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Online Discussion: Tracking new emerging diseases and the next pandemic

Hold off on that Flu shot, for now.....

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    Posted: March 25 2018 at 9:55pm
ABC News: Hold off getting the flu vaccine, AMA says. http://google.com/newsstand/s/CBIw8qzbwjo
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: March 25 2018 at 10:54pm
"People who are vaccinated too early in autumn might have lost protection by late in the spring when the virus has mutated."  says the article.  It is all about the timing for best protection, not advice against taking it altogether,

http://newsstand.google.com/articles/CAIiEEom1a4VCvk9-qOjju9qIzAqFggEKg4IACoGCAow3vI9MPeaCDDciw4
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: March 26 2018 at 3:41am
It's also about checking on your pharmacist,make sure you getting the latest vaccine,not one that's past it's use by date......
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Post Options Post Options   Thanks (0) Thanks(0)   Quote KiwiMum Quote  Post ReplyReply Direct Link To This Post Posted: March 28 2018 at 9:02pm
I've posted this on here before, but recently I was talking to the receptionist at our local doctors and she told me that flu jabs would be delayed here as they were waiting on a new version that would cover the mutated flus that have been in the UK and USA. She thought she'd be getting her jab late April or early May.
If it is to be, it is up to me.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: March 29 2018 at 3:26pm
i wonder if ,only those over a certain age should get it ,that way the younger folks build up their own immune defences,

of coures the sick and infirm get it ,

mind you ,a good immune sysyem and having a few bad flu's in the past  is no defence,

and the proof of that is ,

i was flat on my back for a week ,two years ago................

completly out of the blue...............
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Flu vaccine 2018: Do you need it and when should you get it?

It's nearly time to roll up your sleeve, brace yourself for a small prick, and hope the nurse or doctor offers you a lollypop for your troubles.

The annual flu vaccine will soon roll out across general practices, pharmacies, community health clinics and some workplaces and schools.

In some pharmacies, the flu vaccine is already on offer. But the Australian Medical Association (AMA) has urged people to hold off on getting this year's vaccine, warning some pharmacies are offering vaccinations too early.

"We are concerned when pharmacies are out there advertising early flu shots at a time that might not be clinically appropriate," AMA national president Michael Gannon told ABC News.

"People who are vaccinated too early in autumn might have lost protection by late in the spring when the virus has mutated."

So, when is the right time to get your flu shot? And is it necessary for everyone?

Getting immunised

The Australian Government recommends everyone from six months old wishing to protect themselves against the flu should get immunised.

Vaccination is a safe and effective way to protect yourself from flu; people who get vaccinated are at lower risk of getting an infection (and developing serious disease) than those who do not.

Bastian Seidel, President of Royal Australian College of General Practitioners (RACGP), said it's important for people to get vaccinated whether they are healthy or at high risk.

Getting a flu shot also means you help to protect other people, including those who are too sick or too young to be vaccinated, as well as vulnerable groups such as babies, people over 65 years and pregnant women.

The more people who are vaccinated in the community, the less likely the flu will spread.

It's free for those at risk

Under the Federal Government's National Immunisation Program, there are some people that are eligible for a free flu vaccine because they are most at risk of poor outcomes. This includes:

  • Pregnant women (at any stage of pregnancy)
  • People aged 65 years and older
  • Aboriginal and Torres Strait Islander people aged six months to five years
  • Aboriginal and Torres Strait Islander people aged 15 years and older
  • People aged six months and over with medical conditions that mean they have a higher risk of getting serious disease (such as diabetes, severe asthma, lung or heart disease)

Several state and territory governments are also offering free flu jabs to children between six months and five years old, including in New South Wales, Victoria, Western Australia and the ACT.

Dr Michael Gannon, president of the AMA, says vaccination rates among small children and pregnant women are particularly low in Australia.

"It's one of the worst performing areas. Only around 50 per cent of pregnant women get the vaccine, and we think that's an appalling low number," Dr Gannon said.

In most cases the flu vaccine is available through your local GP. Immunisation services can also be accessed at community health clinics, Aboriginal Medical Services, through school-based immunisation programs, and at some pharmacies and workplaces.

When to get the jab

The best time to get the flu jab can be difficult to predict because the peak period of flu activity varies year by year, said Professor Raina MacIntyre from the University of New South Wales.

"Generally, the peak flu season is around July and August, but it's variable — sometimes it can start in May, and sometimes the peak happens in September," Professor MacIntyre said.

This is important because research shows the effectiveness of the flu vaccine may begin to wane after three to four months.

"It's a trade-off really, between getting the ideal immunity [early on] and not missing the peak of flu activity," Professor MacIntyre said.

