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Will there be a severe flu season this year?

US update. Flu, as expected, did decline over summer. Anticipating a fairly significant flu season like AU has had as we go into fall/winter. Will probably compete with BA.5/BA.4.6 if those show seasonal increases like Flu. However, flu levels are still quite low. Now's the time to monitor closely.

Flu vaccines are expected to be quite effective if we get the types that AU got, which is the usual pattern.
 
marting said:
US update. Flu, as expected, did decline over summer. Anticipating a fairly significant flu season like AU has had as we go into fall/winter. Will probably compete with BA.5/BA.4.6 if those show seasonal increases like Flu. However, flu levels are still quite low. Now's the time to monitor closely.

Flu vaccines are expected to be quite effective if we get the types that AU got, which is the usual pattern.
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Oi, there are countries other than the Great Southern Desert in the southern hemisphere pal!

Like you, I watched our data closely and hit the vaccine at exactly the right time - just as it starts to spread, because when it spreads, it went like covid, with massive disruption to workplaces, schools, and the medical system, which got crushed. In the space of a couple of weeks we went from not much 'flu to more people in hospital with 'flu than covid. Coinciding with minimal covid restrictions, influenza took advantage and exploded.

And we have excellent evidence the vaccine is highly protective, with very few breakthroughs. On a personal note, my daughter hadn't bothered with the vaccine and copped a beautiful dose, while her sensible fiance, who had been vaccinated, didn't catch it from her.

The pandemic has been fascinating for the side-effects as other diseases reduced in concert with the covid measures. Every seasonal virus had been kept out of NZ for 2 winters, along with covid, and when they finally hit, immunity was low and serious illness was high.
 
Interesting discussion amongst docs about the best time to get a flu shot. Similar to my own analysis here but with more nuance.

https://www.statnews.com/2022/09/09/doubling-up-on-covid-booster-flu-shot-may-have-downside/

If you ask someone who researches flu and flu vaccines, they will likely quietly — or in some cases, not so quietly — advise you to wait at least until the end of October to get a flu shot, though they’ll attach the caveat that if you start to hear about flu activity picking up where you live, you should fast-forward your plans.
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I do the flu campaign for public health in my state. What we are seeing is what happened this past winter in Australia. It is peaking early, 98% of the cases are influenza A. The numbers aren't any worse than pre-covid in Australia, and so far, not higher than pre-covid levels here although we are seeing the surge early.

My suggestion is to get your flu vaccine as soon as possible. There are a couple of recommendation changes from the CDC. One is a change in the age range certain brands of vaccine are suitable for and the other is for 65 and older people who should be getting the high dose flu vaccine to make sure it lasts through the season.

The Twindemic stuff is just media hysteria.
 
Jodie said:
I do the flu campaign for public health in my state. What we are seeing is what happened this past winter in Australia. It is peaking early, 98% of the cases are influenza A. The numbers aren't any worse than pre-covid in Australia, and so far, not higher than pre-covid levels here although we are seeing the surge early.

My suggestion is to get your flu vaccine as soon as possible. There are a couple of recommendation changes from the CDC. One is a change in the age range certain brands of vaccine are suitable for and the other is for 65 and older people who should be getting the high dose flu vaccine to make sure it lasts through the season.

The Twindemic stuff is just media hysteria.
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Yeah, I found the twindemic nonsense that was in all the media towards the end of 2020 hilarious. R0 of flu is so low compared to Covid-19 that it was pretty obvious flu was going to be really minimal. It made something of a comeback in 2021/2022 but with a double bump as Omicron temporarily changed behaviour. Still that was only half a normal season.

We are overdue with less population immunity so I expect a pretty high flu season. Timing may depend on C19 variants. There's some that look likely to produce a wave and it may well produce a similar behaviour change that we saw last season.

Currently, looking at CDC's FluView and state distribution. I anticipate getting the shot iin about 2 to 3 weeks as it's still at very low levels here but with a slight uptick.

There's a fair amount of academic research on flu shot timing given waning immunity. Here's a few I found interesting.

Optimizing spatial allocation of seasonal influenza vaccine under temporal constraints
https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1007111

Modelling of optimal timing for influenza vaccination as a function of intraseasonal waning of immunity and vaccine coverage
https://www.sciencedirect.com/science/article/pii/S0264410X19311454
 
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It depends on the person's age and condition; this is the first year that the CDC made a firm recommendation on what type of flu vaccine that would be most appropriate for those 65 and older. IMO, based on the stats and discussions going on about flu at work, I don't think you ought to wait until November. I do know Flumist doesn't seem to last as long as the other flu vaccines so I would avoid that brand for this particular season.
 
Puppycow said:
Is the best timing for the individual the same as the best timing from a public health perspective? What if everyone waited till November?
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Bingo. This is something I've been wondering as well. I haven't run across any discussions on this and it's pretty obvious that the optimal strategy for an individual is not necessarily optimal for general, public health.

It might be that if most were vaccinated early, the flu wave would just be delayed as immunity declined. However, if it pushed the wave enough that seasonal effects kicked in then it likely would be more optimal overall. OTOH, if most got vaccinated at, say the rate was 5% of the expected peak, that the resulting wave would be more supressed.

Hard to say exactly where optimal public policy timing is relative to optimal individual risk reduction.

There is a characteristic of flu waves that might be relevant. It tends to hit younger groups first then spreads to older groups. This suggests an approach where vaccinations are best rolled out early to younger people which should reduce the overall wave while delaying rollout for the older cohorts which suffer more rapidly declining vax immunity.
 
