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| SHOOTING THE FLU | |
 March 9, 1999 
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At least 45,000 Americans die from influenza and pneumonia each year, but most at-risk people do not get a flu shot. Health Correspondent Susan Dentzer explains the flu vaccine and a possible national effort to encourage more people to get their shots. |
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HEALTH CARE WORKER: Let me take a real quick look here.
HEALTH CARE WORKER: Now, you've had flu shots before? PATIENT: Yes.
DR. JAMES WILDE: We found an 88 to 89 percent reduction in influenza among the health care workers who had received the influenza vaccine. SUSAN DENTZER: Despite the vaccine's effectiveness, only about a third of Americans at high risk of dying from the flu get an annual shot, so an editorial in the journal called for a massive national effort to encourage vaccinations by making the shots more available at places like pharmacies and schools. |
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| What is the flu? | ||||||||
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JIM LEHRER: Susan Dentzer is now with Phil Ponce. PHIL PONCE: Susan, first of all, a point of basic information, the flu is a term people throw around pretty freely. What exactly is the flu?
PHIL PONCE: And how do you know you don't have a bad cold as opposed to the flu? SUSAN DENTZER: Well, you might not really know. But the key signs are going to be, first of all, how it starts off with a headache and the dry cough. That's usually a giveaway. A cold doesn't necessarily start that way. And your fever is going to be a tip-off as well, because a cold fever isn't going to hang around the way a flu fever will hang around you for a couple of days.
SUSAN DENTZER: There's a broad range of fact in this. For some individuals, that is to say sickly, bed-bound older persons, it may reduce the incidence as little as 30 percent, the degree of effectiveness is much lower than in the case of the health care professionals, where, as we said, it's almost 90 percent. But it's important to note what we're talking about here. That's preventing the flu. It is very clear that in terms of keeping you out of the hospital and preventing the very high-risk kind of things that can accompany flu, secondary infections, such as pneumonia, and preventing you from dying, the flu vaccine is generally much more effective. And there the effectiveness rates, that is to say eliminating that possibility is upwards of 70 percent for many, many more individuals. PHIL PONCE: So is it fair to say a flu vaccine can't hurt you but it might help you? SUSAN DENTZER: It can't hurt you, might help you, and it almost certainly is going to increase the odds that your life will be saved, you will not die of the flu over the secondary infection related to the flu. |
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| Do you still get the flu? | ||||||||
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SUSAN DENTZER: Well, for one thing, you all may not have gotten the flu, you may have gotten something else, a very bad cold, another kind of a virus, known as RSV, which can mimic a lot of the symptoms that a lot of people confuse with the flu. PHIL PONCE: RSV, what does that stand for? SUSAN DENTZER: Respiratory Syncytial Virus, which is another very widespread virus, particularly among children. PHIL PONCE: So when I went to the doctor and he said I had an acute viral infection, what did that mean? Did that mean I had the flu, even though I got a flu vaccine?
PHIL PONCE: So a flu vaccine can care vary in effectiveness from year to year because every year flu viruses can mutate and come up with new variations that the existing vaccines weren't manufactured to address? SUSAN DENTZER: That's right. And that's why there is in place a global surveillance network to find out as early as possible what variants are likely to be prevalent in the coming flu season. |
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| A personal decision. | ||||||||
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PHIL PONCE: Susan, across the general population, how many people get flu vaccines?
PHIL PONCE: Well, Susan, why is it if the evidence show it is can help you, why is it more people are not getting the flu vaccine? SUSAN DENTZER: Some people are afraid. Some people are afraid that they're going to get the flu from the flu vaccine. Some people think that they're going to get very bad serious side effects, whereas we know that probably the worst side effect you're going to get is a sore arm, sore at the site of the vaccination spot, for one to two days. And I think - PHIL PONCE: But you can't actually get the flu from getting a flu vaccine? That's a myth. SUSAN DENTZER: You cannot get the flu. Many people apparently retain memories of older generations of flu vaccines that were not so pure and you could get some worse side effects than is the case now but also people just don't understand how much their risk could be reduced and the risk in some cases of very serious illness and death.
