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Azar: Not Getting Your Flu Shot is Like Riding in a Car Without a Seatbelt

Top US public health officials implored the US general public and health officials to get a flu shot during a press briefing on the state of influenza in the country on Thursday, February 15.

Comparing not getting a flu shot to riding in a car without a seatbelt, Department of Health and Human Services (HHS) secretary Alex Azar, stressed that there is still time for every American over the age of 6 months to get a flu shot. Azar added that all the panelists on the briefing and their families had received their shots and that even President Trump has been vaccinated this year.

The latest data from the Centers for Disease Control and Prevention (CDC) have revealed that adults who are vaccinated are 36% less likely to get the flu. That number jumps to a whopping 59% for vaccinated young children.

“This flu season continues to be extremely challenging and intense,” lamented CDC Acting Director Anne Schuchat, MD, who also shared that, “Flu activity is likely to remain high and continue for several more weeks.” However, despite the fact that the latest data indicate hospitalizations for influenza-like-illness (ILI) are as high as were seen during the 2009 H1N1 flu pandemic, it does not mean that we are having a pandemic this season.

Several aspects have contributed to making this a particularly difficult flu season. Chief among them is the fact that this season has managed to hit most of the country at the same time, while a typical flu season tends to hit parts of the country at different times. This massive influx of ill individuals has not helped the already-strapped stores of intravenous bags—which were diminished after supply plants on Puerto Rico were damaged in Hurricane Maria—and stores of antiviral medications. Dr. Schuchat stated that they are diligently working with industry to get supplies of these medications where they are most needed.

Another aspect of this season that has contributed to its severity is the predominant strain of circulating virus, H3N2, which is often linked with more severe illness, according to Dr. Schuchat. Furthermore, as the most recent FluView report indicated, more than 30% of laboratory-confirmed flu-positive respiratory specimens recently analyzed in the United States were influenza B viruses, which is 10% above the season’s current average. CDC reported that they have been seeing an increasing proportion of H1N1 as well. Still, the predominant strain remains an influenza A virus (H3N2).

This year’s vaccine, while created to target this year’s circulating strains, has shown approximately 25% effectiveness against H3N2 in adults. Additional effectiveness data released from the CDC Acting Director indicated that the vaccine is 67% effective against H1N1 and 42% against influenza B in adults. Dr. Schuchat acknowledged that there is room for improvement to get those effectiveness numbers up and the government health institutions are working together to make this happen. In a recent statement on the US Food and Drug Administration (FDA) website, Commissioner Scott Gottlieb, MD echoed these sentiments, stating, “The FDA is committed to working together with the scientific and medical communities to better protect the public against the flu and apply lessons learned to next season’s flu vaccines.”

In children, the vaccine has fared much better, with 59% effectiveness against both influenza A and B strains in children. Surgeon General Jerome Adams, MD, underscored this effectiveness by sharing that tragically, three-quarters of the 63 children who have died from influenza infections this year in the United States were not vaccinated.

Additionally, Dr. Adams beseeched the public and health care professionals to get vaccinated, stating that, “A flu shot can be the difference between life or death for you and your loved ones.” He reminded everyone to practice the 3 C’s: Clean, Cover, and Contain: “Clean your hands, cover your cough and sneeze, and contain your germs.”

In addition, he encouraged sick individuals to stay home if they are sick to avoid spreading their germs to others, something physicians themselves often struggle with.
When asked whether or not they felt something could have been done differently this flu season to circumvent the high rates of infection, Dr. Schuchat spoke for the panel stating that the strains chosen to be included in this year’s vaccine were appropriate; however, they were all looking into comparative evidence of the effectiveness of vaccines grown in different mediums, particularly in light of the recent research results that have revealed that vaccines grown in eggs may be less effective. In his FDA statement, Dr. Gottlieb also addressed the issue, sharing that "a preliminary analysis of CDC data and information from patient databases indicate that this year, the cell-based influenza vaccine appears to have somewhat better effectiveness in preventing influenza than the egg-based vaccine. Scientists at the FDA, CDC, and National Institutes of Health are working diligently to fully understand the basis for this finding, so that all of next year’s vaccines can provide better protection in preventing the flu. Better understanding why the cell-based vaccine offered better protection against H3N2 this season, when compared to the egg-based vaccine, may offer important clues to help improve the production of a more effective H3N2 vaccine for next season."

The press panel consisted of HHS secretary Alex Azar, along with the CDC Acting Director Anne Schuchat, MD, Surgeon General Jerome Adams, MD, US Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony Fauci, MD, and Assistant Secretary for Preparedness and Response Robert Kadlec.
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Influenza A (H3N2) has caused most of the illnesses in this severe flu season, but influenza B is becoming increasingly responsible for more infections as the flu season continues to hit the United States.