccine has been slightly modified since last year, and CDC officials have noted encouraging signs so far that the vaccine is well-matched to this year’s virus.
The CDC recommends yearly flu vaccines for people 6 months and older. Vaccination by the end of October is encouraged. But if you miss that date, it is still useful to be vaccinated later in the flu season.
Learn more about influenza and the flu vaccine:
- Confused about Flu Vaccinations? Get the Flu Facts
- Five Reasons to Get Your Flu Shot
- For locations near you to get a flu vaccines, visit flu.gov