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VAC C IN ATION Annual Vaccine Remains Best Defense Against Flu Influenza causes more than 30,000 deaths annually in the United States, with the elderly, infants and people with chronic medical conditions at greatest risk. This has led the U.S. Centers for Disease Control and Prevention to recommend that everyone ages 6 months of age and older get a flu vaccine each year. “This is a very safe vaccine that will significantly reduce the likelihood of contracting the flu,” says Peter Lefevre, MD, an internal-medicine physician at UCLA Medical Center, Santa Monica. “It is especially important for people who are at risk of developing complications such as dehydration and pneumonia, potentially leading to hospitalization or death — as well as for anyone who is going to be in close contact with high-risk individuals.” Because the influenza virus comes in different strains each year, the flu shot must be obtained annually, Dr. Lefevre says. He urges patients to get the vaccine early in the fall. The vaccine comes in several injectable forms and as a nasal spray, which is approved for patients 2-to-49 years old. Peter Lefevre, MD BSA Both the nasal spray and the injection are effective in children up to age 10, but the injection may be preferred in children older than age 10 and adults due to slightly enhanced immune response. Many people mistakenly believe that the vaccine gives them the flu, or that it is ineffective. In fact, Dr. Lefevre explains, the injectable form is an inactivated or “killed” virus to avoid causing the infection. In some cases it can produce a minor immune response in the first 24-to-48 hours, including low-grade fever and muscle pain, as the immune system develops antibodies against the flu — but that is nothing compared to the potentially severe and life-threatening symptoms of the flu itself. Dr. Lefevre adds that because the vaccine is developed about six months in advance based on the best estimates of scientists regarding the strain of influenza that will prevail in the next flu season, it is never 100 percent effective — but it dramatically lowers the risk, and reduces flu symptoms even when full immunity is not conferred. In addition to the highest-priority groups — including children under 5; adults 65 and older; pregnant women; and individuals with respiratory or heart conditions, diabetes, or otherwise compromised immune systems — it is important for healthy young and middle-aged adults to get the vaccine. “This is about both prevention for yourself and protecting others,” Dr. Lefevre says. “Even if you are perfectly healthy and feel like you never get sick, the flu can hit anyone. And even if you’re not worried about being out of commission yourself, you should be concerned about not passing it along to others who might be more vulnerable to influenza’s effects.” Vaccinations are available at a primary-care office near you. For locations, go to: Vaccines Against Pneumonia Recommended for Older Adults A second vaccine is now available to prevent pneumococcal infection — a major cause of pneumonia — in adults 65 and older. David Reuben, MD, UCLA geriatrician, notes that as of last year, the U.S. Centers for Disease Control and Prevention (CDC) recommends that older adults get both vaccines, which are covered under Medicare Part B. The two vaccines, Pneumovax and the newer Prevnar 13, protect against different strains of the pneumococcal virus. For adults 65 and older who have not received either vaccine, the CDC recommends first getting a dose of Prevnar 13, followed by a dose of Pneumovax after waiting six-to-12 months. Those who have previously received Pneumovax should get Prevnar 13 at least a year after their most recent Pneumovax dose. For anyone who has received Pneumovax at a younger age (before 65 years), reimmunization is recommended five or more years later. Approximately 1-million people are hospitalized in the U.S. each year for pneumonia, and about 50,000 people die annually from the disease, according to the CDC, with older adults at the highest risk. Many of these illnesses can be prevented with the one-time administration of the vaccines. “The pneumonia, flu and shingles vaccines are basic steps that older people can follow to protect their health,” Dr. Reuben says. “It is important to take the initiative and make sure to cross these off the list.” Vital Signs Fall 2015 Vol. 68 3