Commentary-Rationing Influenza Vaccines
Commentaryâ
Rationing Influenza Vaccines
By Jeff Cersonsky, MD, FAAP
I received a call this week from a parent of a patient of mine who told me that she had heard that another pediatric practice was planning on dispensing any of their unused flu shots to whomever wanted them after December 1. I made a call to find out whether this was true, and it wasnât, but it doesnât change how I see my moral obligation.
No one is happy about the flu shot debacle this year. I am very concerned about those who canât get the shot and whose medical conditions could significantly worsen should they get the flu. Weâre not talking about people who would just be sick for six or seven days, weâre talking about people who could die from the flu. Those people need whatever shots I have leftover.
I am not giving the flu shot to my family, not even to my wife who, as a teacher, will certainly be exposed to the flu. I am not giving the shot to my daughter in college, who shares a bathroom with 30 other girls and will certainly be exposed to the flu. I will not be giving a flu shot to my other three children, even the one who has very mild asthma. We will wash our hands and eat healthfully and get as much rest as possible; if any of us gets the flu, we will feel lousy for a while, but we will recover. I will follow both the Centers for Disease Control guidelines as well as the health department guidelines and make any vaccines I have leftover available to the babies, cancer patients, lung disease sufferers, and elderly people who so desperately need it.
To review the CDCâs recommendations, the following people should get the influenza vaccine:
Children ages 6 months to 23 months.
People who are 65 years of age and older.
People 2 years old or older who have an underlying, long-term illness (heart or lung disease, metabolic disease (like diabetes), kidney disease, a blood disorder, or a weakened immune system (including people with HIV/AIDS)).
Women who will be pregnant this season.
People who live in nursing homes or other chronic-care places.
People who are 6 months to 18 years of age, and take aspirin daily.
Health care workers who take care of patients.
People who have or take care of a baby under 6 months old. (Do not give a flu shot to babies under 6 months.)
One key group that has been excluded is household members of those at risk (with the exception of babies under 6 months). Remember that children under 9 years of age who are receiving the influenza vaccine for the first time this year need a second immunization a month after the first.
By the way, a recent study showed that the risk to an infant under 1 year of having serious complications of influenza exceeds that of the elderly with chronic lung or heart problems.
For those who do get the flu vaccine, remember that it is designed to prevent the most likely strains of influenza that the experts feel will be prevalent this flu season. It does not prevent colds, other viruses (such as RSV), avian flu, or influenza strains that were unanticipated. Actually, these experts have been very good over the years at predicting the predominant influenza strains, although there was a significant amount of unanticipated influenza strains last year. Their track record otherwise is very good.
Certainly, it doesnât make me happy to feel that I have disappointed any of my patients in that I will be only giving my vaccines to those most at risk. I hope theyâll understand.
(Jeff Cersonsky is a pediatrician with offices at 30 Quaker Farms Road in Southbury. He writes a regular column in The Beeâs quarterly Health Monitor.)