Doc­tors upbeat about this year’s flu shot

The Prince George Citizen - - Health -

Cases of sea­sonal in­fluenza have al­ready be­gun to show up in Canada, and pub­lic health of­fi­cials say that means it’s time to get that jab in the arm – not only to pre­vent the flu for your­self but also to help avoid spread­ing the nasty res­pi­ra­tory bug to oth­ers.

This year’s flu shot is ex­pected to be much more ef­fec­tive than last sea­son’s, which ended up be­ing a poor match for the pre­dom­i­nant cir­cu­lat­ing strain, known as AH3N2, said Dr. Michelle Murti of Pub­lic Health On­tario.

Murti said the 2018-2019 vac­cine should be a bet­ter match, as the H3N2 com­po­nent has been changed to re­flect what’s pre­dicted to be this sea­son’s dom­i­nant type of that strain.

The standard flu shot pro­vides pro­tec­tion against H3N2, an­other A strain called H1N1, and two B strains – Vic­to­ria and Ya­m­a­gata. The vac­cine is in­tended for most adults, as well as chil­dren six months of age and older.

For nee­dle-ad­verse kids, par­ents can in­stead opt for im­mu­niza­tion with FluMist, a nasal prod­uct that tar­gets the same four strains.

A high-dose shot is avail­able for se­niors aged 65-plus, who are of­ten at higher risk for se­vere com­pli­ca­tions from in­fluenza, which in some cases can be fa­tal.

“Mostly what we’re con­cerned about is that H3N2 com­po­nent. That’s the one that can be quite se­vere for se­niors par­tic­u­larly,” said Murti.

“The ques­tion is what kind of a sea­son are we go­ing to see this year? We’ve had two years in a row of H3N2 sea­sons. So I think some of the pre­dic­tions around what we might be see­ing this year is that we might be back to an H1N1 sea­son.”

That’s been the ex­pe­ri­ence in Aus­tralia, as the South­ern Hemi­sphere comes to the end of its in­fluenza sea­son.

“They’ve had a pre­dom­i­nantly H1N1 sea­son – very, very mild,” she said, a mas­sive change from the pre­vi­ous year, when Aus­tralia recorded more than 250,000 lab­o­ra­tory-con­firmed cases and 1,255 deaths due to flu, up from about 90,000 cases and 464 fa­tal­i­ties in 2016, mostly driven by H3N2 in­fec­tions.

“We hope that we might fol­low them this year,” Murti said of this year’s ex­pe­ri­ence Down Un­der. “We think that peo­ple do have a good amount of im­mu­nity against H3N2, which we’ve had for the last two sea­sons.”

The 2017-18 sea­son in Canada was a bit of an anom­aly, sur­pris­ing even some in­fluenza ex­perts. Not only was there a high num­ber of cases of H3N2 start­ing in the fall, but there was a late win­ter-early spring surge of in­fluenza B cases.

De­spite the hope that this coun­try may du­pli­cate Aus­tralia’s flu sea­son, Murti said Cana­di­ans shouldn’t as­sume there’s no point in get­ting vac­ci­nated.

“We never know ex­actly what we’re go­ing to get,” she said. “Was it milder in Aus­tralia be­cause peo­ple also got vac­ci­nated and they got vac­ci­nated against H1N1?

“So I think we can’t be com­pla­cent around try­ing to get the best pro­tec­tion we can. No mat­ter what type of flu you get, it can be quite se­vere for many peo­ple and es­pe­cially if you’re some­body who’s at risk for com­pli­ca­tions of in­fluenza.”

Com­pli­ca­tions in­clude si­nus and ear in­fec­tions, pneu­mo­nia, and in­flam­ma­tion of the heart or brain, which can land an in­fected per­son in the hos­pi­tal and in some cases even re­sult in death.

Those most vul­ner­a­ble to com­pli­ca­tions in­clude very young chil­dren, the el­derly, peo­ple with un­der­ly­ing heart and res­pi­ra­tory con­di­tions, and those with weak­ened im­mune sys­tems. But there are al­ways those who choose not to get vac­ci­nated out of fear.

For kids – and even some adults – with an aver­sion to nee­dles, one phar­macy chain has come up with a way to help take the sting out of the flu shot.

Whole Health Phar­macy Part­ners, a na­tional net­work of in­de­pen­dent phar­ma­cies, has in­tro­duced a vir­tual re­al­ity pro­gram to pro­vide a dis­trac­tion while bar­ing one’s arm for the dreaded jab.

Par­tic­i­pat­ing phar­ma­cies of­fer a list of 10 YouTube videos that can be ac­cessed via the pa­tient’s cell­phone and viewed through vir­tual re­al­ity gog­gles pro­vided by the stores.

“The pa­tient chooses whether they want to be immersed in a room full of pup­pies or they want to go into a div­ing ex­pe­ri­ence with dol­phins or space ex­plo­ration or a beach in the Mal­dives,” said Saleema Bhaidani, di­rec­tor of phar­macy in­no­va­tion and pro­fes­sional af­fairs for Whole Health.

“The good thing about vir­tual re­al­ity is that you put this head­set on them, they’re com­pletely immersed, so they can’t see the nee­dle,” she said.

“So if you dis­tract them from look­ing at (the nee­dle), that can de­crease the per­cep­tion of pain quite dra­mat­i­cally.”

On­tario, which be­gan rolling out its pub­licly funded flu im mu­niza­tion pro­gram Oct. 22, is al­ready re­ceiv­ing reports of in­fluenza cases in some re­gions of the prov­ince and has recorded its first few out­breaks in long-term care fa­cil­i­ties.

In its lat­est FluWatch re­port end­ing the week of Oct. 20, the Pub­lic Health Agency of Canada says there was in­creas­ing in­fluenza ac­tiv­ity across the coun­try, al­though the case num­bers were at what’s called “in­ter­sea­sonal” lev­els, with H1N1 the most com­mon cir­cu­lat­ing strain.

But as the coun­try moves closer to win­ter, Cana­di­ans can ex­pect the sounds of sneez­ing and hack­ing to ratchet up as the an­nual flu fest gets fully un­der­way, say pub­lic health physi­cians, who would like to see the num­ber of Cana­di­ans laid low by the virus dra­mat­i­cally cur­tailed.

And that means get­ting the flu shot, stressed Murti. “It’s the best pro­tec­tion you can have.”


A child wear­ing vir­tual re­al­ity glasses re­ceives a flu shot in a hand­out photo.

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