Jodie said:
It depends on the person's age and condition; this is the first year that the CDC made a firm recommendation on what type of flu vaccine that would be most appropriate for those 65 and older. IMO, based on the stats and discussions going on about flu at work, I don't think you ought to wait until November. I do know Flumist doesn't seem to last as long as the other flu vaccines so I would avoid that brand for this particular season.
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Yes, nice to see the CDC do this since I'm over 65 and anticipate a bigger than usual flu season absent covid-19 variants producing a wave that impacts behaviour. But that isn't going to be obvious prior to getting a flu shot. If it produces a lower first wave and higher second, delayed wave I may well get a second flu shot.
 
marting said:
Yeah, I found the twindemic nonsense that was in all the media towards the end of 2020 hilarious.
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That's exactly what we had in winter. Early winter was dominated by covid, then the 'flu kicked in hard about June and we had more people in hospital with 'flu than covid in July.
 
The Atheist said:
That's exactly what we had in winter. Early winter was dominated by covid, then the 'flu kicked in hard about June and we had more people in hospital with 'flu than covid in July.
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A twindemic is quite possible this year. Unlike the last 2 years, I expect a higher than normal flu season. That is unless a variant emerges to create a new Covid-19 wave by Jan/Feb. If that happens we will likely get a repeat of last year with an initial peak then drop then another delayed surge into May. Overall flu then was less than half a normal season. Probably not as lucky this time with less overall immunity and vax resistance.

I predicted exactly that in this post from Oct 2021.
http://www.internationalskeptics.co...p?p=13643579&highlight=twindemic#post13643579
I suspect flu will remain low as long as Covid-19 is significant enough that people do even modest NPIs. Flu has a much lower R0 than Covid-19. So if we have a significant flu season I strongly expect it to be delayed. Possibly starting in Jan or Feb and peaking in May. Possibly later if it even materializes.
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It was obvious the year earlier (2020/2021) that flu was not going to be significant and, indeed it wasn't. From Sept 2020:

http://www.internationalskeptics.co...p?p=13231753&highlight=twindemic#post13231753
So the "twindemic" fears being propagated assume everyone gets tired of social distancing,masking, and staying home as much as possible and just goes about everything as normal. Might happen if Covid-19 magically goes way down but I don't see behavior going back to anything near normal for a year or so.
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The media hype the last 2 years which didn't materialize, together with the increased anti-vax nonsense could make things even worse now.
 
Yeah mate, I have no doubt you'll time it to perfection!

As long as you're getting the strain we had - which is extremely likely - the vaccine works really well.
 
The Atheist said:
Yeah mate, I have no doubt you'll time it to perfection!

As long as you're getting the strain we had - which is extremely likely - the vaccine works really well.
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Well mate, I got lucky.

Unfortunately timing the flu depends on what happens with the Covid-19 variants and their impact on behaviour. I expect some C19 wave but when and how big is too early to tell. But it will be interesting.

And yes, I too have heard the current vaccines are well above the usual flu efficacy which is really good news.
 
marting said:
There is a characteristic of flu waves that might be relevant. It tends to hit younger groups first then spreads to older groups. This suggests an approach where vaccinations are best rolled out early to younger people which should reduce the overall wave while delaying rollout for the older cohorts which suffer more rapidly declining vax immunity.
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I seem to recall* that Japan focused on immunizing school-aged children to prevent spread of flu, rather than focusing on the elderly (who were most at risk).



*This was probably decades ago, so I may be misremembering the details
 
ZirconBlue said:
I seem to recall* that Japan focused on immunizing school-aged children to prevent spread of flu, rather than focusing on the elderly (who were most at risk).



*This was probably decades ago, so I may be misremembering the details
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It appears that your memory is correct. However, that practice was repealed in 1994. It does seem to have been effective when it was implemented. But it became politically unpopular*, so it was discontinued. Nowadays if you want a flu shot, you must pay from your own pocket. And nowhere is it mandatory, or even encouraged by the government.

The Japanese Experience with Vaccinating Schoolchildren against Influenza (2001, the New England Journal of Medicine)

*I believe that the reason why it became unpopular was because of a small handful of rare severe adverse reactions, which were made big news by the Japanese media, so that everyone was made acutely aware of this remote possibility. Whereas the news does not cover cases of children dying from influenza at all, they cover adverse reactions as front-page news. The former happen frequently, the latter infrequently, but the amount of coverage in inverse to the actual statistical risk. The rare event is more newsworthy than the commonplace event.
 
Puppycow said:
It appears that your memory is correct. However, that practice was repealed in 1994. It does seem to have been effective when it was implemented. But it became politically unpopular*, so it was discontinued. Nowadays if you want a flu shot, you must pay from your own pocket. And nowhere is it mandatory, or even encouraged by the government.

The Japanese Experience with Vaccinating Schoolchildren against Influenza (2001, the New England Journal of Medicine)

*I believe that the reason why it became unpopular was because of a small handful of rare severe adverse reactions, which were made big news by the Japanese media, so that everyone was made acutely aware of this remote possibility. Whereas the news does not cover cases of children dying from influenza at all, they cover adverse reactions as front-page news. The former happen frequently, the latter infrequently, but the amount of coverage in inverse to the actual statistical risk. The rare event is more newsworthy than the commonplace event.
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Well, that sucks.
 
There's no way to predict this unless you are causing it. Statistical modeling will only take you so far.

Sent from my SM-S111DL using Tapatalk
 
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