Egg-free flu vaccines to be offered

The American Academy of Pediatrics recommends that all children 6 months and up get the vaccine as a shot, if possible. Although not recommended last year because it didn’t provide as much protection against some flu strains, the nasal spray containing live attenuated virus (FluMist) is supported for use in children this year by AAP and CDC.

Banking on egg-free vaccines this year, Dr. Zimmerman said, their 10 percent advantage could mean fewer sick people.

“The last time we had a really bad H3 year was in 2014,” he said. “That was a bad year. Last year, 2017-18, was worse, as bad as the 2009 [influenza A(H1N1)] pandemic.” The CDC reported 40 million cases of the flu and 974,000 hospitalizations.

FluMist has always worked with B strains of the flu, Dr. Zimmerman said, but had stopped being effective against the A strains. After remaking the spray vaccine with a new A strain, he said, the manufacturer was successful in getting the CDC to be neutral on what is the best type of vaccine for children. The AAP, on the other hand, expressed a preference for the flu shot.

Allegheny Health Network will follow CDC recommendations on flu vaccines this year, according to spokeswoman Candace Herrington. Egg-free vaccine will be offered to patients and employees with severe egg allergy, she said. The flu shot will be the primary choice for children, she said.

Dr. Zimmerman said eggfree vaccines are the most promising.

“It works better. Secondly, you can make it in a shorter time period, roughly five to seven days,” he said. “Normally you get the strain in February and the vaccine is released in August. That’s six months.” He said if the manufacturer has the capacity, the strains of virus to be used in the vaccine could be selected in April — and include information on flu strains circulating at that time here and elsewhere, including the Southern Hemisphere.

The CDC recommends people get vaccinated by the end of October. The AAP says children under 9 will need two doses of vaccine if it’s their first time and pregnant women can get a flu shot at any time.

Dr. Zimmerman said for the elderly and others whose immune systems are less robust, getting the vaccine in October or early November should take them safely through the flu season.

Having a more effective flu vaccine and getting more people to be vaccinated are key goals at UPMC, according to Mark Tanis, director of UPMC’s Influenza Committee.

“I think it’s difficult when you see after the season’s over, when the vaccine is not effective,” he said. “That makes it difficult for physicians to take. And in light of our flu vaccine advocacy, if it’s not working, it’s always a tough sell.”

This year, he said, the vaccine is expected to be more effective, and within a few weeks, most of the UPMC offices and pharmacies will have it on hand.

“The biggest sell is just making sure people get it,” he said, adding that UPMC employees improved their vaccination rate after the flu shot became mandatory in 2015. Last year, the rate was more than 90 percent, he said, with a small number of employees being exempted.

“If you get the flu shot, you’re protecting yourself and everybody else around you,” Mr. Tanis said, and that includes patients using UPMC facilities. Employees are urged to get the flu shot before the season gets underway, he said.

Dr. Zimmerman said the new flu vaccines are a safe bet: “We plan for my family to go egg-free this year.” investigator into the use of hepatitis C-infected hearts in transplantation. “This is going to have the biggest impact we’ve seen in decades.”

In a grim irony, the increase in organs available for transplants is caused in part by the opioid epidemic engulfing the United States. Heroin addicts often share needles, contributing to the 400 percent increase in acute hepatitis C among 18to-29-year-olds from 2004 to 2014, according to the Centers for Disease Control and Prevention. Among those ages 30 to 39, the uptick was 325 percent.

“A little less than 15 percent of our donations are the result of the epidemic,” said Kevin Cmunt, head of Gift of Hope, an organ procurement agency covering parts of Illinois and Indiana.

In 2016, an estimated 42,000 people died of opioid overdoses in the United States. Those two data points — the sharp increase in hepatitis C and the surge of opioid deaths — suggest that many more organs may be available for transplants.

“For all the damage (the opioid epidemic) has caused, the potential benefit is organ donation,” said Michael Chang, head of gastroenterology and hepatology at the Veterans Affairs Portland Health Care System in Oregon.

UNOS manages the national transplant waiting lists and evaluates donors and recipients based on compatibility and need. Geography also plays a major role, because organs have limited viability after the donor’s death, ranging from four to six hours for hearts and lungs to 24 to 36 hours for kidneys.

The shortage for all is severe. In 2017, 34,770 organ transplants were performed in the United States. The number of patients on the waiting list for organs is more than 114,000. The biggest demand by far is for kidneys, followed by the liver, the heart, the pancreas, lungs and intestines.