The drumbeat has started to get your flu shot. As influenza starts showing up around the country you will no doubt be urged to get vaccinated. But last year’s vaccine produced dismal results. Even though it was a surprisingly good match for the circulating viruses, the CDC found that the vaccine was only about 27 percent effective for those over 65, the very people who are most vulnerable to complications of influenza.

The most virulent form of flu last year was H3N2. Only 9 percent of senior citizens who were vaccinated got protection against that strain according to the CDC.

What are people to do if they come down with the flu this year despite a flu shot? Even though there are antiviral medications like Tamiflu (oseltamivir) and Relenza (zanamivir), many doctors don’t believe they are very effective. For reasons that are not obvious, many health professionals have not embraced antiviral medications against influenza.

A new study in the journal Pediatrics suggests this attitude might be deadly. Investigators from the CDC and the California Department of Public Health analyzed data from 800 children who had been hospitalized because of the flu. These were very sick kids who ended up in intensive care units (ICUs). The researchers found that children who received antivirals within 48 hours of coming down with symptoms were more likely to survive than children who went untreated. In their own words, the authors state that:

“There is strong evidence that NAI [neuraminidase inhibitors, aka antiviral drugs] treatment of hospitalized adults is beneficial when initiated early in the clinical course of influenza, although evidence from randomized placebo-controlled trails is lacking…A recent meta-analysis reviewing data from 90 studies of adults and children with H1N1 found NAI treatment within 48 hours of symptom onset reduced the likelihood of severe outcomes such as death and ICU admission…Our results suggest that prompt NAI therapy in children with influenza virus infection who are hospitalized in an ICU may improve survival, including in those more severely ill who require mechanical ventilation.”

Sadly, doctors have been reducing their prescribing of antivirals during flu season. During the last pandemic between 2009 and 2010 roughly 90% of the patients reviewed in this study received antivirals. Two yeas later that had dropped to 63%.

The researchers’ conclusion:

“These results and our findings suggest that further efforts are needed to educate clinicians to increase antiviral treatment in hospitalized patients with seasonal influenza, including those who are critically ill.”

Peggy Weintraub, MD, chief of pediatric infectious diseases at UCSF (University of California, San Francisco) did not participate in the study but commented:

“Antivirals matter and they decrease mortality, and the sooner you give them the more effectively they do that.”

There is now solid evidence that antiviral drugs make a difference in the course of influenza. For those most vulnerable, a prompt prescription can shorten the duration and severity of an infection.

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  1. Terry G

    Donnie, the study was funded by the California Department of Health. The authors are affiliated with the California Dept. of Health and the Centers for Disease Control and Prevention, and all declared no relevant financial interests.
    It is always good to ask these questions. In this case, the drug makers apparently did not influence the research design or the findings, which are after all about children sick enough to be hospitalized.

  2. JB

    Here is one other question/concern I have – I don’t think it’s just a matter of test tube results. Let consider some other logistics: How often do people actually go to a doctor within 48 hours of the onset of a viral illness, if that is when they are supposed to get Tamiflu for it to be most effective? When I or someone in my family gets sick, they start off a little sick, then get sicker, then sickest, and only when they feel the sickest do they go to the doctor, and in my experience that is a few to several days, not within the first 48 hours when you still have no idea if its just a run of the mill cold or going to turn into something more serious. And lets face it, people don’t get viral illnesses because they have a tamiflu deficiency, do they?
    Pile on the questions about how accurate are the tests for type A and B, and how rapid? Does it just add more time to the clock and if not, who’s to tell about whether there are false negatives or not when you are standing in the doctor’s office. Without which, doctors could easily start administering tamiflu “just in case”, and we already know the dismal position of antibiotics due to antibiotic resistance created from the misuse and overuse of antibiotics. Are you in a position to tell me that viruses will not develop anti-viral medication resistance? Do we really need to keep repeating the mistakes of the past here.
    And none of it takes into account the idea that viruses circulate constantly and we all are exposed to
    them on an ongoing basis, and that it is only when the supportive nutrients that allow the immune system to function well drop to levels too low, that then the body starts exhibiting symptoms (feels sick). What else within our control happens during “flu” season, or “low immune function” season? Less sun/D3 production and more sugar (halloween/thanksgiving/school year birthday parties/christmas).
    Let’s see a study of whether grain-free sugar-free eaters get the “flu” less than those that eat insulin- spiking foods.

  3. Russ1a

    Right on, JB. I haven’t looked myself, but I bet, as has been my experience in the past, if all the studies were examined, you wouldn’t find ONE that examined vitamin D deficiency as a factor in the causation or treatment of the flu cases analyzed. My view is that vitamin D research is actually being suppressed by Big Pharma behind the scenes because it cannot be patented. Natural cures and/or prevention are the SWORN ENEMY of Big Pharma. Anyone interested in natural cures or prevention is going to have to do a lot of thinking for themselves, as we are not going to be helped much by medical research as it exits today, controlled to a very great extent by Big Pharma. As an example, here is a link to a youtube vid on how vitamin D PREVENTS type one diabetes: . If you want more search for: “ucsd vitamin d” on youtube.
    Sincerely, Russ

  4. jn

    I work in health care. ‘Flu’ is way over-diagnosed during flu season. Most of what is diagnosed is flu is really a cold virus–of which there are thousands of different types–of one sort or another. Flu gets diagnosed because it is trendy for that season. Occasionally, someone gets lucky with Tamiflu, but, as you say, it may be placebo.
    I have never had a flu shot, and have never had the flu. ever. at the first sign of any illness, I do what Linus Pauling did–start taking vitamin c at 1,000 mg per hour until symptoms abate. in spite of what your doctor will tell you there are at least 8 placebo controlled, randomized studies showing that c lessens the symptoms and duration of viral illness symptoms by up to several days, and like Tamiflu, works better the earlier it is started–cold and flu included. he wrote an excellent book called ‘vitamin c, the common cold, and the flu’ or variations thereof. it’s long out of print, but you can always find it at used book stores. a good and necessary read.
    oh, and I am 55. don’t know if I’ll get flu shot when I am 65 nor not, but I doubt it. there is nothing magic that says immune systems are programmed to fail at that point. all the new regs stating that everyone–even babies–should receive flu shots are based on studies that were largely funded by vaccine makers. It’s unnecessary.
    People’s Pharmacy response: This test-tube research from Japan suggests that antiviral drugs and antioxidants such as vitamin C can work synergistically to reduce complications.

  5. Anne G.

    Never had a flu shot. Rarely get the flu. My friends get the shots every year. They always seems to get the flu within a few weeks after the shot.

  6. Sha

    I, too, remember simpler days; but, I welcomed and have had a ‘flu shot since they were available. I worked in a hospital, as a night Ward Secretary, and the shots were no cost to us.
    I had whooping cough; and survived on mare’s milk, until a Nubian milking goat was found. In the holy lands, they used milk from a female donkey; a guest from there, told me.
    An undiagnosed illness left me with post polio symptoms.
    During my first year; I was taken to a neighbor’s for care, because my mother was nursing the entire family, ill from an outbreak of “Spanish Flu”. This ‘flu, blamed on returning soldiers from WWI, just kept showing up; perhaps, forever, or mutations of same!
    These are just a few instances of what, we as a people, endured.
    At 76, I will take all the help I can get.

  7. jas

    I caught the flu several years back and was prescribed Tamiflu within 48 hrs. of my symptoms appearing. I absolutely HATE taking any prescription or OTC drugs, but I did take the Tamiflu not knowing anything about it at that time. My symptoms lessened quickly and I felt better so quickly I was very surprised. Perhaps I had a mild case of the flu, but I do remember that Tamiflu had a relatively quick response and seemed to have stopped this flu infection dead in its tracks. I doubt if it was a placebo effect because I was soooo reluctant to take it and didn’t exactly have a positive outlook about it; nor did I know anything about it as it had just come out at the time, I think.

  8. nb

    As I am probably much older than most of your readers, I thought this idea was interesting. When I was growing up our biggest problem was measles, chicken pox, mumps & etc. While there are now ways to stop these epidemics, the flu was not as prevalent in our community as it is today among school children. I wonder if that was because we were outside much of the time. School buses were used only for those going to the next town for schooling. But the bus stops were few and far between. Those going to school in our community walked to school, sometimes in knee deep snow. We played outside at recess twice a day and rode our sleds on a local hill. We ate made from scratch food, even in the school lunch room. Much of it was food put away in the fall in local lockers run as a business as home freezers were not prevalent. Hunting was not a sport. It was used to get enough meat to carry us over the winter. I could go on, but I think you get the idea. Back to basics and spending time in the great outdoors.

  9. jn

    love these comments! totally agree with both.

  10. Donnie

    I would like to know who funded this study. There have been so many negative reports about Tamiflu and the side effects caused by it. Along with reports of it not working well, if at all.

  11. JB

    I’d be more interested in an analysis of the 3rd option for children, not mentioned here. A Japanese study came out in 2010 and showed a 58% reduction of catching influenza A in kids between the ages 6 & 15 by using vitamin D3 supplements, 1200 iu/d. Why wait until they get sick, and then try to manage it? There is an old saying, an ounce of prevention is worth a pound of cure.
    I’m not sure they looked at B strains, but one write up mentioned that influenza B strains circulate later in the winter & their study was only a few months and stopped in March.

  12. jn

    There’s a good reason doctors are prescribing less tamiflu. there was a big study a couple years ago published in one of the major medical journals showing it wasn’t at all effective. Very expensive and doesn’t work–2 very good reasons. The study quoted above may be worth looking at, but it’s also different–these were pediatric patients, and they were hospitalized. We need to be comparing apples to apples.

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