The Center for Disease Control (CDC) in Atlanta has issued their Frequently Asked Questions list for the 2018-2019 Flu Season, and frankly it’s a bit hard for the layperson to understand.
Spice, our on-staff pathophysiologist, takes a look at the highlights and puts them in language we can all understand:
The CDC FAQ explained:
CDC: Flu vaccines have been updated to better match circulating viruses [the B/Victoria component was changed and the influenza A(H3N2) component was updated].
Spice Says:
Influenza isn’t a virus. It’s a giant family of related viruses. Each little variety requires its own immunization. It’s impossible to immunize against all possibilities, so the ‘flu shots’ usually cover four varieties.
Every year, the vaccine makers look at what flu strains are causing the most illnesses in the southern hemisphere during their winter (our summer) and uses that to decide which varieties to put in the seasonal immunization. That lets them provide the most protection you can get with a single shot. This year’s vaccine has two differences from last year’s. (I for one am glad to see the change; those two varieties were trouble-makers last year and I won’t miss them.)
CDC: For the 2018-2019 season, the nasal spray flu vaccine (live attenuated influenza vaccine or “LAIV”) is again a recommended option for influenza vaccination of persons for whom it is otherwise appropriate. The nasal spray is approved for use in non-pregnant individuals, 2 years through 49 years of age. There is a precaution against the use of LAIV for people with certain underlying medical conditions. All LAIV will be quadrivalent (four-component).
Spice Says:
The flu vaccine is usually given as a shot, but there’s a nasal spray version too. Both work about equally well for most people. The nasal spray version is a weakened version of the virus; the shot is a killed version. Because of that, they don’t want people with weak immune systems getting the nasal spray. A person with a normal immune system will not get the flu from the nasal version, but a person with a bad immune system might. This year’s flu vaccine covers all four strains that are in the shot. That’s not always true; they can’t always get all the shot varieties into the inhaler.
For the needle haters out there, the nasal version works just as well for most people.
CDC: Most regular-dose egg-based flu shots will be quadrivalent.
Spice Says:
Four strains are covered this year by the garden-variety normal flu shot, as usual. Some years they put five in there, depending on who’s getting sick with what in Australia during their winter.
CDC: All recombinant vaccine will be quadrivalent. (No trivalent recombinant vaccine will be available this season.)
CDC: Cell-grown flu vaccine will be quadrivalent. For this vaccine, the influenza A(H3N2) and both influenza B reference viruses will be cell-derived, and the influenza A(H1N1) will be egg-derived. All these reference viruses will be grown in cells to produce the components of Flucelvax.
Spice Says:
Some people can’t take the normal flu shots because of allergies to components or other problems. If you’re one of these people, your doc should have told you by now; so if you’ve never heard of this don’t worry about it.
If you are one of those people, your version of the shot will cover the same four strains as everybody else is getting this year.
CDC: No intradermal flu vaccine will be available.
Spice Says:
The intradermal version of the flu shot uses a smaller needle and goes into the skin instead of the muscle, but it’s a bit trickier to make. There isn’t one available this year.
CDC: The age recommendation for “Fluarix Quadrivalent” was changed from 3 years old and older to 6 months and older after the annual recommendations were published last season to be consistent with Food and Drug Administration (FDA)-approved labeling.
CDC: The age recommendation for Afluria Quadrivalent was changed from 18 years old and older to 5 years old and older after the annual recommendations were published last season to be consistent with Food and Drug Administration (FDA)-approved labeling.
Spice Says:
They’re more comfortable now than they were to start with that these particular formulations are safe for younger children.
CDC: Baloxavir marboxil (trade name Xofluza®) is a new influenza single-dose antiviral drug approved October 24, 2018 by the Food and Drug Administration (FDA). Baloxavir marboxil is approved for the treatment of acute uncomplicated flu in people 12 years old and older who have had flu symptoms for less than 48 hours. More information is available in the FDA press release.
Spice Says:
This Xofluza stuff is a newer version of a drug along the lines of Tamilfu. It’s not a vaccine and you don’t take it before infection to protect yourself. It’s prescribed when you’ve had flu symptoms for less than 48 hrs, and if you take this one oral dose the illness will be more brief and mild than if you didn’t take the stuff.
Understanding the changing, mutating nature of the flu
CDC: There are many different flu viruses and they are constantly changing. The composition of U.S. flu vaccines is reviewed annually and updated as needed to match circulating flu viruses. Flu vaccines protect against the three or four viruses (depending on vaccine) that research suggests will be most common. For 2018-2019, trivalent (three-component) vaccines are recommended to contain:
- A/Michigan/45/2015 (H1N1)pdm09-like virus
- A/Singapore/INFIMH-16-0019/2016 A(H3N2)-like virus (updated)
- B/Colorado/06/2017-like (Victoria lineage) virus (updated)
Quadrivalent (four-component) vaccines, which protect against a second lineage of B viruses, are recommended to contain:
- the three recommended viruses above, plus B/Phuket/3073/2013-like (Yamagata lineage) virus
Spice says:
This is just telling what particular varieties are in this year’s immunizations. There are the two most ‘popular’ A strains and the two most ‘popular’ B strains, as usual.
Since 2010, CDC estimates that flu has resulted in between 140,000 and 710,000 hospitalizations each year. You can find some prepper-relevant ideas about whether or not the flu shot is worth it for you here.
I got the nasal spray once…and would never do it again. I ended up with the juice running down my chin. IDK if it was my imagination or not, but after that I had persistent sinus problems and a cough that took all Winter to dissipate. That was about 15 or 20 years ago and I’ve not gotten any flu shot ever since then. So, no, I definitely wouldn’t recommend it to others…even if they are healthy with a strong immune system.