Doctors Push For Winter Shots

Americans should get both a flu vaccination and a protective shot against pneumonia this month, doctors at the Mayo Clinic said recently. The flu appears to have killed more Americans than usual last winter and the growing threat from bacterial pneumonia underscores their concern.

Although both shots are free for Medicare patients, those most at risk, one-third of such patients don't get regular flu shots, and 55 percent have never had a pneumonia vaccine, according to a recently released study.

But the shots also are vital for certain younger people, said Dr. Gregory Poland of the Mayo Clinic, recalling how he had to amputate the hands and legs of a young mother to save her from a pneumococcal infection that had spread into her blood.

"An epidemic of apathy and ignorance" about the need for vaccination "fuels an epidemic of disease and death," Poland said. "This is a public health emergency."

Influenza in an average year kills 20,000 Americans. The government has not yet finished analyzing last winter's cases, but preliminary data suggest many more people died, said Dr. Keiji Fukuda of the Centers for Disease Control and Prevention.

Of additional concern, influenza has started causing unusual outbreaks during the summer, he said. Up to 40,000 people, mostly tourists, from 47 countries were sickened by a flu outbreak in Alaska in summer 1998, and a similar outbreak occurred this year. The CDC also spotted summer outbreaks in Louisiana, Florida, Oklahoma and Texas.

Still, flu is always worse in the winter. People need a flu shot annually because different influenza virus strains circle the globe each year. The optimal time for vaccination is between now and mid-November.

"There is no way to predict" how bad flu will be this winter, Fukuda stressed.

But officials estimate that one in 10 Americans could suffer needlessly if vaccination rates don't improve.

A flu shot isn't the only protection: Too many patients, and even doctors, do not know that a vaccine against pneumococcal infection is vital, too, said Surgeon General David Satcher. Unlike flu shots, most Americans need just one dose of pneumococcal vaccine for lifetime protection.

Pneumococcal bacteria cause half a million cases of pneumonia each year, plus infections in the brain, ear and other organs. Some 40,000 Americans a year die.

Both vaccinations are recommended for:

• Everyone over 64. (One physician group recommends flu vaccine starting at age 50, something the CDC is investigating.)

• Younger people who have chronic heart or lung disorders, including asthma, or who have diabetes, kidney disease or a weakened immune system.

• Anyone in close contact with those high-risk patients, including family members and health care workers.

Even healthy young people without hose risks can benefit: One recent study found people who got a flu shot lost 43 percent fewer days of work.

Why don't people get vaccinated? The new Medicare study found 57 percent of the unvaccinated said they didn't know they needed the pneumonia shot and 19 percent didn't know they needed the flu shot.

Too often, doctors don't recommend the vaccinations, public health officials complained and too often, doctors refuse to give flu shots after mid-November. Later shots can still be helpful, Fukuda said.

"Don't wait for your doctor to recommend vaccination be proactive and ask for the shots," CDC vaccine chief Dr. Walter Orenstein advised. "It's your health and your life."