It’s that time of year again! The earthquakes, hurricanes, and floods have finally passed. It is time to get ready for this winter’s respiratory season. We are talking about the Flu Shot!
Micro employee Sokha Tan smiles for the camera
It is critical that everyone gets a flu shot. Not only will this protect you, your family, and your coworkers, but our patients as well. The flu vaccine comes in two forms: the shot in the arm and the nasal spray. Approximately 36,000 people in the United States die each year from influenza. Anywhere from 5-20% of the population get the flu annually, 4 million of whom are children. It has been estimated that $1.7 billion is spent on medical costs associated with the flu, and an additional $2.1 billion of indirect cost is spent on items such as employees missing work. Many of these deaths and illnesses and the work absences can be prevented by getting the vaccine. The flu season typically runs between December and April. The safety profile of flu vaccine is very impressive. The most common reactions are local injection- site tenderness with the shot, or headache with the nasal spray vaccine. Anyone with direct patient contact or working in clinical areas who has not received the influenza vaccine must wear a mask within 6 feet of a patient during the flu season.
Experts recommend that everyone over the age of 6 months receive influenza vaccine each year. While everyone should get a flu vaccine each flu season, it’s especially important that the following groups get vaccinated either because they are at high risk of having serious flu-related complications, or because they live with or care for people at high risk for developing flu-related complications:
1. Pregnant women
2. Children younger than 5, but especially children younger than 2 years old
3. People 50 years of age and older
4. People of any age with certain chronic medical conditions
5. People who live in nursing homes and other long-term care facilities
6. People who live with or care for those at high risk for complications from flu, including:
Health care workers
Household contacts of persons at high risk for complications from the flu
Household contacts and out of home caregivers of children
There are three types of flu in the vaccine every year. Included are two different influenza A strains and one influenza B strain. These are generally determined by what flu viruses are circulating in the southern hemisphere during their respiratory virus season, since these are the viruses that are most likely to be transmitted in the northern hemisphere this year. This year the vaccine is including protection against the following strains: Influenza A H3/N2 virus (A/Perth/16/2009 H3N2), influenza A H1N1 virus (swine flu 2009, so called “A/California/7/2009H1N1”), and one influenza B strain (B/Brisbane/60/2008). It is of note that influenza strains are identified by sentinel labs throughout the world and are named by the type, the location they were first isolated, the virus’s numerical sequence of isolation, the year of isolation, and the type of hemagglutinin and neuraminidase (two proteins on the outer surface of the virus). So A/California/7/2009 H1N1 is influenza A isolated as the 7th influenza from California’s sentinel lab in 2009 with type 1 hemagglutinin and type 1 neuraminidase.
When a very high percentage of a community is immune to a given disease, people who have no immunity are far less likely to be exposed to someone who has active disease. This is known as herd immunity. They are, therefore, protected by the immune “herd” that surrounds them. Influenza vaccine can provide some herd immunity, but for many reasons, this should be considered protective in the same way we can see herd immunity in some other vaccine-protected diseases.
Among these reasons are the following:
1) Influenza vaccine protection is relatively brief, lasting only months, rather than a lifetime;
2) For people whose immunity is waning, or young children, and the over 55 and elderly populations, vaccine protection is less effective in preventing disease occurrence. The influenza vaccine is especially strongly urged for that group, however, because of resulting immunity, even when only partial, does provide protection against severe disease. As it reduces severity, it reduces risk of hospitalization and the risk of a fatal disease;
3) Finally, even mild disease results in the viral shedding that can spread the virus to others in the community who are unprotected.
Therefore, although some herd immunity may occur in populations heavily vaccinated for influenza viruses, the herd immunity protection should not be expected to parallel that seen in very different diseases, and different types of immunity.
The Microbiology Laboratories utilize direct detection for viral antigens in nasopharyngeal swabs. Antigens are detected by immunofluorescently-labeled antibodies (DFA) whose binding is visualized by med techs using a fluorescence microscope. The test is relatively rapid (~2 hrs), although our time to report is 4-6 hrs within receipt in the Lab. The test is performed 24/7/52. If DFA is negative, we look for viruses with more sensitive methods that depend on a person’s immune system function. If the host has a normal immune system, we test by rapid culture (so-called “shell vials” or “spin amplification culture”) that is resulted after 48 hours. If the host has a questionable immune system, we test by amplifying virus genome from nasopharyngeal swab (so called “polymerase chain reaction” or PCR).
Occupational Health is offering the influenza vaccine to physicians, faculty, staff, employees, students, and volunteers free of charge. The dates and times that the vaccine will be administered are below.
| Location | Date | Time |
| JHH Pediatric Annex | 9/26/11, 9/28/11, & 9/30/11 10/3/11 – 10/5/11, 10/7/2011 |
6:30 AM – 5:00 PM |
| JHH Pediatric Annex | 10/1/10 & 10/9/10 | 6:00 AM – 10:00 AM |
| JHH Houck Lobby | 9/26/11 – 9/30/11 & 10/3/11 – 10/7/11 10/10/11 – 10/14/11 |
7:00 AM – 5:00 PM
7:30 AM – 4:00 PM |
| JHH JHOC Plaza | 9/26/11 – 9/30/11 & 10/3/11 – 10/7/11 |
7:00AM – 5:00PM
|
| Bayview: The Pavilion Conference Room | 9/19/11 | 7:30AM – 4:00PM |
| Outreach: Green Spring Station
Pavilion II Conference Room |
9/28/11 | 10:00AM – 12:00 Noon
and 2:00 PM – 3:30 PM |
| Outreach: White Marsh
2nd floor conference room |
9/28/11 | 2:00 PM – 3:30 PM |
| HCGH – rear of cafeteria (see Bonnie or Tina for instructions) | 9/28/11 | 6:00 AM – Midnight
|
After October 10, 2011 the vaccine will be administered at Phipps 351 and 98 Broadway, Suite 421, Monday through Friday, 7:30 AM to 4:00 PM.
Amelia Maters
Manager
Microbiology and Immunology Laboratories
Department of Pathology