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Free flu vaccines heading to Chicago neighborhoods

by Julia Dilday
Oct 14, 2008

Questions and answers about influenza with Dr. Julie Morita, medical director for the Chicago Department of Public Health Immunization Program 

Influenza and pneumonia (a major complication of influenza) killed 525 Chicagoans in 2005, making these illnesses the 8th leading cause of death in Chicago, according to the Chicago Department of Public Health. But a flu vaccine can dramatically reduce the risk, experts say. Tuesday kicked off the first of nearly 100 influenza vaccination clinics offered by the department, in addition to the eight permanent Fast Track Immunization Clinics across the city.

How serious is the flu?
About 200,000 people are hospitalized every year with influenza complications. About 36,000 die as a result of complications of the flu. The majority of the deaths and hospitalizations are among the elderly and chronically ill. Nationally, up to 20 percent of people can be affected by influenza.

What are some of the most serious potential complications of the flu?
Pneumonia and encephalitis.

Are there any misconceptions about the flu? 
Many people believe that the flu itself is a mild illness, that it’s a cold. During the flu season there are many other viruses that cause respiratory illnesses. And so people will get a cold and think that it’s the flu. But when you get the flu you actually have a high fever with a fairly abrupt onset. You feel bad. Cough, runny nose, sore throat, muscle aches -- those are the classic symptoms of the flu. And you’re in bed. Most people are not feeling well for five to seven days. Many people miss work or stay out of school because of it. So there’s a lack of true understanding about what the flu actually is. As a result of it, people don’t realize how important it is to try to prevent those kinds of illnesses.

Which strain of flu is expected this year?
Every year the strain of influenza that causes illness changes. It’s never possible to predict with 100 percent certainty which strain it will be that causes the problem. The World Health Organization and the Centers for Disease Control and Prevention do surveillance for influenza, which means they’re looking to see what strains are causing disease throughout the world. They decide in the beginning of the year which strains are most likely to cause disease and they make sure those are the strains that are included in the vaccine.

So this year, for 2008-2009, the recommendations were made in the spring of 2008. They include three different strains in the vaccine itself. It’s most likely going to be one of those three strains that’s causing the disease. It’s not always just one strain, and it’s not always the strain that’s included in the vaccine. But typically, there’s a good match between what’s in the strain and what’s causing the disease.

What is the general recommendation of the Chicago Department of Public Health regarding the flu vaccine?
Anybody who really wants to get the flu vaccine can get it to prevent the disease. In addition to those people who want it, there are certain groups who really need to get the vaccine to keep them healthy and to keep them from ending up in the hospital or having serious complications.

·People who are over 50 years of age.

·All children between six months and 18 years of age. Children less than five years in age are actually at a higher risk for hospitalization or going to the doctor.

Of all the people who get infected, there’s a high proportion that are school-aged. They transmit it to each other. It circulates and causes illness. Then they also spread it to others. So the recommendation that they should get [vaccinated] is not because they’re more likely to end up in the hospital, but because they’re a huge burden of disease. They are the source of infection for many, many people. So by vaccinating them, we can potentially protect a lot of other people.

·People with chronic illnesses: chronic heart, chronic lung, diabetes, chronic kidney disease. All those people should get the flu vaccine, because they’re more likely to get sick and end up in the hospital.

·People who work with or take care of people with chronic illnesses, like healthcare workers.

·Parents, grandparents and daycare providers of young infants less than 6 months of age. They should all get the vaccine, so they’re not infecting the young babies. Young babies can’t get the vaccine. It doesn’t work in them. And they’re also more likely to end up in the hospital, so it’s really important to protect the people who are around them.

The vaccine is effective, it can save lives.

Why should healthy people who are willing to take a chance with the flu still get vaccinated?
That’s a huge issue. There is an element of responsibility in getting the vaccine to protect not only yourself, but those whom you’re around.

You can transmit the illness before you get symptoms. So people say, “Oh, when I get sick I just stay home so I won’t give it to anybody else.” But the problem is, you can give the illness to people prior to becoming sick. You may not even realize you’re sick and you’re spreading it to other people already.

What is a common myth surrounding the flu vaccine?
I think a lot of people believe that the flu vaccine itself can give you the flu. With the flu shot, it’s impossible to get the flu from the vaccine itself [because the three viruses in the vaccine are inactive, meaning they cannot cause infection].

The inhaled spray, the FluMist®, which is another form of the vaccine, has a weakened form of the virus, and so people who don’t have normal immune systems could actually get a case of the flu, if they get that vaccine. So it’s not meant to be used for them. But normal, healthy people can’t get the flu from that vaccine [the FluMist®] either.

How easy will it be to obtain the vaccine this year? Aside from the private sector (doctors’ offices, pharmacies, etc.), where can Chicagoans go to get vaccinated?
There will be more vaccine available this year than ever before. It’s more of a matter of whether people are willing to take the time to seek it out. The Chicago health department is very fortunate because, for over 10 years now, we’ve been getting about 50,000 doses of flu vaccine. [That's in addition to nearly 200,000 doses they distribute to doctor’s offices for the federally-funded Vaccines for Children program.]

We coordinate about 100 single-day flu clinics in park [facilities], aldermanic offices, Department of Senior Services buildings -- a variety of locations throughout the city. If someone in Chicago wants to know where to get one, they can call 311, tell where they live and find a clinic that is closest to them.

In addition to that we have immunization-only clinics called Fast Track clinics. In general more kids go to those clinics, but adults can go to them as well. Those are stationary locations that are always available.

Are city-provided vaccines limited to a certain group? Do Chicagoans have to pay out-of-pocket for them at the time of the visit?
The vaccines are purchased using city tax dollars so they’re meant for city residents. Beyond that, there are no limitations on who can get it. It can be for adults or children. We do collect Medicare information from senior citizens so we can bill for reimbursement for the administration of the vaccine. Beyond that, there’s no charge to the individual.

Is the vaccine currently available at health department clinics?
We are currently giving the vaccine out right now and this is very early in the flu season. In the past 10 years, the vast majority of peaks of flu activity occurred in February or later. Typically we see it later in the winter. But, it’s possible to come early, so it’s always good to get the vaccine as soon as you can.

So when are we technically ‘out of the woods?’
You can’t say. It varies from year to year. I wish we could predict. But, with influenza, you never know. Even when you get the flu early on, you should still consider getting vaccinated because you get protected from the other two strains that are included in the vaccine. So it’s never really too late.

Have hospitalizations from the flu been reported in Chicago yet this season?
No, not yet.