New option for fighting the flu

In Canada, we have many reasons to love winter — but the return of flu season isn’t one of them. With the snow and cold temperatures comes that miserable virus that nearly one quarter of us will get every winter season, says Health Canada. Many people will wind up in bed for a week or more, but tens of thousands of people will wind up in a hospital bed due to complications like pneumonia.

Or worse… Together, influenza and pneumonia consistently rank #8 in the top 10 causes of death in this country, according to Statistics Canada. In 2008 (the latest year for which data is available), the two were responsible for nearly 5,400 deaths. The majority of those deaths occur in people over age 65 — a group at a higher risk for complications. Part of the problem is that our immune systems change as we get older, and older adults are more likely to be coping with a chronic condition like heart disease or diabetes.

It’s hardly surprising that experts recommend we take precautions to avoid the flu — like getting a flu shot, even if it isn’t 100 per cent effective. Some people do experience side effects or reactions, so it’s important to talk to your health care providers about the benefits versus any potential risks.

However, not all flu shots are alike: This year, there’s a new vaccine available in Canada for people over age 65. To find out more about this option, we talked Dr. Jay Keystone, Director of the Medisys Travel Health and Immunization Clinic in Toronto and Professor of Medicine at the University of Toronto.

Some recent reports show that the flu vaccine isn’t always effective for everyone. Why do people who get the flu vaccine still get sick — and why does the vaccine seem to be less effective in older adults?

Seniors and children are the hardest hit during the flu season. Young children do not yet have fully developed immune systems and therefore are more susceptible to the flu and its serious complications. On the other hand, as seniors age, their immune systems decline, making them more susceptible to the flu and the additional health risks associated with getting sick. For seniors, their ability to mount an effective immune response against infection gradually wanes with age. Although older adults may still get influenza in spite of receiving the vaccine, studies have shown that the illness will be less severe and not likely to be fatal. Flu vaccines are the best protection for avoiding the seasonal influenza. For seniors, a new vaccine, Fluad®, approved earlier in the year by Health Canada, could provide an enhanced immune response to help provide better protection.

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What is Fluad? How is it different from the regular flu vaccine?

Fluad is the first seasonal flu vaccine in Canada to contain a “booster” (an adjuvant) to help increase the body’s immune response and help provide better protection against the flu. Adjuvants have been shown to be a safe and effective way to stimulate a stronger immune response from a vaccine.

Fluad is new to Canadians, but how long has it been around? What kind of track record does it have in other countries?

Fluad is backed by a long history of global experience, with over 50 million doses distributed since 1997. Like other flu vaccines, Fluad has a long safety record.

Who should consider getting Fluad and why?

Canadian seniors aged 65 or older are particularly hard hit by the flu, with the highest rate of hospitalization and death. Seniors, particularly those with chronic medical conditions — such as heart or lung disease, or diabetes — may be at increased risk of complications from the flu, such as pneumonia or respiratory distress. In Canada, nine out of 10 influenza deaths occur in the elderly. Public Health Ontario is now providing Fluad free-of-charge for seniors in long term care institutions. If you’re 65 years and older, talk to your doctor about your influenza vaccine options.

What about people who are under age 65? For instance, should people aged 60-65 talk to their doctors about the vaccine too?

Flu shots are the best protection for people of all ages to protect themselves and their families against the seasonal flu. Canadians should be talking to their doctor or nurse about getting the flu shot. For people 65 years and older like myself, three vaccines are recommended this year including Fluad. The adjuvant in the vaccine may help provide additional protection against influenza because antibody levels produced by this vaccine, are for the most part, significantly higher than those generated by the standard flu vaccine.

What can people expect from the Fluad shot? How effective is it?

Studies in Europe have shown that Fluad helps protect seniors compared to the traditional flu vaccines providing stronger protection for those who have chronic diseases such as diabetes and cardiovascular conditions. In theory, Fluad should provide better protection than the standard flu vaccine in Canada but according to Health Canada we need more studies to confirm its benefit compared to other flu vaccines.

What are the risks and side effects of Fluad? How serious and how common are they?

Fluad has been distributed in other parts of the world for 10 years with approximately 50 million doses given worldwide. Fluad has a clinically acceptable safety profile similar to other flu vaccines and was well tolerated in older adults and adults with chronic diseases.

Is there anyone who should not get the flu shot (either version)?

Various flu vaccines are available for people of all ages. Only those with a severe allergic reaction to eggs or components of the vaccine should not receive an influenza vaccine. It’s recommended that individuals talk to their doctor or health care provider about the best options for protection against the flu.

What other strategies can people use to help avoid the flu this season?

As a doctor and a senior — the best way to avoid the flu is to get the flu shot! But some other important practices include:

– Washing your hands with soap and water thoroughly and often.

– Keeping an alcohol-based hand sanitizer (gel or wipes) handy at work, home and in your car. It needs to be at least 60 per cent alcohol to be effective.

– Covering you mouth when coughing or sneezing! The flu virus passes easily between people and surfaces.

– Trying to keep common surfaces and items clean and disinfected.

– AND, if you are sick with the flu, staying home from work to protect your co-workers,

With the holiday season approaching, many people will be traveling. Should they be worried about picking up the flu on the airplane? (If so, are there any steps people can take to protect themselves?)

Now is the time to protect yourself against the flu if you haven’t already. Get your flu shot and talk to your doctor about other ways you can help avoid the flu! Again it’s good to keep an alcohol-based hand sanitizer (gel or wipes) handy. Other strategies to avoid germs include washing your hands and if you’re in public spaces like airplanes and airports try to keep clear of surfaces that might be filled with germs. After using the toilet in the aircraft and washing your hands, avoid touching counter surfaces and always open the door with a paper towel. I made that mistake last month and wound up in hospital with a severe viral illness. However, when I left hospital I got the flu shot on the first day that it was available.

Any final words of advice for avoiding the flu this season?

People of any age can get the flu, which usually lasts two to seven days, sometimes longer and can be fatal in the elderly and in people with chronic diseases. The flu shot is safe and the most effective way to protect yourself and your family from the flu. For seniors 65 years and older, most at risk of severe illness from the flu, it is important to protect yourself this season. Don’t procrastinate… be the first one on your block to be vaccinated.

EDITOR’S NOTE: This content is provided for informational purposes only. Talk to your doctor about the risks and benefits of getting the flu shot and which option is best for you or your loved ones.

ON THE WEB
For more information about FLUAD, read the FLUAD press release and the Public Health Agency of Canada. To find out more about influenza, go here.

Additional sources: Health Canada, Statistics Canada.

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