Submitted by Allison Baroco, MD, Augusta Health Infectious Diseases
As we round out 2017, experts who usually make noncommittal responses to flu vaccine 
predictions have noted a particularly bad flu season in Australia due to H3N2 influenza A, and there are concerns the same thing will happen in the northern hemisphere.
News headlines are quoting a dismal 10% vaccine efficacy.
Why has this happened and what should we as a healthcare community do with this information?
First, why did this happen?
The low effectiveness is not due to strain-vaccine mismatch. Unfortunately, the problem is related to alterations in key flu vaccine proteins during egg-based vaccine production. Because flu vaccine is produced with use of eggs it takes too long to manufacture new flu vaccines and therefore the problem cannot be corrected this season.
Despite the low predicted efficacy of this year, why should we continue to promote the vaccine?
- The Australia experience with H3N2 may not be repeated in the United States. Even flu experts grapple with unpredictability of seasonal flu activity, and the person standing next to you may have influenza B, for which there are predictions that the vaccine will provide much better protection this year.
- Some protection is better than none. There have been many studies including a recent paper that found flu vaccine prevented influenza-related hospitalizations, suggesting attenuation of severe disease.
- If you are a healthcare provider, you owe it to your patients! Especially if your patient population includes babies, pregnant women, elderly, people with cardiopulmonary disease, obese individuals, or immunocompromised hosts. Have I missed anybody here…
- It is the only thing we have got. Hopefully in the future new technology will bring better flu protection with vaccination, however this is what we have for now.
- It’s safe. The vaccine does not cause the flu and the CDC recommends everyone over the age of 6 months obtain a flu vaccine each year. There are very few exceptions to this rule.
What else can we do? Remind our patients to wash their hands when out in the community during flu season and to stay at home if they develop flu-like symptoms. (i.e. Avoid church, school, work, grocery store, etc.). The same goes for healthcare workers; we are not immune to passing this highly contagious infection to our patients.
Adapted from HIV and ID observations blog December 3, 2017 by Paul Sax. “Why even with depressing predictions about flu vaccine effectiveness, we should still recommend and get it”