Maryland is moving into flu season, but unlike last year, when the H1N1 flu pandemic triggered a scramble for vaccine, public health officials say there is plenty to go around. And that's important because for the first time the U.S. Centers for Disease Control and Prevention recommends that everyone 6 months and older get a flu vaccination — not just vulnerable groups.
A CDC advisory committee made the universal call after last-year's late-breaking H1N1 pandemic disproportionately hit young people who were not in a high-risk category.
The H1N1 flu killed about 12,000 Americans and sickened millions last season. Maryland reported 45 lab-confirmed deaths, including five children, though many cases were not confirmed. The pandemic was officially declared over in August after a nationwide vaccination campaign.
The state reported its first lab-confirmed flu case of this season Wednesday, an adult with the H1N1 strain who is recovering.
"It looks like it's developing to be a normal flu season, but flu is always unpredictable and always changing," said Frances Phillips, Maryland's deputy secretary of public health services. "The best way to protect everyone is for everyone to get a flu shot."
Phillips noted that in a normal year, the seasonal flu kills an estimated 36,000 people nationally and up to 1,000 in Maryland. For hundreds of thousands more, it causes high fever, a cough, aches and exhaustion for days. It can cause infections such as pneumonia that are particularly threatening to seniors and those with underlying health conditions. In children, the flu commonly leads to ear and lung infections.
Phillips said this year the H1N1 strain is included with two other seasonal strains into one vaccine so adults need only one dose, though some children younger than 9 still need a booster. Last year, the government commissioned and bought a separate H1N1 vaccine because the strain was discovered after manufacturers had begun producing seasonal flu vaccine.
There were long lines for the H1N1 vaccine, and it was rationed to children, health care workers, pregnant women and those with underlying health conditions. They also needed a second vaccination for seasonal flu, though there was little illness from it last year.
No one is predicting long lines this year. The vaccine will again be offered free by local health departments, but much of the vaccine will be distributed by personal physicians and retail outlets.
The one-shot scenario this year should make it more convenient for people, said Dr. W. John Langley, a pediatrician and the chief medical officer and vice president of Maxim Health Systems, which staffs vaccination clinics for companies and retailers.
Steve Pellito, Maxim's national director, said ample supply means retailers and others already have the vaccinations on hand. The two Maxim executives believe that all the publicity surrounding the H1N1 virus has raised awareness of the flu and, perhaps, people's willingness to be vaccinated.
"There was such an enormous program to immunize people last year," said Langley, who believes it contributed to the lower-than-expected impacts of H1N1 and the near crowding-out of seasonal flu last year. "It prevented what could have been a bad pandemic."
The CDC reported that higher numbers of people received the seasonal flu vaccine last year. Normally, only about a third of the population seeks a seasonal flu vaccination.
Langley said it's a misconception that washing hands and taking other steps is as effective as a vaccination in warding off the flu. People are contagious with the flu virus for 24 hours before symptoms show. Still, he said, hand washing, covering a cough and staying home when sick are good preventive measures.
The vaccine in shot form is generally administered to adults in the arm; the arm can become sore and red, but that won't lead to the flu. A mist is available in some places.
At the Costco in Glen Burnie, where Maxim has been holding clinics, a steady stream of people came by for their shots Tuesday. Darryl Scarborough, who has been administering shots for decades, said business seemed a little slower to start this year, but he expected it to pick up in the next couple of weeks.
Many people who stopped by the Maxim table were shopping, but some came just for the $20 vaccination. Sharon Valenti of Glen Burnie said she has a sick grandchild, and the whole family gets immunized so they don't worry about infecting him with the flu.
Fran and Michael Linder, owners of the Daily Scoop ice cream shop in Pasadena, said they don't want to get customers sick — or catch the flu from them.
Others said they just don't want to get the flu. Derrick Page of Crownsville said he gets a shot every year. And Kathleen Smith of Brooklyn Park, who caught the flu four years ago, said she doesn't want a repeat.
"I tell everyone to get a shot because it works," she said. "You go a season without getting sick, and it makes a believer out of you."
So far this year, the CDC says, based on activity in the Southern Hemisphere, the vaccine appears to be a good match for the virus that is circulating. The season has just begun in the United States, and the CDC says there have been only low levels of flu reported.
Public health officials believe all the attention given to flu will prompt more people to get a vaccination. The National Foundation for Infectious Diseases, a nonprofit information clearinghouse, found in recent surveys that 92 percent of doctors discuss the vaccine with their patients, and 95 percent of the doctors plan to get vaccinated themselves.
The group's surveys also found that more than two-thirds of Americans were aware of the new CDC recommendation that all should be vaccinated, and about the same number intended to get a vaccination — seniors had the highest rate at 73 percent.
Almost two-thirds of people, however, thought there were other effective ways to prevent the flu and weren't worried about the ailment. More than 60 percent thought the vaccine could make them sick, something health professionals say is a myth.
Other research shows that vaccination can help more vulnerable children than previously thought. A study expected to be published next year in the journal Archive of Pediatrics & Adolescent Medicine by Johns Hopkins University researchers shows that babies whose mothers are immunized while pregnant appear less likely to get the flu or to be hospitalized with respiratory illnesses in their first six months of life — a time when they can't get their own vaccinations.
For young kids who are old enough for the vaccine but allergic to eggs, other Hopkins research shows many can still be immunized. The vaccine is developed in eggs, but those without a severe allergy can still get a vaccination.
Already, many of all ages in Baltimore are heeding the advice to get a vaccination, said Dr. Anne Bailowitz, the city's chief medical officer. Last year, Baltimore officials vaccinated people 31,500 for H1N1 flu and 11,000 for seasonal flu.
Typically, 5,000 are vaccinated for seasonal flu, she said. Less than two weeks after clinics began again in the city, 800 people had been immunized, a "pretty vigorous response," said Bailowitz, adding the city has reached out through churches, Facebook and Google's flu finder. Because of funding problems, the city will not offer separate school clinics this year, however.
She urged those who were sick or had a vaccination last year to again get a vaccination because immunity isn't guaranteed. She said only those tested know precisely what they had, and many viruses mimic the flu.
"People saw the benefit of getting vaccinated last year," Bailowitz said. "There's definitely heightened interest."
•The CDC recommends everyone 6 months and older get a flu vaccination.
•The 2010-2011 flu vaccine will protect against three flu viruses, including the H1N1 virus.
•The vaccine is widely available at doctors' offices, retail outlets and public clinics.
•The flu can cause fever, cough, aches, runny nose and fatigue. It can lead to death.