SUSAN DENTZER: Yes. Happily enough to say, there is a possibility in the next couple of years there will be on the market something known as flu mist vaccine, which actually is a vaccine that is made of live -- attenuated live viruses. It sounds scary to say, but, in fact, what this is, is viruses that, in effect, could be more effective in terms of a vaccine of preventing you from getting the flu. Also, these would be administered through a nasal spray. So, in effect, it would mimic getting the real flu. You'd get a live virus, you'd get it through your nose, which is how you tend to get flu virus in the first place, and it's thought that this will be more effective in preventing flu. We'll see if it comes on the market and if it has in fact that effect. PHIL PONCE: Did you get a flu shot? SUSAN DENTZER: Of course. PHIL PONCE: Did you get the flu? SUSAN DENTZER: No. PHIL PONCE: Lucky, Susan. Thank you. SUSAN DENTZER: Thanks, Phil. |
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SUSAN
DENTZER: Influenza, known as the flu, afflicts millions each winter,
causing symptoms like chills, fever, a dry cough, muscle aches, and
fatigue. Although most people recover within several days to two weeks,
the flu remains a serious public health problem, and one that is arguably
getting worse. 
SUSAN
DENTZER: Between 10 and 30 percent of the population gets the flu each
year, as new strains of influenza viruses emerge. About 130,000 Americans
are hospitalized, and as many as 30,000 die of it. An estimated 10,000
or more also die of flu complications, such as pneumonia. Although the
flu hits almost everybody, particularly school-age children, it can
be especially dangerous to people with chronic illnesses, like emphysema
and HIV, and it can be deadly to the elderly. More than 90 percent of
influenza-related deaths occur in people over 65. 
SUSAN
DENTZER: The best way to avoid becoming ill is to get a flu shot before
flu season begins each fall. The vaccines must be administered annually,
since they are designed to attack the strains of virus likely to circulate
each flu season. Their effectiveness is underscored by a new study in
this week's issue of the Journal of the American Medical Association.
Researchers looked at health care workers who received flu vaccines
and those who did not. Dr. James Wilde was the study's lead author.
SUSAN
DENTZER: The flu, Phil, is a viral infection that's caused by the influenza
virus, which comes in three forms, known as Types A, B and C. The ones
we really care about are Type A and B. Those tend to cause the large
disease outbreaks, the epidemics that we've become familiar with. As
we said in the piece, the symptoms are familiar. You start off, you
tend to start off with a dry cough, a headache. That evolves quickly
to fever and chill - chills, rather, leading to fever. Then you get
something a couple days later that seems pretty much like a cold, nasal
congestion, coughing again. You tend to get a lot of muscle weakness,
muscle fatigue, and you can feel that for as much as a week to two weeks
after the rest of your symptoms disappear.
PHIL
PONCE: Susan, this study in the Journal of the American Medical Association
dealt with young health professionals and how effective the vaccine
was in that group. But across the board, how effective are these flu
vaccines?
PHIL
PONCE: Susan, without making the segment too personal, we had a staff
meeting yesterday and Jim asked for a show of hands for a show of people
who had gotten a flu vaccine. And every person in the room, about 12
of us, raised our hands and he asked how many have gotten the flu, about
six of us raised our hands. Explain that. 
SUSAN
DENTZER: It meant that you had a virus that caused a lot of havoc in
your body and that the doctor did not go on to make sure that that was
an influenza virus. So, it's quite likely that you had some other kind
of virus. You may, indeed, have gotten the flu, you can't rule that
out. But it's quite likely and particularly, for example, last year
when the flu virus - the flu vaccine was made, the actual variant of
the virus that ended up causing most of the flu outbreak in the United
States last year turned out not to have been captured in the vaccine.
That did not appear to have happened this year but that does happen
from year to year. So it may be that you get a vaccine and it wasn't
necessarily targeted to the variant of the virus that caused the flu
in that given year. 
SUSAN
DENTZER: In the United States about 75 million people. So, it's a little
bit more than a third of the population. The concern now, as we said
in the piece, is that many of the people who are at high risk for getting
the flu and having serious complications or dying of it are not getting
it. 65 percent of the elderly fortunately are now getting the flu vaccine.
That's a dramatic increase from recent years. And hopefully it will
continue to go upward. But if you look at the next younger group of
people, say people age 50 to 64, many of whom who are starting to have
chronic diseases like diabetes and other things that would be indications
of a need to get flu vaccine, that group of people is not getting the
flu vaccine to the degree it should, as is the case with many young
children. Very young children should probably get the flu vaccine because
they can have worse cases than slightly older children and others who
may have compromised immune systems, such as with HIV and so on. So
there's a large group of people who need to get the virus - who need
to get the vaccine who are not getting it. 
PHIL
PONCE: And real quickly, things that are in the pipeline, drugs or vaccines
that maybe are improvements?