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Vaccines may provide overall protection by Mary Helen Yarborough Public Relations As signs of a potential influenza pandemic emerge from Asia, health officials are urging everyone to get the annual autumn flu vaccination, especially health care workers.   This year’s vaccine, recommended by the Centers for Disease Control and Prevention (CDC) and World Health Organization, again contains three components (trivalent): two for the harsher A strain viruses, H3N2 and H1N1; and a vaccine for the generally less harmful B strain. CDC designated these components based on the most prevalent virus strains detected in China and the Far East earlier this year.   Vaccinations will be available for free to all MUSC employees starting Oct. 16 and will be administered through MUSC Employee Health and at numerous satellites on campus. (See http://www.musc.edu/ehs/flu_2007.htm.)   “I hope employees realize what a benefit it is that these vaccinations are given for free,” said Joye Veitch, family nurse practitioner and Employee Health director. “So I hope more people take advantage of it.”   As in previous years, Employee Health and Infection Control are teaming up to provide the flu vaccine to MUSC, MUHA and UMA employees. This year, the MUSC Clinical Preparedness Department (CPD), headed by Brian Fletcher, also will participate in the vaccinations by conducting a mass inoculation drill. The mass inoculation will be staged at a CPD tent from 7 a.m. to 8 p.m. Oct. 16 - 17 outside the Education Center/Library Building. Fewer people protected A recent CDC report is critical of the relatively small percentage of adults in the United States that were vaccinated last year. In the 18-49-year-old age-group, only an average of 20 percent received flu vaccines for the 2005-2006 flu season, with South Carolina  reporting 19.7 percent in this age group.   The rate doubled for the 50-64 age group, which saw an average of 40.3 percent with vaccinations nationally. In South Carolina, only 33.4 percent of this age group received vaccinations. (For more information, see CDC’s Morbidity and Mortality Weekly Report, Sept. 21, 2007, Vol. 56, No. 37.)   At MUSC, Veitch said that vaccination rates have been fairly strong and even increased by nearly 1,000 last year.   But Employee Health and Infection Control have small staffs and require supplemental help during a large vaccination period. Veitch said departments are being contacted to request help from medical center staff in conducting on-site vaccinations.   Meanwhile, Veitch expressed gratitude for Cheryl Brian, R.N., safety office nurse; Mary Allen, R.N, quality coordinator for Outcomes and Quality Management Office; and many other nurses on campus, as well as assistance from the MUHA Volunteer Office who help administer vaccinations around MUSC.   “Cheryl Brian and all of these dedicated employees have been wonderful to help us with vaccinations at Harborview Tower and other locations on campus,” Veitch said. “What they do saves money and man-hours, and helps us provide the flu vaccine to more employees.”   To expedite the process, an employee express line will be provided at the disaster tent for employees who present their completed vaccine consent form. “Our goal is to minimize time away from patient care,” Veitch said. Vaccines don’t give you the flu Counter to claims by those who say flu vaccines “give them the flu,” about one in three people experience minor ailments following a flu vaccination. The non infectious symptoms indicate that the body's immune system responded vigorously, said Robert Ball, M.D., infectious disease consultant and epidemiologist for the S.C. Department of Health and Environmental Control (DHEC) Regions 6 and 7. “That’s the body’s natural response to the viral  antigens,” he explained. “It means your immune system is working.”   Most people do not feel any ill effects from the flu shot, but still become immune, protecting  against the flu virus as well as from complications of pneumonia and death, Ball said. One form of vaccination, FluMist, may cause a mild nasal infection, he added, but not the shot.   FluMist, a live attenuated trivalent influenza vaccine is administered by nasal inhalation rather than by injection, which generally is better for vaccinating children, Ball said.    Ball said that influenza vaccinations may not prevent all people from getting the flu virus, "it will cut your chances of getting very ill or dying from it," he said.   A flu vaccine generally protects against the three  strains for which they are designed for up to six months. To boost one’s immune system for the spring and summer, Ball also suggests that people consider getting a second flu vaccine.   “I get a flu vaccination twice a year,” said Ball. “That covers me for the other half of the year, provides higher immunity, and may cross-protect me against other strains.”   Most vaccines carry a shelf life that expires June 30, Ball said. He gets a second shot in the spring  to protect him for the rest of the year.   “We waste millions of vaccines every year, because a relatively small percent of the population gets vaccinated,” Ball said. “But it's also because many are wasted by the automatic expiration on June 30. Imagine an 85 percent protection for the population. That’s what you could have if everyone got vaccinated.”   Ball said this is  called herd immunity, in which the general population’s immunity prevents the rapid spread of the virus, Ball said.    Ball said that getting a seasonal flu shot containing the N1 component also could possibly  reduce chance of catching avian influenza, A-H5N1, which is emerging as a threat in southeast Asia.   This so-called bird flu A-H5N1 has killed hundreds of people in Asia, in particular Indonesia where health officials finally concluded the strain passed from human to human  last year. Still, most people seem to get the avian or bird flu by direct contact with an infected bird, particularly chickens.   The fact that the virus has mutated to pass from one person to another is an alarm to health officials who anticipate a wider spread of the disease within several years, Ball said.   Other alarms include the high mortality rate in the Indonesia cases, the reduced effectiveness of Tamiflu in these strains, and a recent case of maternal-fetal (transplacental) transmission. The five main winter viruses are: Influenza An and B strains Coronaviruses, the  strains that cause common colds, which mutated into the severe acute respiratory syndrome (SARS) in 2003 Rhinoviruses, which generally cause most the common colds Adenoviruses, which most commonly cause respiratory illness,  gastroenteritis, conjunctivitis, cystitis, and rash illness. The respiratory syncytial virus, comon and often severe in young children. Friday, Oct. 5, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.