A dose of reality

End of summer means flu season is nearly upon us; not to worry, though – ‘flu shots are now available!’

Here are some unofficial – and maybe unhappy – signs of summer’s approaching end:

“Shield yourself from the flu,” reads a parking-lot placard outside a Rite Aid. “Get your flu shot today.”

“Flu shots are now available!” reports the woman whose recorded voice answers callers to Walgreens. “Walk in anytime – no appointment necessary.”

Already? Yes, already. While flu season in Spokane County generally gets its official start in October, health officials say, residents can improve their chances of avoiding illness and spreading the potentially serious disease by getting vaccinated as soon as the shots are available.

They’re available. Armed with vaccines, some pharmacies and clinics are alerting potential patients – including low-income residents who might qualify for free vaccinations – that they’re ready to start delivering injections. Others plan to start offering them in coming weeks.

The Centers for Disease Control and Prevention recommends that everyone age 6 months and older gets a yearly flu vaccine, ideally by October.

In each of the past five years, the Spokane Regional Health District has reported its first case of flu in either October or November.

But the region’s first official case probably isn’t really its first, said Dorothy MacEachern, an epidemiologist who’s leading the Spokane Regional Health District’s flu-prevention efforts. “Reportable” cases, as defined by state law, are only those that lead to hospitalization.

“It’s so unpredictable how flu circulates that it just seems to make sense to get protected as soon as you can,” MacEachern said. “There really isn’t a downside.”

Vaccination is especially smart for people who are planning to travel or mix with a new group of people – returning to school, for example, she said.

“The protection afforded by the vaccine doesn’t kick in until about two weeks after you’re vaccinated, and then it will last the entire flu season,” MacEachern said.

Pharmacies at Rosauers stores got their first vaccine shipments around mid-August and have started offering them to customers, said Gary Glennie, pharmacy director for the Spokane-based supermarket chain.

The stores offer standard and high-dose injections, along with the “intradermal” vaccine injected into the skin instead of the muscle, requiring a much smaller needle, Glennie said. The pharmacies can order a nasal spray version for those who would like to avoid needles altogether.

Starting today, the Community Health Association of Spokane is offering vaccines at all nine of its clinics on a walk-in basis to its own patients and others who need them, spokeswoman Kelley Charvet said. That includes nasal-spray, high-dose and several other options.

While they also accept insurance, the CHAS clinics will provide free vaccines for uninsured people whose families live on less than 200 percent of the federal poverty level, Charvet said. For a family of four, that’s $47,100.

The health district’s anti-flu education efforts follow a steep rise in serious cases last season.

Spokane County saw a nearly 40 percent increase in flu hospitalizations in the 2012-13 flu season over the year before: 151 cases last year, up from 109 in 2011-12. The county’s flu season generally ends in March, peaking in February or March.

The health district’s public clinic, which used to offer flu vaccinations, has closed amid budget cuts and shrinking patient numbers. The district will work with nursing and pharmacy schools to set up off-site clinics to provide shots for homeless people, MacEachern said, but mostly it’s working on flu-prevention education.

While most people recover within a couple of weeks and don’t require medical care, some groups face higher risk of serious complications, MacEachern: pregnant women, babies and people 65 and older.

In recent years, it’s also become clear that people with chronic conditions – regardless of age, and with conditions as varied as asthma and obesity – are more seriously affected by flu, MacEachern said.

Kim Papich, the health district’s public information officer, said health officials continue to face an old myth when it comes to flu vaccinations: “A lot of people still think the flu shot can give you the flu.”

The most common side effects are a sore arm and maybe a low fever or achiness, according to the CDC, and the nasal-spray vaccine – which, unlike the flu shot, contains weakened live viruses – could cause congestion, a runny nose, a sore throat or a cough. But the vaccine can’t give you the flu.

“Flu is a pretty significant disease between how it affects an individual and how easily it is spread,” MacEachern said. “A person can be incubating that illness and so they can actually spread it to someone else before they become sick. We have a lot of vulnerable people in our community who either can’t be vaccinated or the vaccine isn’t quite as effective in them. In the spirit of protecting our community, flu vaccine is good.”

Developing

next year’s vaccine

 Flu viruses change quickly, and the seasonal flu vaccine is formulated each year to keep up with them.

 To formulate the next season’s vaccine, experts meet in February or March to study the strains of flu circulating in the Southern Hemisphere – which eventually move north – and to identify the vaccines that can prevent them. Vaccines typically cover two strains of influenza A (H3N2 and H1N1) and one strain of influenza B.

 “It’s an extremely well-educated guess,” said Dorothy MacEachern, an epidemiologist at the Spokane Regional Health District.

 While most vaccines manufactured for this season will be three-part vaccines, some will be formulated to protect against four flu viruses – two A strains and two B strains. All nasal-spray vaccines will be “quadrivalent,” for example, according to the CDC.

 Another recent development: In November the FDA approved the use of a vaccine created with viruses grown in animal cells rather than in chicken eggs.

 Residual egg protein in vaccine virus grown in eggs can trigger reactions in some people with egg allergies. The cell-based vaccine can work for those people.

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