This is National Influenza Vaccination Week, and Every Child by Two and Families Fighting Flu are working hard to ensure that families, parents, and individuals are exposed to the most current influenza immunization information, the specific trends of this flu season, and the facts about influenza vaccines for children, pregnant women, and health care workers.
To that end, they hosted a conference call last week featuring Dr. William Schaffner, a renowned flu expert, Chairman of the Department of Preventive Medicine from Vanderbilt University School of Medicine, and current president of the National Foundation for Infectious Diseases; and Jennifer Lastinger, mother of four, a member of Families Fighting Flu, and a passionate advocate for flu vaccination.
What follows is Jennifer's harrowing story of suddenly losing her perfectly healthy 3 1/2 year old daughter Emily to influenza, and Dr. Schaffner's comprehensive account of current best practices and information regarding staying healthy during flu season and influenza immunizations.
Their sessions were followed by an extensive Q&A session with me and other call participants, which due to concerns about length and tl;dr, I have documented on my personal site.
I was asked to speak today about the tragic death of my daughter Emily. She was 3 1/2, she was happy, she was healthy, she was the light of my life. She loved princesses and Power Rangers. She was a smart and sometimes challenging little sister to her big brothers, and would have made a wonderful big sister and friend to our youngest daughter.
Emily became ill on a Wednesday -- January 28, 2004. She was not acting like herself and was running a low fever, so my husband Joe and I took her to the pediatrician the next day. She was diagnosed with influenza. We were not overly concerned; we thought we knew the flu. We were sent home with an antiviral and some instructions for treating her symptoms.
Our doctor told us to expect that Emily would be fairly sick for at least a week, maybe longer. Over the next couple of days, Emily had periods where she would get more sick, but then she would rebound. Every time she presented with a new symptom, my husband or I would call the pediatrician's office. We were always reassured that this was all normal influenza, that she would likely feel worse before she got better.
That Sunday she seemed to be getting worse. We called the pediatrician's office, and were told again that it was all normal flu; that we could bring her into the ER if we wanted to but it didn't seem necessary based on what we were describing. And she did seem to get a little better in the afternoon.
That night was a hard one. Joe stayed up with her for most of the night because I was very pregnant at the time. In the morning we called the doctor again as we wanted him to see her. We thought we were being very cautious, conservative even, but we were relieved to have an appointment.
I had left Emily watching TV in our bed for about five minutes while I gathered dirty clothes for the laundry. When I returned to our room, I found her lying on our bed, unresponsive. I screamed for Joe and tried to revive her; Joe called 911, threw the phone at me, and started performing CPR on Emily. When the ambulance arrived, they immediately put her in and took her directly to the ER. At the hospital, they eventually restored Emily's heartbeat, but it seemed like it took forever.
We were transferred to the Intensive Care Unit at our local children's hospital, where they continued to work on her. They worked and worked, but even with the shock and stress we could pick up on the visual cues -- when we arrived at the Children's Hospital, a chaplain met us along with the ICU intake team. We were told that Emily would soon reach the maximum amount of drugs that she could take into her system to keep her heart beating, and every test showed no brain activity.
She did not survive that day. She did not survive influenza. We had to tell our three-year-old daughter goodbye.
We left the hospital that night and drove home in shock. In the morning we told our two sons, who were seven and five at the time, that their sister had died. It was really, really hard -- but nothing compares to living without our daughter, wondering what we could have, should have done as parents to make sure something like this didn't happen.
We spent months reviewing everything -- every step, every decision we made, getting experts to look at things. In the end, we came to some conclusions:
We needed to let other parents know how deadly influenza can be, even for healthy children like Emily.
The flu vaccine age recommendations were simply not broad enough. Only kids age six months to two years, and kids with other medical issues, were recommended. That had to change.
The process of discovering what went wrong put us in touch with other families. Together, we established Families Fighting Flu (www.familiesfightingflu.org) in 2005. Sadly, our numbers continue to grow each year. Our members are primarily made up of families whose children have suffered serious medical complications or died from influenza.
