Monday, December 31, 2012

Vaccines in 2013

Happy almost-2013! In honor of the New Year, I thought I would share a couple of the news items I will be watching for in 2013.

First, as always, is flu. This year's flu season has supposedly been off to a very early start, but by my accounting of the total number of infections on the CDC's national influenza summary, through week 51, there have only been 15,106 infections this year. I know--there have also been 16 pediatric deaths, which is absolutely terrible, and if you are one of those 15,000-some who is infected, you're probably in significant discomfort at best and some pretty serious trouble at the worst. And I also know that the number of reported cases represents only a fraction of the number of actual infections. But, still, 15,000 infections doesn't sound like a lot, in a nation of 300 million--to me, anyway. Everyone is going to have a different reaction to that information.

Vaccination rates are about the same as they were last year. I'm sitting in a room of five adults right now, and none of us got our flu vaccine; two say they intend to, but it hasn't been convenient so far. So, I guess we're contributing to the problem. Next year, there will be two quadrivalent flu vaccines: MedImmune's Flumist Quadrivalent and the newly approved Fluarix, an intramuscular vaccine produced by GlaxoSmithKline. Both of these vaccines will protect against the two most common Influenza A-type and Influenza B-type viruses. The addition of a second Influenza B virus may result in fewer infections.

But, as the CDC's website reminded me today:

The seasonal flu vaccine does not protect against influenza C viruses. In addition, flu vaccines will NOT protect against infection and illness caused by other viruses that can also cause influenza-like symptoms. There are many other non flu viruses that can result in influenza-like illness (ILI) that spread during the flu season.

I mean, I knew that, but it doesn't exactly get me excited for a flu vaccine, since it just reminds me of all of the things that can still make me sick no matter what I do. Yippee.

Anyway, next year, I will be looking out to see how these quadrivalent vaccines are marketed, if the uptake rates are higher, if more adults in particular (like those sitting with me in the room right now...) are motivated to be vaccinated, and so on.

Second, I'm also going to continue to watch news of the pertussis outbreaks. I'll be watching to see how/if the epidemic continues, how rates of infection pan out (adults? children? infants? college students?), and how serious is this going to get. Mostly, I'm curious to see how the story gets told: is this going to continue to be evidence of the "evil" of vaccine skeptics, who demanded the (now less-effective) acellular vaccine despite relatively unsubstantiated evidence that the whole-cell DTP vaccine caused neurological side effects? And damaged herd immunity by refusing the TDaP vaccine? Or, will those who remain skeptical use this as evidence of long-term ineffectiveness of vaccinations as a practical public health solution? Both arguments are out there. I'll be interested who uses what argument and when.

Back to dissertating. Happy New Year. Get a flu shot. Or wash your hands a lot. Or both. Or just accept sickness as an inevitability of life. Welcome, 2013!

No comments: