Study Shows High-Dose FLUZONE Outperforms Regular In Seniors

For Sanofi Pasteur the preliminary results from a 2-year clinical study involving 126 centers and some 32,000 seniors just presented to the Advisory Committee on Immunization Practices (ACIP) were just what the doctor ordered. 

Data showed their new “high-dose” FLUZONE (H-D) flu vaccine formulated specifically for use in seniors did exactly what was intended—boosting the efficacy of that formula for preventing confirmed flu cases by 24.2% compared to the standard dose vaccine used previously.

Older patients suffer more flu illnesses, hospitalization, and deaths compared to younger folks, even if vaccinated, in part because the efficiency of their immune systems declines with age and they don’t respond as well to regular dose flu vaccine.  Consequently, an elderly person’s antibody response to the regular vaccine was variable and usually less than that of children and younger adults. 

Sanofi’s high-dose formula with 4X the amount of viral antigenic material was designed to “turbo-charge” their immune systems’ responses and produce greater quantities of antibodies thus protecting them more effectively against flu infections…and this study shows convincingly it did just that.

The study was done over two flu seasons—the milder-than-usual 2011-2012 and the much more severe than average 2012-2013 seasons.  Moreover, the good results held for each flu season and across both seasons, all flu strains, and all senior age sub-groups.  Early results also showed the H-D version provided better protection against pneumonia, hospitalization, and cardiorespiratory conditions.  The H-D variety did cause slightly more local reactions at the injection site but overall side effects were similar with the two formulations and there were no indications of serious adverse events.

The Sanofi M.D. presenting the results said using the new H-D product would prevent four to five more flu cases for every 1,000 people vaccinated with the FLUZONE than would be prevented with the regular dose version. [Another way of seeing the difference between the two formulations is that for every 217 people receiving the FLUZONE High-Dose variety, one more flu case gets prevented.]

Doctors on the Advisory Committee who saw all the data alluded to the fact that this new high-dose vaccine could be a “game-changer” in that the previous one-size-fits-all approach needs to be re-examined. Lisa Jackson, MD, MPH, who is a flu vaccine researcher but not an ACIP member said: “This (these new findings with H-D) raises the question of whether everyone could benefit from a higher dose (of vaccine, regardless of age or immune status).”  Lots of people at “high-risk’ from flu also have compromised immune systems of varying degrees.  If the elderly responded so much better to the H-D formula, perhaps others will also. 

Dr. Jackson added: “I don’t know if ACIP will make a preferential recommendation for high-dose flu vaccine, but they should, in my opinion.”

 A better flu vaccine this year for seniors who were a group hit hardest by flu last year…well, that really is great news and “just what the doctor ordered” because “Every life matters…every shot counts!”

REMINDER: LVHN, SLUHN Offering Free Flu Shots

Our two largest hospital systems–Lehigh Valley Hospital Network and St. Luke’s University Hospital Network–are offering FREE FLU SHOTS at varying times during November.

St. Lukes’ free flu shots are “for the uninsured” only and require prior registration.  Please call 1-866-STLUKES (785-8537) to register and to determine availability of all vaccine types for all age groups (remember, seniors should probably get the “high-dose” variety).

  • Saturday, November 2, 9-11 AM, St’ James Lutheran Church, Route 309, Coopersburg, PA
  • Thursday, November 7, 1-3 PM, St. Luke’s Palisades Family Practice, 7790 Easton Road, Route 611, Ottsville, PA
  • Wednesday, November 13, 3-6 PM, St. Luke’s Hospital (Quakertown Campus), Taylor Conference Rooms, ground floor, 1021 Park Avenue, Quakertown, PA 

LVHN will again be administering FREE flu vaccines at its annual DRIVE-THRU FLU CLINICS being held at Dorney Park (Saturday, November 9) and Coca-Cola/Iron Pigs Park (Sunday, November 10), 9AM-3PM both days.  These free shots are available to adults and children regardless of insurance coverage status. This is their 16th season for the event and thanks to the 800+ volunteers involved this year.

Nonperishable food donations, with valid expiration dates, will again be accepted.  The food donations are optional and not necessary to receive the shots.  Preregistration is preferred but not required and it is literally a drive-thru process.

Visit (FluDriveThrough) for more information, to see vaccine information statements, complete consent forms, and pre-register online. 

Find some folks who perhaps don’t have coverage and/or are low-income and/or don’t have transportation and take them to the LVHN Drive-Thru so they can get their shots.  It’s a “neighborly” thing to do.

Also, remember to use your Knights’ Referral Document (from your local KOC council or here on this website) and take it with you to turn in at those locations.  It will help us track the impact our CRUSADE is having.  THANKS!

During Flu Season, Your Workplace Can Be Hazardous

Work is one place you are most likely to catch the flu bug this year according to the FOURTH ANNUAL STAPLES SURVEY, because “nearly 90% of office workers come to work even if they know they are sick.”

Perhaps it’s the economy with people fearing for their jobs, but the rate of people showing up at work sick has jumped from 80% in last year’s survey and 60% in the 2011 Staples survey…and that is not a healthy trend.

Even though most people acknowledged that a 3-day stay at home with the flu was appropriate, the majority of workers say they stay home just two days or less (many not at all) thus putting co-workers’ health and office productivity in jeopardy.  Almost half the respondents (45%) said they “simply didn’t want to fall behind on their workload.”

The admission about coming into work sick was somewhat surprising given other data showing that some elements of people’s understanding about flu prevention had actually improved since last year’s survey.

  • 49% (vs. 38% last year) understood they were most contagious for one day before getting flu symptoms and stayed contagious for 5-7 after getting sick (and 2 days or so after their fever ceased)
  • 76% correctly identified the break room as the least clean spot in their office area, a sharp increase from 26% last year
  • And, while 57% knew flu viruses can survive on hard surfaces for up to 3 days (a slight improvement),  66% still cleaned their desks once a week or less (vs. 51% last year)…a definite step in the wrong direction.

Another piece of bad news is that facility managers (FMs) were clueless that the break room was the main breeding ground for germs with only 7% answering that question correctly.  And not even 50% of FMs reported ordering and having on hand critical supplies to help prevent the spread of germs—things such as cleaning or disinfecting chemicals.  In addition only 43% of FMs said it was their responsibility to ensure a healthy building for their workers while 40% said that such matters were up to the workers themselves…a serious case of “passing the buck” if you want to keep the office humming.

The TOP-3 flu prevention items that workers said they wanted their employers to provide were hand sanitizers in the common areas (47%), hand sanitizing wipes on their desks (42%), and touch-free restroom facilities (39%).  Employees also said that telecommuting options would be helpful during flu season.  Employers should know that telecommuting might be a good policy to implement during peak flu season because productivity often falls to less than 60% when offices are overrun by mini-outbreaks caused by workers continually coming in sick and infecting others.

For businesses’ bottom lines during flu season, it just might be that “an ounce or two of prevention provides a significant ROI (return on investment).”


US Southeast Appears To Be The Early Flu Hotbed

The CDC has not yet issued its Week 42 (2013) report for the 2nd week of the 2013-14 flu season, but from various other sources FluCrusader has been watching, it’s U.S. region 4 (involving MS, AL, FL, GA, TN, KY, SC, and NC) along with Texas that seem to be leading the nation in ILIs and confirmed flu cases, but Missouri and Washington aren’t far behind.

Texas, Alabama, and South Carolina are seeing flu cases in significant but still “low” amounts, but health officials are concerned that the cases in all three states are much earlier than usual and increasing at rates more like late November and early December last year, and that “could mean trouble” especially if vaccination rates lag behind.

Springfield, MO, confirmed 12 flu cases there this week and Texas says ILIs are running at a rate of 2.8% and with 18 confirmed positive flu cases (out of 704 submitted samples for a 2.6% rate), an “up-tick’ is definitely occurring.  One school outbreak has also been observed there but contrary to an earlier report there have been no pediatric casualties.

Alabama is also simmering some significant flu with 30 confirmed cases in Mobile County alone.  A Dr. Richard O. Oyler from a Compass Urgent Care Clinic there says “September was busy enough but the past two weeks (the first and second week of October) have really ramped up…it has been exceptionally busy.”  With more than 100 cases of RIDT-positive flu cases, he says “I saw eight cases yesterday…in the 20 years I’ve been a doctor, I’ve never seen it this busy this early.”

Two rather surprising findings in early flu cases have been (1) the higher than usual percentage of B-strain cases and (2) the many reports of A-strain cases without fevers, something that is usually a hallmark finding with flu.

Finally, another place where flu is ahead of schedule and a bit heavy (“regional”) in numbers is Puerto Rico and travelers to that destination are advised to get flu shots at least two weeks in advance of traveling there or risk getting sick while there on business or a vacation.  Last year more than 11 million vacations were postponed or ruined completely by surging numbers of flu cases in December and January.

It ill be interesting to see where and when the first real outbreaks begin this flu season…maybe nowhere if vaccination rates improve quickly.  Have you gotten yours?

Every Year, The American Economy Is A Flu Victim Too

According to a document called WALGREENS 2013 FLU IMPACT REPORT, in addition to killing some 35,000 people each year, flu takes a “deadly” toll on America’s economy every flu season, some worse than others.

Last year’s (2012-13) flu season, one of the worst in the past decade, Americans missed more than 230 million days of work costing our economy $30.4 billion—almost three times more than the $10.5 billion in losses incurred during the milder 2011-12 flu cycle.  Employers alone lost $8.5 billion in lost wages due to flu-related sick days (25% more than one year earlier).

Walgreens chief medical officer, Harry Leider, M.D., commented that “flu season is always unpredictable…the impact it can have on individuals and families at home and in the workplace can be significant…with flu season peaking early (last year), a lot of people weren’t prepared and as a result lost vacations and missed out on holidays (underscoring) the importance of getting flu shots early…(something) our report shows more people are planning to do (this year)…”

Last year’s flu peaked earlier, in December and very early January rather than January and February, thereby coinciding more with “holiday off time.”  As a result, flu caused cancellations or interruptions of more than 11 million vacations AND still caused more than 90 million lost school days—both figures nearly 300% higher than for 2011-12.  Effects on “missed holiday events” were even worse—17 million vs. 4.7 million in 2011, an increase of 400%.

In last year’s flu season, here are some mind-numbing figures that resulted—almost all of which are preventable:

  • Workers contracting the flu missed at least 3 work days
  • Sick workers who go into work rather than staying home transmit flu germs to some 20-25 people each day
  • 42% of people who got the flu thought they got it from a co-worker
  • 6.2 million workers missed a business trip (300% more than the prior season)
  • 71% of all American will be impacted by a case of the flu, either their own or that of someone they must then take care of
  • More than one-fifth (22%) of all sick days went uncompensated
  • 45% of parents said they needed to take time off from work to care for a child who got the flu
  • Half (49%) claimed they had at least one child miss school and the time missed averaged three days

Walgreens report had some good news in it as well.  It seems folks will do some things differently this year, starting with 60% saying they would get shots earlier this flu season.  And, it appears many are, as much as 50% [remember in an earlier posting, this FluCrusader told you frequencies of flu shots at both Walgreens and Rite Aid pharmacies were ahead of last year’s schedule].

Also, 87% of those surveyed said they would be washing their hands more frequently, 49% said they were taking family members to get shots, 43% said they would be avoiding or limiting time in public places, and 11% claimed they would be “working more from home” to avoid spreading flu germs. [Now there’s an excuse for telecommuting that your boss may just find acceptable, at least during flu season, if it keeps the workforce healthier.]

However, the Walgreens’ report showed that when it comes to getting flu shots “earlier” there are still a lot of headwinds that must be overcome:

  • Last year, nearly 1/3 (31%) of survey respondents waited until November or later to get their flu vaccines [remember our earlier post that explained peak vaccination rates for almost all age groups weren’t hit last year until January or even February]
  • Walgreens data showed 20% —that’s 1-in-5—of 7 million flu shot recipients at Walgreens got their shots in January, and
  • Nearly 4 out of 5 Americans (79% actually) thought it only takes 10 days or less after getting a flu shot for our bodies to build up full immunity (when in fact it takes 14 days and sometimes more). 

Clearly more education and better information are needed.

Right there again are two special reasons for the Knights’ Crusade Against Influenza—to educate the American public about influenza, the variety and timing of flu shots, and appropriate flu-fighting and flu prevention activities.  Why?

Because “Every life matters…every shot counts!”

To beat flu, “don’t get it…don’t spread it…”  The first step in that mission is for “everyone 6 months and older” to get vaccinated…earlier rather than later…and then take steps each and every day to avoid contact with ubiquitous flu germs and spreading them to others.

There is nothing America can’t do, if we put our minds to it, including beating the flu.  Join us in our Knights’ Crusade Against Influenza!


PA Posts The Flu Season’s Second Week Results

Pennsylvania’s flu cases rose a bit in week 41—the new flu season’s second week.

Total reported (but not yet confirmed) flu cases in PA jumped from 9 last week to 39 as of October 12.  All were flu-positive by the sometimes inaccurate rapid influenza diagnostic test (RIDT).  More reliable tests (rt-PCR) are underway to see just how many turn out to be “true flu.”  Thus far, the PA DOH says the remaining samples they have received and tested have been non-flu respiratory viruses, particularly human rhinovirus (common cold) and respiratory syncytial virus (rsv).

“Two of thirty isolates have been confirmed as FLU”—so it appears that PA has officially confirmed its first flu case(s) of 2013-2014.  Officials also stated that 7 flu-related hospitalizations were reported (something we told you here several days ago)—four in people >65 of age, two in people 19-25 yrs old, and one in a child (<18).

Outbreaks of influenza-like-illness (ILIs) were also reported in two separate long-term care facilities, but the number of residents involved was unspecified and they too will require rt-PCR confirmations.

Butler (with 13 cases), Allegheny (4), and Dauphin and Washington counties (3 each) have the highest reported cases so far.  

To Beat Flu, Vaccination Rates Must Improve

The CDC in conjunction with the government program Healthy People 2020 has set an overall annual influenza vaccination rate goal of 70% for all age groups but particularly the elderly (65 and older) and children 17 and under (and especially those 6 months to 5 years of age).

Reviewing data from the 2012-1013 flu season, the CDC found some good news but not enough to throw a party.  Flu vaccination rates last year finished about 3-5% better than the previous year but still well below the number the CDC would like.

The highest flu vaccination rate of 67% occurred in the 65 and older group probably because CDC promotions stress shots for that age group and Medicare provides full coverage for their costs.  Children 6-months to 17 years old were second with 45.3%.  Adults 50-64 finished the year at 42.7% while adults 18-49 had the lowest rate–27.2%.

Results also varied widely by states with Massachusetts (the best) getting slightly over 61% and  Florida (the worst) not hitting 40%.

Besides the fact that the overall vaccination rate came in at less than 50% for the nation as a whole another major disappointment was that it took until late December and well into January for every groups’ peak numbers to occur.  Coming off a rather mild flu season in 2011-2012, instead of getting vaccinated early, people waited until some cities and states were already in near panic mode reporting local and regional flu epidemics to get what they should have gotten a minimum of 4-8 weeks earlier.

Let’s hope that mistake doesn’t get repeated this year and that all age groups come closer to hitting that 70% target rate.