HOW BAD WILL THIS YEAR BE?

Flu is one of medicine’s most unpredictable foes.

For example, last fall started off fairly mild. But in February, a strain notorious for more severe illness, called H3N2, suddenly popped up. Worse, even though each year’s vaccine contains protection against H3N2, the circulating bug had mutated so it wasn’t a good match. A vaccine that had worked well for the first few months of flu season suddenly wasn’t much use.

But if that harsh bug returns, this year’s vaccine has been updated to better match it.

LOTS OF OPTIONS

Manufacturers say 162 million to 169 million vaccine doses will be available this year, and people can ask about different choices. Most will offer protection against four flu strains.

Traditional flu shots are for all ages. For needle-phobic adults, one brand uses a needle-free jet injector that pushes vaccine through the skin. And the FluMist nasal spray is for generally healthy people ages 2 through 49.

Two brands are specifically for the 65-plus crowd, whose weakened immune systems don’t respond as well to traditional shots. One is high dose, and the other contains an extra immune-boosting compound. Those brands protect against three flu strains, including the more typically severe ones.

And people allergic to eggs have two options, one brand grown in mammal cells instead and another made with genetic technology and insect cells.

NO-EGG VACCINES GAINING NEW INTEREST

Newer technologies could speed production, which is currently a six-month process.

But there’s another reason going egg-free is getting scientists’ attention: Certain strains change a bit while growing in chicken eggs, an adaptation that can make the resulting vaccine a little less protective.

It’s mainly a problem for those worrisome H3N2 strains. While it’s not clear how much difference that makes, Schaffner said some doctors already consider using egg-free brands for high-risk patients.

OTHER STEPS TO TAKE

Cover coughs and sneezes. Wash your hands frequently during flu season. One recent study showed washing is better than hand sanitizers.

Ask about anti-flu treatments if you’re at high risk of complications.

And most important, stay home if you’re sick to keep from spreading the misery.

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