The CDC recommends that people who are at increased risk of complications from the flu receive the flu vaccine. This makes sense. The CDC also recommends that people who are “household contacts” of someone who is at increased risk of complications from the flu also receive a flu shot.
What is the reasoning behind this? (My guess would be herd immunity among people with the closest contact to the person at risk of complications, but I don’t know if something more specific is involved.)
Also, how much of an increased risk of getting the flu does the person have if their household contacts don’t get vaccinated?
Well, if you stop over at your 97 year old grandma’s house twice a week to vacuum the living room and cook her dinner, you don’t want to risk getting her sick (because you had the flu for two days before you had any symptoms).
At least that would be my understanding. Especially if she didn’t get the shot.
What about someone who is at risk for complications, but did get the flu shot and is in the age range where the shot has a high chance of provoking the correct immune response?
The flu shot is only about 70% effective in healthy people and much lower in many of those at highest risk (ie. autoimmune issues, elderly). Not exposing those at risk to the flu is important, even if they’ve had a flu shot.
I thought the CDC changed as is now officially recommending everyone over the age of 6 months get a seasonal flu shot.
Anyways - my son is allergic to egg. So the wife and I made sure to get one. Anyone can carry germs into the house I suppose. But only those who are sick produce the germs - which equals more flu germs around, increasing the chances of the non-vaccinated to get sick? Just my guess.
An often overlooked culprit in big afflictions like heart attax & strokes is inflammation. Dr. David Agus, the author of The End of Illness, makes the point that flu provokes an inflammatory response in our bodies. So let’s say of 100 people who get the flu, some % have the gene that makes them susceptible to stroke. 5 years from now, the process set in motion by the flu endured previously will cause a stroke in some % of those who are genetically susceptible to them. In other words, had they gotten the flu shot, they wouldn’t’ve had the flu, the destructive inflammatory process wouldn’t’ve happened, & therefore some strokes would’ve been prevented.
The traditional advice, before the immunize everyone except very specific groups approach that is now in place, was to target the high riskers and also to target their immediate herds.
Of those two targets arguably it mattered much more to target the herd than the high riskers themselves. The main reason is that high riskers, especially the elderly, do not have great response to the vaccine. So actually unless the elderly’s herd is immunized they have, at most, only slight increased protection by being vaccinated themselves.
The big push in my mind needs to be vaccinated school aged kids who are not themselves at high risk of serious influenza illness. They are the ones who spread it through society. Break the stream there and everyone is just not as likely to be exposed. Preschoolers and working adults are the second priority. Getting the high riskers themselves is better than not but won’t do anywhere near as much good for them as preventing their exposures in the first place.
Yeah, 33 as a needed-to-treat number is actually much lower than I would have expected. Not bad, flu shot, not bad!
60 is about what I would have WAGed, and 99 is still well within the realm of Worth It, for me, for my patients and for my two higher risk family members.
I talked my employer into letting we nurses give each other our flu shots at a company party from his ordered stash (we ended up with far too many doses this year due to an unexpectedly low patient census). Little wine, little pizza, little alcohol wipe, bang, we’re done. It was the most fun I’ve ever had getting (or giving) a shot!
Targeting high risk individuals alone is indeed not as effective as it has been advertised.
In years that there is a mismatch between what is predicted (and in the vaccine) and what is out there the injectable vaccine has worked very poorly.
Even in those years the nasal live influenza vaccine has worked well.
Only low risk individuals can get the nasal live influenza vaccine; those people also respond more vigorously to the killed injectable vaccine.
The biggest spreaders of the virus through the community are kids in schools.
It should be no surprise that the most effective tactic is going to be NOT targeting the high riskers who respond poorly to a vaccine that may not even be effective if they did respond, but rather universal vaccination with particular emphasis on using the nasal vaccine in low risk individuals who spread the bug the most - in particular kids in schools and day care.