According to the Department of Health, the government-funded seasonal flu vaccines will be available nationally from mid-April.

This matches recommendations from both the AMA and RACGP, who say the best time to get the flu shot is towards the end of April and into the beginning the May.

"This should really cover the vast majority of Australians," RACGP president Dr Bastian Seidel said.

AMA president Dr Michael Gannon agreed, and said healthy people should get vaccinated at the same time as those eligible for a free vaccination.

It doesn't provide total protection

The flu vaccine doesn't provide complete protection, but any prevention is better than no prevention, Professor MacIntyre said.

"In healthy adults, [the vaccine] should be 60 to 70 per cent effective, which is pretty good," she said.

For people with impaired immunity — such as older people and those with chronic illness — the vaccine is less effective and doesn't elicit such a strong immune response.

The new enhanced vaccines are specifically targeted at the strains that were prevalent in last year's deadly flu outbreak.

Getting vaccinated every year is important because the most common strains of the influenza virus change every year.

"So the vaccine that you get this year won't necessarily protect you against the different virus that may be circulating next year," Professor MacIntyre said.

If you are in a high risk category or have concerns or questions about the flu vaccine this year, it's best to speak with you GP, Dr Seidel said.

"They can very specifically give you advice that works best for you."

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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: April 08 2018 at 3:35pm

'Enhanced' flu vaccines made available after last year's 'horrific' season left 1,000 people dead

Updated 18 Feb 2018, 10:30am

The Federal Government says it is providing two new "enhanced" flu vaccines for free to people over 65 after last year's "horrific" flu season.

Key points:

  • Vaccines Fluad and Fluzone High Dose will be available from April
  • The "enhanced" vaccines will target the mutation that occurred last year
  • The vaccines will protect the elderly

Last year there were more than 1,000 flu related deaths — 90 per cent of those were people aged over 65.

There was criticism of the vaccines used last flu season.

The Chief Medical Officer, Professor Brendan Murphy, believes the new "enhanced" vaccines will be more effective.

"We are pretty confident this will be better protection," he said.

"No flu vaccine is complete protection, the standard vaccine seems to protect well in younger people, but we are confident this will give better protection for the elderly."

Federal Health Minister Greg Hunt also thinks they'll work better and protect those over 65.

The vaccines, available from April, are specifically targeted at the strains, in particular the mutation, that were prevalent last year.

"Last year we had the best in the world, but these new vaccines weren't available," he said.

"The medical advice, both from the vaccine producers, the World Health Organisation and the Chief Medical Officer is that the mutation which occurred last year in many countries will be specifically addressed by these new vaccines."

New vaccines generate strong immune response

From April, both vaccines, Fluad and Fluzone High Dose, will be available through the National Immunisation Program following a recommendation from the Pharmaceutical Benefits Advisory Committee.

These new trivalent vaccines work in over 65s by generating a strong immune response and are more effective for this age group in protecting against influenza.

Fluad contains an adjuvant, which triggers the stronger immune response, and Fluzone contains four times the active ingredient, which also triggers a stronger immune response.

Professor Murphy is continuing to investigate ways to improve protection from seasonal influenza, particularly for the elderly.

This includes mandating a requirement for residential aged care providers to provide a seasonal influenza vaccination program to all staff.

Additionally, the Aged Care Quality Agency is continuing a review of the infection control practices of aged care services across the country.

The outcomes will inform new guidelines around the areas of the greatest risk to the safety, health and wellbeing of care recipients.

Topics: healthvaccines-and-immunityaustralia

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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: April 08 2018 at 3:38pm

Adjuvants: Introduction

Rebecca Helson, London, UK

Traditional vaccines derived from live-attenuated- or inactivated whole organisms or toxins were effective in inducing predominantly antibody-based immunity, but highly reactogenic. Developments to produce safer, less reactogenic vaccines also capable of inducing cell-mediated immunity have resulted in compromised vaccine efficacy. Adjuvants (taken from the Latin, “adjuvare,” meaning “to help”) are designed to improve poorly immunogenic vaccines. Adjuvants were originally described by Ramon as ‘substances used in combination with a specific antigen that produced a more robust immune response than the antigen alone,’ thus encompassing a wide range of materials.

