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PostPosted: Sun Jan 20, 2013 5:14 pm 
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Unless you haven't been paying attention to the news, you know by now that this is an early and moderately bad flu season. By CDC's classification system, influenza is "widespread" in 48 of 50 states. Only Hawaii and Tennessee escape this highest category, and the latter because flu peaked early there.

The good news is that this year's flu vaccine is a pretty good match for the prevalent strains. H3N2 - the bug that's causing the most severe symptoms and (mostly pediatric and elderly) deaths - is responsible for as much as 75% of the cases. And a version of that is in this year's vaccine. Most of the Type B flu is Yamagata, and that too is in the vaccine. There are some new strains and non-vaccine old favorites floating around, but they account for a minority of the cases. So if you haven't gotten your flu vaccination, it isn't too late.

Here's more interesting news. There's been a good amount of research done in the last few years attempting to link exercise and fitness levels to vaccine efficacy. Typically an influenza vaccine doesn't eliminate the chance of getting the flu; rather it reduces the chance. It seems to work better in some than in others. The normal vaccine effectiveness rate is somewhere between 50% and 75%. This year they estimate the vaccine effectiveness at 62%, which is about average. If there's a way to improve that vaccine effectiveness - particularly in the more vulnerable populations like the elderly - well the recipe for that is something the scientific community is searching for. Already they've established that more fit people tend to have better immune systems, and better immune systems produce more antibodies to the vaccine antigens. But that doesn't help someone today who may or may not be in good shape.

So scientists at Iowa State University and University of Birmingham in England have been doing tests on whether exercise on the day of the shot makes a difference. There are many permutations that have been tested on both humans and laboratory animals. Some exercise was before, and some after vaccination. Some exercise was whole body, and some on the arm getting the vaccination. Different doses of exercise have been tried. The bottom line is that a "right dose" of exercise appears to increase the antibody response to the vaccination by as much as a factor of 2. Too little and too much exercise lessened the peak response. The hypothesized mechanisms for how this could happen vary. For instance there is a known inflammatory (and immune system activating) response to an exercised muscle. (That's one reason we get sore.) Exercise also will spread the vaccine antigen from the intramuscular injection site to the entire body in an efficient manner.

Moral of the story?

  • If you haven't gotten your flu vaccine by now, get it. If you've already caught influenza, it still isn't too late. There are several circulating strains, and this year's vaccine is trivalent (H1N1, H3N2, B Yamagata).
    ...
  • Don't be a Uechi weenie. A needle in the deltoid isn't going to kill you. Get your shot, and then go work out. At the very least, the released endorphins will make you feel better. At best, you may be maximizing the benefit of the immunization.
    ...
  • For now, don't obsess about whether you should get the vaccination before or after exercise. Just do both on the same day. And as always, don't overdo it.

- Bill


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PostPosted: Sun Feb 24, 2013 8:20 pm 
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The CDC is now saying this season's vaccine has been only 56% effective overall, still within the norm. But more importantly it has been only 27% effective against all three strains in those aged 65 and over, and in that demographic only 9% effective against the more dangerous H3N2.
CDC: Flu vaccine only provided 9 percent protection for seniors against worst strain

That lack of effectiveness in the elderly is in line with results published in recent years, however no adequate trials have ever been conducted on the elderly so there is no way to know what the potential effectiveness might be.
Reassessing Flu Shots as the Season Draws Near

Of note however is this paragraph in the first news link:
Quote:
As dismal as the numbers looked, he said, there needs to be perspective. The vaccine was still 27 percent effective overall for seniors over 65 years. For that age group, there aren't other preventive disease-fighting approaches as effective, he said. He also added that the better protection rates reported in children and adults under 65 suggest people in those age groups were less likely to give influenza to older people.


and this from the second link:
Quote:
Many of these are big-picture concerns that an individual patient cannot do much about. The reassuring news is that even critics of the influenza vaccines agree that serious complications are rare.

Another option for those who want to reduce their risk of influenza and flulike infections may be simply this: Wash your hands more often. There is good evidence this works.


I would think doing both the vaccine and the frequent washing is the best bet, covers more bases that way. Just be careful of static electricity (or open flame) around hand sanitizer if you use it
Can Hand Sanitizer Ignite? Yes, Thanks to Static Electricity

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PostPosted: Sun Mar 03, 2013 10:02 pm 
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Glenn

I wrote a response to this back when you posted, but it didn't take.

I'm on the leading edge of research here, following whether or not millions of people got their vaccinations (on a person by person basis), what motivated them to get vaccinated (or not), the consequences of timely vaccination (or not), and the outcomes of it all. The picture is still playing itself out. Mortality by flu and pneumonia is still peaking even though the prevalence of new influenza cases is waning.

What isn't represented by the statistics you cited is the severity of "vaccine failure" cases. It's not all or nothing. In the past those who did get influenza after having been vaccinated got a less severe form of the illness. Already I'm seeing differences in mortality in vaccinated vs. unvaccinated populations - even with the alleged "failure" of this year's vaccination in the elderly population.

What's also worth mentioning is the importance of younger people getting the vaccine. The best use of a single vaccine is in the younger person who is in contact with the more vulnerable elderly. When you eliminate the vectors to our geriatric population, influenza infections go down dramatically.

We shall see.

For what it's worth, next year's vaccination will still have the H3N2 antigen component that "failed" in this year's trivalent vaccination. Obviously the WHO sees value in it. They may however choose a slightly different strain.

Bill


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PostPosted: Mon Mar 04, 2013 5:44 am 
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Bill,

I was just updating the numbers you posted, these other factors are discussed in the links I provided. For example from the first link
Quote:
"It's important to remember that this 'effectiveness rate' refers to prevention of outpatient medical visits due to the flu. We do not yet have this year's statistics on how effective the vaccine was in preventing serious complications such as pneumonia and death," CBS News medical correspondent Dr. Jon LaPook told CBSNews.com. "Based on previous flu seasons, it is likely that even when patients get the flu despite receiving the flu vaccine, the vaccine still cuts down on the severity of the disease."

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