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The science of the flu shot

Infectious diseaseOctober 10, 2016Mailman School experts explain what's in the seasonal vaccine, why it only partially works, and how to get more people to protect themselves.

Once in the air with the autumn cold, flu vaccinations are being given out in clinics and pharmacies across the country. Vaccination, while imperfect, is the most reliable way to avoid a potentially fatal infection. While many accept it as a seasonal inconvenience, the flu kills about 19,000 Americans in an average year.

Following the pioneering work of Hilary Koprowski, who developed a vaccination protocol with attenuated live viruses, Jonas Salk and Thomas Francis developed the world's first modern flu vaccine with fertilized chicken eggs in 1938. Your vaccine was first used to protect American troops during World War II. In the years since then, the method of making the vaccine has remained largely the same, but the quality of the information that goes into its development has changed dramatically, says Stephen S. Morse, an infectious disease expert and professor of epidemiology.

what is an epidemiology study

It is known today that the flu is in a constant flux and mutates as it moves from one reservoir of disease to another - from migratory birds to chickens to humans and back. There are also several variations: Influenza A, B, C, and D. The first two are the most common and are used in the vaccine.

In the early years, scientists developed the vaccine on the basis of much less data. Today they predict which strains will appear in the United States and other Northern Hemisphere countries using a combination of methods, including using data collected from large samples in the Southern Hemisphere, where the flu season occurred during ours Summer months peaked.

Flu vaccinations today contain three or four strains of influenza A and B that scientists believe are most likely to spread in the coming month. Even if the stain doesn't exactly match, it can provide partial protection. However, despite all the advances, the selection of strains of influenza is still an imprecise science.

The effectiveness of a flu shot can vary widely. In 2014-15, the vaccine was estimated to work in only 23 percent of people, but in the previous year it was 51 percent.

What we do is part art and part science, says Morse. The flu remains one of the more complex viruses we have to deal with and no one can tell you for sure what this year's strain will be until it shows up. It seems so prosaic, so banal, and yet it defies all our predictions.

Jeffrey Shaman, Associate Professor of Environmental Health Sciences, adapted weather forecasting techniques to produce real-time, location-based estimates of influenza outbreaks. Even if the technology is not used in strain selection, the prognosis may encourage greater public vaccination. For health officials, it can make decisions about how many vaccines and antiviral drugs to store and whether other measures such as closing schools are required in the event of a virulent outbreak.

Flu never surprises me, says Melissa Stockwell, Associate Professor of Population and Family Health and Pediatrics. It's a tricky virus too, and unlike other vaccinations where we get a range of doses and have longer protection, we have to get a new dose every year.

Stockwell's most recent work has been adapting new technologies to study respiratory infections, educate people about treatment, and remind them to get vaccinations. She found that more than a quarter of people with the flu don't see a doctor for treatment when they show symptoms. The good news is that educational text messages can increase the chances of someone getting a flu shot.

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She believes that misconceptions about flu vaccination, such as the vaccine that makes recipients sick, prevent more people from getting vaccinated. Boosting the image of a flu shot through social media could be one solution to popularizing the flu shot. One way to do this is to customize the I Voted campaign to say I have my flu shot so people can be proud of it.

Because while alternatives like hand sanitizing and avoiding sick people can prevent infection, nothing works like a flu shot.

You can't avoid sitting on the train and suddenly someone coughs up, says Stockwell. The vaccine really is the best way to avoid disease.

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Related faculty

Stephen Morse Professor of Epidemiology at Columbia University Medical Center Melissa Stockwell Associate Professor of Pediatrics and Population and Family Health Jeffrey Shaman Professor Environmental Health Sciences (im International Research Institute for Climate and Society/Earth Institute)

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