But we have made an impact. We have worked very hard over the past seven years to make positive changes. The CDC now recommends flu vaccines for all children six months and over. There is National Influenza Vaccination Week every December, which helps raise awareness of the importance of flu vaccinations, and now there is a National Family Vaccination Day during that week. Here in Texas, where I live, my husband and I have helped pass a law called Emily's Law that requires schools to provide flu vaccine information on their websites during flu season, to advise about flu prevention and where kids can get vaccinated.
But unfortunately, kids still die every year from influenza. This actually makes me sad and angry -- I have already lost my daughter, but other parents don't have to. Every day my family and I are faced with a life without Emily. She should be enjoying fifth grade sleepovers, cheerleading and soccer, and texting with friends.
She will never do any of those things.
Emily was an extraordinary little girl whose life was cut way too short. short by a vaccine-preventable disease. Emily was not vaccinated against the flu. So my message for all parents is very simple:
Please vaccinate your children, and yourself, this and every flu season. It could save the life of someone you love.
Dr. William Schaffner
Influenza is a serious respiratory illness, it usually peaks in the United States in February or March, so there is still plenty of time to be vaccinated. It's serious, it's not a bother like the common cold -- it causes approximately 200,000 hospitalizations each year in the U.S., up to 32,000 deaths, and untold visits to the doctor.
The cornerstone of influenza prevention is the influenza vaccination. It comes in a variety of forms, including a nasal spray variety available for people aged 2 through 50 who are otherwise healthy; there is a high-dose injectable variation for individuals who are age 65 and older, and for the first time this year there is an intra-dermal variation with a needle so tiny it doesn't even go through your skin, and it provides an immune response that is comparable to the injectable vaccine. So those who are needle-averse can get either the nasal spray vaccine or the intra-dermal option.
The vaccine is a good vaccine, it's different from the measles vaccine in that the influenza virus is mutable, it changes -- so it's tough to predict which strains will be active during the coming winter season, which is why we all have to be immunized on an annual basis. I say "all" because although in the past, the flu vaccine was recommended by segments of the population -- particularly those people who were likely to develop more serious complications from the flu -- for the last two years, the CDC's Advisory Committee on Immunization Practices has made the recommendation very simple:
Everyone older than six months of age in the U.S. should be vaccinated.
Now, that said, there are still people who still have a special need for vaccination. Surprisingly, pregnant women who develop influenza tend to develop complications at the same rate as people who are elderly. And if vaccinated during pregnancy, pregnant women will pass their protection through their placenta and onto their new baby -- protecting that baby during the first six months of life when the baby is too young to be vaccinated.
Another way to protect very tiny infants is the "cocoon" strategy -- ensuring everyone who will come in contact with new infant is vaccinated for the flu -- family members, extended family members, and other caregivers. Basically, anyone who might touch that baby and transmit infection. It's the same rationale behind the recommendation that all health care workers be vaccinated so they don't transmit infection either.
It's especially important that children be vaccinated, because not only can influenza put a perfectly healthy child in the Intensive Care Unit within 48 hours, but when children get influenza, they excrete more virus through their respiratory secretions, and for a longer time, than adults do. So children are the "great distributors" of influenza virus in our communities -- they give it to everyone else.
Recent surveys have indicated that younger physicians and parents aren't as keen on immunizations in general, and de-prioritize flu vaccines specifically. But we need to bring to everyone's attention that flu vaccines are important for them and everyone around them. No one wants their child to become seriously ill, no one wants their child to transmit influenza to a grandparent or a relative with an underlying illness.
The bottom line is, let's get everyone immunized -- and we can all protect ourselves, and each other.
More information and opinions on flu vaccines:
- American Council on Science and Health: Moms-to-be: Don't Fear the Flu Shot!
- Steven Novella: Fear Mongering the Flu Vaccine
- OMGhada: Flu Shot: Should We or Shouldn't We?
Photo Credit: danielpaquet.
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