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Wednesday
Jul222009

Day 11: Be Afraid—Pneumonia Follows Flu

I’m sorry this comes so late. My roommate interrupted me with a mandate: We had to dress up as a couple on a blind date. She ordained no less than 150 minutes of uninterrupted improvisation while we drank. Excessively, I fear.

The first person to break character would have to spend a painful sum on anything the other wished to order online. No question she’d cash in. So, then, would I, even if it never arrives….

I wish I could remember the BS I came up with. She can fling it in her sleep. I fear I was predictable, an East Village guitarist trying to assemble a band. I wore sort of gothic clothes, black boots and cool hat. She began as a fetching, innocent out-of-towner, turned out to be a lass with a past. She loves to lure me to the dark side.

It was hard not to crack up, so she took the prize. Which she instantly spent downloading music. So I feel we both won. Pandemic Playhouse: A worthy game for quarantined adults!

I even found out why she doesn’t read my blog: She prefers to get her flu information “from the source’s mouth.”

Now for what I wrote so soberly before she refreshed my mind.

The Puzzle of Pneumovax 23

Readers ask about the pneumonia vaccine I mentioned. I don’t normally get flu shots because I prefer to rely on my natural immune response. The eggs in which they grow influenza vaccine haven’t been so receptive to avian flu, so I’m not optimistic about a timely H5N1 vaccine.

TIME-HONORED PRACTICE: FLU VACCINE IN MOTIONMan is already striving to dispense with the chickens. Companies are making flu vaccine via something called cell culture. The tobacco industry wants to grow vaccine in a certain leafy crop that’s losing its allure. And the corn industry wants to raise flu vaccine for humans and swine in stalks.

Maybe my youth makes me complacent. I share some of Bill Maher's suspicion that too many vaccines might weaken our immune systems. And I’m repelled by arguments such as this one, which compares people who decline vaccination to drunk drivers!

Still, I find Pneumovax compelling. Virtually every H5N1 case includes pneumonia, which is an inflammatory condition with many causes, not a disease. A third of all swine flu pneumonia deaths might have been prevented had the victims been vaccinated against bacterial sources of pneumonia. (The other deaths were caused by viral pneumonia, for which no vaccine exists.)

Since 2001, newborn Americans have been vaccinated against bacterial pneumonia, which globally kills two million kids a year. Merck’s Pneumovax 23 shot for adults is stronger, fights 23 different strains with few side effects. Then it can be boosted, reactivated after at least five years. What’s an adult not to like?

There’s a mystery. The government’s advisory committee recommends P 23 shots only for adults who are HIV carriers, are otherwise immuno-suppressed, or are over 65. Merck’s P 23 Web page recommends shots for immunocompetent (healthy) people 50 and older, says the shot should last up to nine years, and then fuzzes over the question of revaccination.

Part of the problem is that the shots have been around only since the 1980s and the data on the usefulness of boosters is limited. The policy solution seems to be have been to hoard the shots for old folks.

That might be a waste. As this blog entry by Mike Coston explains, a study in Edmonton showed no benefit to people over 65, compared with those who had not received it. This dovetails with evidence that older folks don’t show that much response to seasonal flu shots either. Maybe it’s all academic. Few people among the recommended groups bother to get Pneumovax 23.

Since none of this makes much sense, I insisted on getting injected in April 2009, when the news broke about swine flu in Mexico. The doctor wasn’t happy because I’m so young, but I’m pleased to have done it. P 23 is your call. Don’t sue me....

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