We seem to be in the throes of an early beginning to the flu season. I’m not sure that the coverage, which would indicate this year is far worse than others, is anything other than premature, but that would be a good thing if it leads more people to get flu shots and to wash their hands more frequently. Every year, influenza kills tens of thousands of Americans, and there is no reason to take the many strains of the virus that are circulating lightly.
Flu shots? Lots of people don’t get them. They’re a nuisance to get, they can cause side effects including headache and fever, and lots of people are skeptical that they even work. And you know what? That skepticism is warranted. Influenza vaccine will only prevent infection 60% to 70% of the time, in the best of cases. That means that of every 10 people who would have gotten the flu without the shot, three or four still will. And flu shots can take two weeks to take effect. No wonder a lot of people complain that they got the shot and got sick anyway, or even that they suspect the shot gave them the flu. That’s exactly what you’d expect. I even wonder if the loud calls by public health experts can be counterproductive, because they leave people thinking that the flu shot is more effective than it is.
And flu vaccines work even less well in the elderly. The archaic technology for making them, which involves injecting influenza virus into chicken eggs and separating out the resulting antibodies, only allows for a few flu strains to be included and they must be picked far in advance. A recent review by a panel of expert scientists, including former executives from GlaxoSmithKline and Eli Lilly, found that studies of the vaccines probably overstate their effectiveness. Most vaccines don’t get used unless they are 80% or 90% effective; of our commonly used vaccines, the flu shot is probably the worst.
As New York University bioethicist Arthur Caplan notes, that’s exactly why everyone should get one. We know that flu shots really do work at slowing the virus down. In the past, they’ve helped limit the spread of pandemics — see this video of legendary Merck vaccine-maker Maurice Hilleman talking about what happened in 1957. It’s healthy people, with healthy immune systems, in whom the vaccine works best.
Hopefully, in the future, we’ll have much better options when it comes to the flu vaccine. There’s already the live virus nasal flu vaccine, sold by AstraZeneca, and this year brought the first U.S. flu shots made in cell cultures, not chicken eggs, from Novartis. The real hope, though, is that a biotechnology company or drug maker will create a vaccine that works for a decade, or, better yet, works against all flu. A universal flu vaccine that could be given to infants could be a blockbuster on the scale of Pfizer’s Prevnar, the best-selling vaccine in the world. But in the meantime, we need to stick with the lame old flu shots we have.
Also: please wash your hands. Often. For twenty seconds at a time. That means you should stand there at the sink for as long as it takes to sing happy birthday twice. And if you see anybody jetting rapidly from the sink, it’s not impolite at all to ask them why they don’t care more about infants or the elderly.