Well if your data above is true, then while I think the risk over all is still low, I think the significant number of cases combined with the mortality rate, justifies your presentation of the argument, and I am not convinced it is in fact "Fear Mongering".
Thank you. If one compares cost and risk of flu shots, (both minimal) to risk of flu which is high, times frequency which is relatively rare, the equation still tips easily toward 'get the shot'.
As for my "sample", if you mean my patient population, I would say they are average in all respects, and therefore would exhibit a typical amount of ignorance as to the seriousness of the flu and its risks.
Yes, and I'm sure you see your share of people who believe flu and flu vaccine myths, but you are missing the population of healthy people who haven't seen a health care provider in years. Not that I'm saying these added persons skew your sample by
that much, but I do spend a lot of time trying to dispel the unique flu vaccine myths in my practice. The same folks who don't think twice about tetanus or hep B vaccine do manage to put flu shots in a different category in their minds.
I think that the jury is still out (though I agree, it seems to be leaning heavily toward universal vaccination) on vaccinating EVERYONE for the flu. As a result, here where I work in Canada, while we recommend the flu shot to just about everyone, only the "at risk" groups get it covered in terms of cost.
The jury is out, but in particular because it is only hypothesized that by vaccinating everyone we will significantly impact the community spread of influenza. That is the basis of the current ACIP recommendation regarding vaccinating all kids 6 months to age 18 in this country. ACIP has not yet addressed the MRSA/flu connection. I suspect they will however, when they meet again either in April or Oct of 2009.
I think that we should be honest with our patients when dealing with whether they should be vaccinated.
in other words, there is a difference between:
"Out of tens of thousands of people who get the flu each year, there are X number of fatalities. In addition, of those who get the flu, several hundred (which works out to X% of total cases) can acquired a co infection of MRSA Pneumonia. Of those who do obtain such a co-infection about one to two thirds of cases can be fatal."
Versus
"If your teen doesn't get the flu shot she might get the flu, and possibly MRSA Pneumonia which might kill her."
As health professionals we must always indevour to choose the first example.
TAM
There are 2 ways to honestly present the need for flu vaccine. There is the, "gee it's a rare risk but you might consider a flu shot", approach. And there is, "the benefit by far outweighs the risk", approach.
In addition, one also looks at what it takes to educate a patient or parent. We know that just providing knowledge in many cases is not sufficient to educate a patient. If, on the other hand, you can provide the patient with information which is relevant to them, you can be successful where just imparting knowledge is not.
I do believe the evidence clearly points to CA-MRSA, and staph a. with the PVL gene is indeed an emerging pandemic. I have seen much evidence this is the case. I found it quite interesting and worrisome that a similar staph a./flu synergism occurred in the 1968 flu pandemic. I don't think it is an exaggeration to point out the potential for influenza to be more deadly in young otherwise healthy people in the coming years. And I don't think the general public is aware of this new hazard.
I would rather error on the side of caution here than take the position we need more evidence. I don't think we do need more evidence. But even if we did, the harm in not sounding this alarm outweighs the risk in sounding it and having the risk not materialize as it appears it is going to.
