Flu shot did poor job against worst bug in seniors

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staff, Gazette
Thursday, February 21, 2013

— This yearís flu shot is doing a startlingly dismal job of protecting senior citizens from the harshest strain this season, proving only 9 percent effective, the government said Thursday.

Health officials donít know why this is so, but it helps explain why so many older people have been hospitalized with the flu this year.

Flu vaccine tends to protect younger people better than older ones and never works as well as other kinds of vaccines. But experts say the preliminary results for seniors are disappointing and highlight the urgent need for a better vaccine.

Overall, the vaccineís effectiveness is a moderate 56 percent, which means those who got a shot have a 56 percent lower chance of winding up at the doctor with the flu. That is nearly as good as other flu seasons, the Centers for Disease Control and Prevention said Thursday.

For those 65 and older, it offers far less protection. It is 27 percent effective against the three strains in the vaccine, the lowest in about a decade but not far below from whatís expected. But the vaccine did a particularly poor job of protecting older people against the toughest flu bug, which is causing more than three-quarters of the illnesses this year. CDC officials say itís not clear why.

Vaccinations are recommended for anyone over 6 months, and health officials stress that some vaccine protection is better than none at all. While itís likely that older people who were vaccinated are still getting sick, many of them may be getting less severe symptoms.

ďYear in and year out, the vaccine is the best protection we have,Ē and vaccinations are still recommended for senior citizens, said CDC flu expert Dr. Joseph Bresee.

To be sure, the preliminary data for seniors is less than definitive. It is based on fewer than 300 people scattered among five states.

But it will no doubt surprise many people that the effectiveness is that low, said Michael Osterholm, a University of Minnesota infectious disease expert who has tried to draw attention to the need for a more effective flu vaccine.

Older people have weaker immune systems that donít respond as well to flu shots and are more vulnerable to the flu and its complications, including pneumonia.

Health officials at a meeting Thursday said they donít know why this yearís vaccine did so poorly in that age group. One theory, as yet unproven, is that seniorsí immune systems were accustomed to strains from the last two years and had more trouble switching gears to handle this yearís different, harsh strain.

Among infectious diseases, flu is considered one of the nationís leading killers. On average, about 24,000 Americans die each flu season, according to the CDC.

This flu season started in early December, a month earlier than usual, and peaked by the end of year. Hospitalization rates for people 65 and older have been some of the highest in a decade, at 146 per 100,000 people.

Flu viruses tend to mutate more quickly than others, so a new vaccine is formulated each year to target the three strains expected to be the major threats. But that involves guesswork.

Because of these challenges, scientists tend to set a lower bar for flu vaccine. While childhood vaccines against diseases like measles are expected to be 90 or 95 percent effective, a flu vaccine thatís 60 to 70 percent effective in the U.S. is considered pretty good. By that standard, this yearís vaccine is OK.

For seniors, a flu vaccine is considered pretty good if itís in the 30 to 40 percent range, said Dr. Arnold Monto, a University of Michigan flu expert.

A high-dose version of the flu show was recently made available for those 65 and older but the new study was too small to show whether that made a difference this year.

The CDC estimates are based on about 2,700 people who got sick in December and January. The researchers traced back to see who had gotten flu shots and who hadnít. An earlier, smaller study put the vaccineís overall effectiveness at 62 percent but other factors that might influence that figure werenít taken into account.

The CDCís Bresee said thereís a danger in providing preliminary results because it may result in people doubting ó or skipping ó flu shots. But the data was released to warn older people who got shots that they may still get sick and shouldnít ignore any serious flu-like symptoms, he said.

The new data highlights an evolution in how experts are evaluating flu vaccine effectiveness. For years, it was believed that if the viruses in the vaccine matched the ones spreading around the country, then the vaccine would be effective.

This yearís shot was a good match to the bugs going around this winter, including the harsher H3N2 that tends to make people sicker. Yet the season proved to be a moderately severe one, with many illnesses occurring in people whoíd been vaccinated.

A slate of new vaccines will be available next summer, including some that protect against as many of four strains of flu and some that can be made more quickly. But experts say itís not clear whether they will be any more effective.

Last updated: 8:08 am Monday, April 29, 2013

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