PUBLIC HEALTH
May 22, 2014

Preparing for a Flu Pandemic

Vaccinating early can curb a pandemic. So can washing your hands.

With spring finally sprung in most parts of the country, a flu shot may not be the first thing on your mind. That's OK; it is on the minds of the researchers whose job it is to predict how the next flu season is going to play out.

Vaccinations are a key piece of any plan to reduce the impact of influenza, a virus that spreads quickly and easily from person to person. A new study has found that getting the flu vaccine to people a few months earlier could save a lot of lives and money. But, amazingly, so can practicing good “flu etiquette.”

Vaccinating three months earlier — at six months after the start of the outbreak, rather than nine, which is typical now — would prevent over 230,000 infections and 6,000 deaths.

Researchers at Stanford University used computer modeling to predict what would happen if a pandemic slightly stronger than the H1N1 pandemic of 2009 were to hit. As pandemics go, the one of 2009 was relatively mild: It killed “only” 0.3% of those infected. In contrast, the Spanish Flu of 1918 killed about 2.5%.

The team looked at what would happen if a stronger pandemic hit a city of 8.3 million — about the size of New York City — and how its spread would be affected by introducing the vaccine at different times of the year.

What they found was that vaccinating three months earlier — at six months after the start of the outbreak, rather than nine, which is typical now — would prevent over 230,000 infections and 6,000 deaths. And in terms of cost, the city would save $50 million in medical bills.

“We had a test run of our preparedness in 2009,” said study author Nayer Khazeni in a news release. “It's great that it happened under a very mild pandemic situation, and I think that's given us a lot of opportunity to learn and revise. I hope that recommendations based on our study findings will help make us even more prepared.”

“Timing is crucial,” said study author Douglas Owens. “Delays of a few weeks or months can make an enormous difference in the number of people who are infected. If you had a bad pandemic flu, it can have an enormous impact on the number of people who die.”

The problem is that it takes time to make flu vaccine. Typically, the vaccine is made in chicken eggs, and the whole process of development and manufacture usually takes about six months. When researchers have to add in new strains of virus, the wait time is even longer.

Newer technologies, using DNA manipulation and other methods, may speed the development of a new vaccine, but these aren’t in the works quite yet. The researchers predict that when these methods are in place, the total process could be shortened to only four months, which could save another 6,000 lives and $50 million in medical costs.

Practice Flu Hygiene
Vaccinating isn’t the only thing that can stop the flu: Simple acts, like washing your hands more often, sneezing into your elbow (rather than your hand), staying home if you’re sick, and wearing a face mask, can together have about the same level of effectiveness as vaccinating at four months after start of the outbreak. From a flu researcher’s vantage point, that’s pretty amazing.

“I think the most encouraging finding of our study is that nonpharmaceutical interventions can really serve as a bridge to mass-vaccine creation and delivery,” said Khazeni. As always, get the flu shot as early in the season as you can.

The CDC recommends that everyone over the age of six months be vaccinated. And whether you’re vaccinated or not, always practice good flu etiquette because it may just save another person from getting the flu, and maybe even a life.

The study was carried out by a team at the Stanford University School of Medicine and published in Annals of Internal Medicine.
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