News & Views: Fighting Flu and the Annual Campaign to Immunize

It happens every year like clockwork — influenza disease spreads throughout the country like holiday cheer. And, it is always preceded by the fall push to get one’s entire patient population immunized. Influenza is not unique in its ability to spread, but our efforts to combat it are unique compared with other vaccine-preventable diseases. Collectively, healthcare providers across the country take on this huge initiative to immunize virtually an entire population — only to do it all again 9 to 12 months later. Worse, this massive effort is all to induce a level of protection that is often middling at best. That said, some protection is better than no protection, so we continue to do the best that we can.

So, why is a better influenza vaccine so elusive?

Improving influenza vaccines has been difficult because of the nature of influenza viruses. The most troublesome aspect of the virus is its ability to mutate. As influenza replicates, it accumulates genetic mutations that alter the proteins on the surface of the virus rendering immunologic memory partially or completely ineffective. While this level of genetic mutations may seem “sloppy,” it works in favor of the virus’s evolutionary struggle to survive.

A second aspect of the virus that complicates our ability to control it is the fact that influenza viruses can infect across species. When influenza strains originally derived from birds or pigs mutate or combine with human influenza strains, novel influenza viruses are the result. Many of these new viruses will not be robust enough to survive let alone cause disease in humans, but sometimes they can. To see more about this, watch the animation from Hilleman: A Perilous Quest to Save the World’s Children.

Dr. Offit recently discussed the difficulties associated with making an influenza vaccine more extensively in a column for The Daily Beast and in a short video.

A recent commentary in the New England Journal of Medicine addressed influenza vaccine efficacy and garnered media attention due to statements related to vaccine efficacy for the current influenza season. For more information about the article and these statements, read the “In the Journals” article by Dr. Offit.

Get help with influenza vaccination programming

Because of the need to immunize against influenza annually, many resources exist. Find these tools for specific patient populations:

• Children — Families Fighting Flu (FFF), the National Association of Pediatric Nurse Practitioners (NAPNAP), and HealthyWomen partnered to produce a toolkit promoting immunizations in the pediatric population. Called Do You Know the Flu?, the kit includes fliers to display, guidance for answering questions related to influenza vaccination, personal stories about children who suffered from severe influenza infections and more. PSAs called Play It Safe and several personal story videos are also available in the multimedia section of the FFF website.
• College students — The National Foundation for Infectious Diseases (NFID) published a report related to vaccinating college students against influenza last spring. The report discusses data related to influenza infections as well as identifying challenges to immunizing this population and presenting a series of recommendations to address the challenges.
• Adults older than 65 years — NFID also published a call to action last fall titled, Reinvigorating Influenza Prevention in US Adults Age 65 Years and Older. The publication discusses the increased risk of heart attack, stroke, hospitalization and death following influenza infection in people older than 65 years as well as best practices related to influenza vaccination. A related infographic is also available.
• Healthcare workers — The Centers for Disease Control and Prevention (CDC) has a toolkit prepared for the 2016-17 influenza season that includes information relevant for healthcare workers and why it is important for them to be vaccinated against influenza. A variety of materials are also available specifically for healthcare workers in long-term care facilities.
• All populations — The CDC has a digital campaign toolkit available. The kit includes print-ready materials, messages to share in newsletters, social media images and messages, web resources and more.