Thursday, September 09, 2010

Vaccine begins to arrive as flu season nears By Don Sapatkin


Aug. 25, 2010

David Yoslov, 23, gets a flu shot from pharmacist Eric Reid at the CVS at 19th and Chestnut.

Remember the seasonal flu?

The last typical season was the winter of 2008-09. The pattern was upended by an out-of-season pandemic flu the following spring and fall, and hardly any flu at all last winter.

Now the best educated guess by public-health experts is that influenza will next appear in a more-or-less normal season that contains several strains, including the so-called swine flu.

And vaccine is starting to arrive.

Several retail drugstore chains are already offering vaccine or plan to start soon. (For locations and eligibility, go to

Most county health departments in the Philadelphia region have begun receiving vaccine, and all plan clinics in the fall. Shipments to private practices are harder to measure. But all five manufacturers reported two to three weeks ago that they had already started delivering what is anticipated to be a record 150 million to 180 million doses, vaccine expert William Schaffner of Vanderbilt University School of Medicine said Tuesday.

In a conference call with reporters, Schaffner delivered a message that is likely to be repeated many times in the coming months by public-health officials who worry that confusion and flu fatigue - the verbal kind - could get in the way of prevention.

"Influenza can put you in the hospital," said Schaffner, an adviser to federal agencies on flu policy. "It's not too early to get vaccinated."

Emphasizing the point was Serese Marotta of Dayton, Ohio, whose son - Joseph, 5, with no preexisting health conditions - died of the new H1N1 flu last October, nine days after he threw up on a school bus.

He had been hospitalized almost immediately, was diagnosed with pneumonia and later influenza, and appeared to be over the worst of it when, in the midst of a conversation with his mother, "his eyes rolled back and then the monitor went off," Marotta said. She said the official cause of death was "catastrophic intestinal rupture" as a result of the flu virus.

While the flu is typically known for causing respiratory illness, that case is a reminder that "it has the potential of causing all sorts of life-threatening complications," said W. John Langley, chief medical officer for Maxim Healthcare Services, a firm that gives seasonal flu shots in many states. Langley, a pediatrician, was also on the conference call organized by Families Fighting Flu, a nonprofit made up of families and health-care workers that says it seeks to educate the public about the severity of influenza and the importance of vaccination.

What is known as "seasonal flu" actually consists of several strains, with the dominant strain varying from year to year. A pandemic flu by definition is a new strain - sometimes lethal, sometimes not - to which most people have little immunity. After it's been around for awhile, people develop immunity and it moves into a seasonal pattern.

Many experts expect that to happen this year, although it is not known whether the new H1N1 or an older H3N2 - already seen in a few areas this summer - will dominate.

The seasonal vaccine offers protection against both of those Type A flus, along with a Type B that tends to come later in the season and cause milder illness. This so-called trivalent formulation is typical of recent seasons, although the strains often differ from year to year. There is no separate vaccine for the new H1N1, also known as swine flu.

But there are two noteworthy changes this year:

A stronger formulation was approved specifically for people age 65 and older, whose immune systems are not as robust as those of younger people. The single shot, made by Sanofi Pasteur, is known as Fluzone High-Dose.

The U.S. Centers for Disease Control and Prevention, which has been gradually expanding the population it recommends receive flu shots, this year added healthy adults ages 18 to 49. That means everyone over six months of age is now recommended to receive the vaccine. (The nasal spray form is approved only for healthy people ages 2 to 49.)

David Yoslov, 23, of Center City, belongs to that demographic. Last week, he said, he looked online for flu shots locally and made an appointment for the CVS Pharmacy at 19th and Chestnut Streets.

"I just feel it is one of the few things you can do to help keep yourself healthy," Yoslov said after getting the shot Tuesday.

CVS accepts insurance but Independence Blue Cross, the region's largest insurer, rejected the submission. A spokeswoman said Tuesday night that most plans cover vaccines, and she was trying to determine what happened in this case.

For Yoslov, the rejection was an inconvenience, but he had no qualms about paying the $29.95 to get his shot.


Contact staff writer Don Sapatkin at 215-854-2617 or

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