The world experienced its worst pandemic ever in 1918, leaving between 50 and 100 million people dead over a period of 15 months. In the U.S., approximately 675,000 died over a period of one year. Experts approximate that most people died in a 10 week time frame in the autumn of 1918.
One hundred years later, we are still seeing deaths from influenza, despite having a vaccine and treatment available. As of February 17, there have been 97 pediatric deaths recorded as being the result of influenza.
There is a lot debate surrounding the annual flu vaccine. Many people safely assume if they received the shot that they are protected. Data has shown that this year’s vaccine is only 36 percent effective at preventing influenza. Additionally, it has been shown to be only 25 percent effective at preventing the H3N2 influenza strain, the most common circulating one this season.
As if it weren’t enough to be presented with an ineffective vaccine, the treatment for influenza is in short supply. Where I practice, there is currently one pharmacy (among many) that still has any left in stock. Since the medication is on back order, it is apparent the other pharmacies will not be restocked anytime during this influenza season.
And then there is the point-of-care testing, or the rapid influenza test, that many medical centers across the country use to diagnose the virus and risk stratify their patients. This year these tests are also in short supply and on back order in many areas.
Patients are concerned for themselves and their family members, and I can only offer them a vaccine that is more ineffective than not. I cannot offer them any treatment unless they go to the only pharmacy still stocked (I expect that will not last long). And I can only diagnose them based on clinical history and examination, which in most cases is sufficient, but there is no good alternative for when it is not.
While the world fights off the flu, it is clear that our experts need to step up and find better solutions. In the 21st century, no child should die from influenza. Year after year, scientists predict the strain that will be most prevalent trying to out-game the virus. But it is no more than that: an educated guess. In an era where we are called to practice evidence-based medicine, we need a vaccine that will work against all strains.
Drug shortages are a frequent occurrence in health care. Most often they are happening due to financial considerations. A drug shortage should never happen when it is most needed, such as a major public health danger. Pharmaceutical companies need to be more responsive to the needs of patients and create better medications. Instead of aiming for “best of the class” we need new classes of medications, especially those aimed at fighting infections.
While victims continue to succumb to this menace, we need to learn from the missteps of this year’s flu season.
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