Get your shots for seasonal flu — a hidden threat

THE Centers for Disease Control and Prevention estimated that at least 13,000 people died from influenza in the United States in four months.

That recent news item is not a fiction or a forecast, it is fact. But there's a twist.

This CDC estimate is from one month ago, before the arrival of the new A H1N1 flu strain (also referred to as swine flu). These 13,000 deaths between January and late April were from seasonal influenza that strikes this country every winter and that over the past several months has been killing 800 Americans a week.

As the dust of the A H1N1 outbreak settles, an inconvenient truth is becoming more apparent. Every year, influenza circles the global and kills an estimated 250,000-500,000 people. In an average year, 36,000 of those people live in the United States — a country that spends more on health care than any other country.

It's hard to believe that thousands die each year in this country from a disease largely preventable by a vaccine that most of us have chosen not to get. People who are at high risk of serious flu-related complications include pregnant women, children younger than 5 years old, people of all ages with chronic medical conditions and people 65 years and older.

Yet people are not being immunized. According to recent national surveys, only 30 percent of infants and fewer than 15 percent of pregnant women are immunized against flu. Among the elderly, who account for nine out of 10 flu deaths in the United States, only two-thirds are immunized. And flu-shot rates are lowest in young, healthy people (13 percent among adults 18-49 without high-risk conditions) — the same population most affected to date by the new A H1N1 strain.

As we race to find solutions to defeat this new flu, we are at risk of tripping over an old problem — failure to effectively vaccinate ourselves against seasonal influenza.

It's uncertain at this time how severe this novel flu outbreak will be in terms of illness and death. Government agencies and manufacturers are at work developing a new vaccine but this will take many months. The good news is that production of the seasonal flu vaccine for next season is nearly complete and will be completed.

So how do we increase flu-vaccine rates? The two-part answer is simple in concept:

We need to make flu shots more available. Health-insurance policies should cover flu shots. Doctors should routinely schedule their high-risk patients to be immunized each fall. Businesses, schools, shopping malls and public-health centers should offer flu-shot clinics. (The federal government pays for the flu vaccine for anyone 18 or younger on Medicaid or without insurance.)

We need to change our behavior and take advantage of this availability. We should become better at getting the word out about the importance and availability of influenza vaccines, and we must dispel the myths on the safety of the vaccine. In reality, the benefits far outweigh the risks.

In short, we should use the H1N1 scare as a wake-up call to get our act together for the annual administration of influenza vaccine. At worst, we will prevent a lot more seasonal influenza deaths; at best we will be better prepared to deploy future vaccines against the return of H1N1 or whatever pandemic strain Mother Nature chooses to throw at us.

Dr. David Fleming is director of Public Health-Seattle & King County; Dr. Kathleen Neuzil is director of the Influenza Vaccine Project, PATH; and Dr. Ann Marie Kimball is director of the Asia Pacific Economic Cooperation Emerging Infections Network, University of Washington. Alan Aderem, director of the Institute for Systems Biology and Dr. King Holmes, chair of the UW Department of Global Health, also contributed to this article.