Adjuvants affect the immune response in various ways:

  •  To increase the immunogenicity of weak antigens
  •  To enhance speed and duration of immune response
  •  To stimulate and modulate humoral responses, including antibody isotype
  •  To stimulate cell-mediated immunity
  •  To improve induction of mucosal immunity
  •  Enhance immune responses in immunologically immature patients, particularly infants
  •  To decrease the dose of antigen required; reducing costs and eliminating inconvenient requirements for booster shots

Many molecules have been considered for use as an adjuvant, including mineral compounds (e.g. Alum), water-in-oil or oil-in-water emulsions (e.g. Freund’s adjuvant), as well as natural and synthetic toxins derived from bacteria (e.g. cholera toxin, CT and lymphotoxin, LT). Based on their mechanism of action, adjuvants have been categorised into two broad groups; the particulate vaccine-delivery systems that target antigen to antigen presenting cells(APCs) and the immunostimulatory adjuvants that directly activate such cells through specific receptors e.g. toll-like receptors (TLRs) resulting in inflammatory responses that amplify the innate immune response. The ultimate aim is to activate the innate immune system to respond more rapidly to infection and for the adaptive immune response to become more specific.

The precise mechanisms of many adjuvants remain largely undefined due to the complexity of the immune response, but generalisations can be made to allow the design of more rational adjuvants aimed at particular arms of the immune system.

Summary of adjuvants approved for human use

AdjuvantDescriptionApproved vaccine products
Aluminium-based mineral salts (Alum)E.g. Aluminium phosphate,Calcium phosphate,Aluminium hydroxideEg. Anthrax (BioThrax®, Emergent Biosolutions)Hepatitis A (Vaqta®, Merck)DTP (Triple AntigenTM, CSL limited)
MF59Submicron oil-in-water emulsionInfluenza (FLUAD®, Novartis)
Monophosphoryl lipid A (MPL)Bacteria-derived immunostimulantHepatitis B (Fendrix®, GlaxoSmithKline)
VirosomesSpherical vesicles containing viral membrane proteins in the lipid membraneHepatitis A (Epaxal®, Berna Biotech)Influenza (Inflexal®, Berna Biotech)

© The copyright for this work resides with the author

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IMPORTANT SAFETY INFORMATION

Fluzone Quadrivalent, Fluzone Intradermal Quadrivalent, and Fluzone High-Dose vaccines should not be administered to anyone with a severe allergic reaction (eg, anaphylaxis) to any vaccine component, including eggs, egg products, or thimerosal (the multidose vial is the only presentation containing thimerosal), or to a previous dose of any influenza vaccine.

Tell the doctor if you/your child has ever experienced Guillain-Barré syndrome (severe muscle weakness) after a previous dose of influenza vaccine. If you notice any other problems or symptoms following vaccination, please contact your health care professional immediately.

Side effects to Fluzone Quadrivalent, Fluzone Intradermal Quadrivalent, and Fluzone High-Dose vaccines include pain and swelling at the injection site (also itching at the injection site and shivering in adults receiving Fluzone Intradermal Quadrivalent vaccine); muscle aches, fatigue, and headache (also irritability, abnormal crying, drowsiness, appetite loss, vomiting, and fever in young children receiving Fluzone Quadrivalent vaccine). Itching, redness, swelling, and firmness at the injection site have occurred more frequently with vaccine administered into the skin compared to vaccine administered into the muscle. Other side effects may occur. Vaccination with Fluzone Quadrivalent, Fluzone Intradermal Quadrivalent, or Fluzone High-Dose vaccine may not protect all individuals.

INDICATION

Fluzone Quadrivalent, Fluzone Intradermal Quadrivalent, and Fluzone High-Dose vaccines are given to help prevent influenza disease caused by influenza A and B strains contained in each vaccine. Fluzone Quadrivalent vaccine is given to people 6 months of age and older. Fluzone Intradermal Quadrivalent vaccine is given to people 18 through 64 years of age. Fluzone High-Dose vaccine is given to people 65 years of age and older.

For more information about Fluzone QuadrivalentFluzone Intradermal Quadrivalent, or Fluzone High-Dose vaccine, talk to your health care professional and see complete Patient Information.

REFERENCES

  • 1.Fluzone High-Dose vaccine [Prescribing Information]. Swiftwater, PA: Sanofi Pasteur Inc.
  • 2.Fluzone Quadrivalent vaccine [Prescribing Information]. Swiftwater, PA: Sanofi Pasteur Inc.
  • 3.Fluzone Intradermal Quadrivalent vaccine [Prescribing Information]. Swiftwater, PA: Sanofi Pasteur Inc.
  • 4.U.S. Department of Health and Human Services. Vaccine and vaccine safety. http://www.vaccines.gov/diseases/flu/. Accessed October 12, 2017.
  • 5.CDC. Prevention and control of seasonal influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices – United States, 2016–17 Influenza Season. MMWR; August 26, 2016;65(5):1–54.
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