Antioxidants, Zinc, Selenium, fermentable Oligosaccharides, and structured Triacylglycerol Supplement Increased Vaccine Response and Decreased URIs: An Abbott Lab, Univ of Florida, and Drexel Univ DB PC study of 66 nursing home elderly given an 8 oz. supplement daily for 183 days found fewer days of URI symptoms (3/patient vs. 0) and better influenza antibody and lymphoproliferative status after a flu shot. Nutritional Formula Enhanced Immune Function and Reduced Days of Symptoms of Upper Respiratory Tract Infection in Seniors. Langkamp-Henken B, Bender BS, Gardner EM, Herrlinger-Garcia KA, Kelley MJ, Murasko DM, Schaller JP, Stechmiller JK, Thomas DJ, Wood SM. J Am Geriatr Soc. 2004 Jan;52(1):3-12

Ginseng (American) Helped Prevent in DB: Two DB PC studies of 198 elderly in nursing homes, each a different year, taking 200 mg of a proprietary American ginseng, found seven on placebo sero-converted for influenza infection vs. one on ginseng (OR 7.1). Two on placebo also had confirmed RSV infections. Eastern Virginia Med School. A Placebo-Controlled Trial of a Proprietary Extract of North American Ginseng (CVT-E002) to Prevent Acute Respiratory Illness in Institutionalized Older Adults. McElhaney JE, Gravenstein S, Cole SK, Davidson E, O'neill D, Petitjean S, Rumble B, Shan JJ. J Am Geriatr Soc. 2004 Jan;52(1):13-9

Ginseng Increased Benefit on Flu Vaccine:  An Italian DB PC study using ginseng found a decrease in flu or colds by 60% in 8 weeks after flu shot vs. placebo with higher antibody titers after the flu shot. U Milan, Scaglione, Drugs Exp Clin Res ’96;22:65-72 

Vaccine Didn't Helped Asthmatic Kids: In a Dutch DB PC study of 696 asthmatic children 8-18 years old, with shots given on November 1st, 24 of the vaccinated children and 18 of the unvaccinated tested positive for the flu by April 1st.  There was no difference in asthmatic symptom frequency during the 5 month study. Influenza vaccination in asthmatic children: randomised double-blind placebo-controlled trial. Bueving HJ, Bernsen RM, De Jongste JC, Van Suijlekom-Smit LW, Rimmelzwaan GF, Osterhaus AD, Rutten-Van Molken MP, Thomas S, Van Der Wouden JC. Am J Respir Crit Care Med. 2003 Dec 4. Ed: The flu vaccine is worthwhile for older adults and in at least one study for children.  However, some years is not as well formulated as others with the range of efficacy for older adults ranging from 35% to 80% prevention of disease.

Vaccination of Children Reduces Household Spread: An English study of over 6,000 family members in homes of vaccinated children and 93,000 in homes of unvaccinated found a 43% reduction in the rate of influenza in households of vaccinated children compared to the control households. Dr. Liu. During the second influenza season, the protective effect was "even more pronounced" (67%). Infectious Disease Society of America,  41st Annual Meeting: Abstract 497. Presented Oct. 11, 2003

Vaccine Associated with Lower Health Risks: Stockholm County, Sweden (n = 259627) were invited to take part in a vaccination campaign with influenza and 23-valent pneumococcal vaccine (PV). A no. of persons (100,242) (vaccinated cohort) were vaccinated with one or both vaccines during the campaign. The incidence of hospital admissions during 1 year after the vaccination campaign, adjusted for sex and age, was significantly lower in the vaccinated than in the unvaccinated cohort for influenza (relative risk [RR] 0.68), pneumonia (RR 0.78), and invasive pneumococcal disease (RR 0.46). In the vaccinated cohort, the in-hospital mortality was lower for pneumonia (RR 0.55), COPD (RR 0.53) and cardiac failure (RR 0.72). Karolinska. Effects of a large-scale intervention with influenza and 23-valent pneumococcal vaccines in elderly people: a 1-year follow-up. Hedlund J, Christenson B, Lundbergh P, Ortqvist A. Vaccine. 2003 Sep 8;21(25-26):3906-11.

Vaccine Helps Elderly in Netherlands: Influenza vaccination was associated with a significant reduction of morbidity and mortality in vaccinated elderly (relative risk [RR], 0.72; 95% confidence interval [CI], 0.60-0.87). Influenza infections decreased significantly in the vaccinated population (RR, 0.48; 95% CI, 0.26-0.91). Mortality was reduced significantly in elderly with comorbidity (RR, 0.67; 95% CI, 0.48-0.94). The risk reduction for pneumonia was nonsignificant (RR, 0.77; 95% CI, 0.55-1.07) but was temporally related to the peak influenza activity. Influenza vaccination in community-dwelling elderly: impact on mortality and influenza-associated morbidity. Voordouw BC, van der Linden PD, Simonian S, van der Lei J, Sturkenboom MC, Stricker BH. Arch Intern Med. 2003 May 12;163(9):1089-94.

Vaccine No Increase Demyelinating Disease Risk: 440 cases and 950 controls matched on HMO, sex, and date of birth. Onset of first symptoms of demyelinating disease at any time after vaccination and during specified intervals after vaccination (<1 year, 1-5 years, and >5 years). Cases and controls had similar vaccination histories. The odds ratios (95% confidence intervals), adjusted for potential confounding variables, of the associations between ever having been vaccinated and risk of demyelinating disease (multiple sclerosis and optic neuritis combined) were 0.9 (0.6-1.5) for hepatitis B vaccine; 0.6 (0.4-0.8) for tetanus vaccination; 0.8 (0.6-1.2) for influenza vaccine; 0.8 (0.5-1.5) for measles, mumps, rubella vaccine; 0.9 (0.5-1.4) for measles vaccine; and 0.7 (0.4-1.0) for rubella vaccine. Vaccinations and risk of central nervous system demyelinating diseases in adults. DeStefano F, Verstraeten T, Jackson LA, Okoro CA, Benson P, Black SB, Shinefield HR, Mullooly JP, Likosky W, Chen RT; Vaccine Safety Datalink Research Group, National Immunization Program, Centers for Disease Control and Prevention. Arch Neurol. 2003 Apr;60(4):504-9

Vaccine Cost-Effective for Working Adults: 4561 participants in DB PC clinical trial. Live active flu shots lowered work loss due to illness symptoms by 18% (RR 0.82), days of working at reduced effectiveness by 18% (RR 0.82), and days with a health care provider visit by 13% (RR 0.87). The mean break even cost for vaccine and its administration was US$ 43.07 per person vaccinated (5-95% percentiles, US$ 25.72-58.92). Cost benefit of influenza vaccination in healthy, working adults: an economic analysis based on the results of a clinical trial of trivalent live attenuated influenza virus vaccine. Nichol KL, Mallon KP, Mendelman PM. Vaccine. 2003 May 16;21(17-18):2216-26

Vaccine Helps American Elderly: 140,055 >64yos in 1998-1999 cohort and 146,328 in the 1999-2000 cohort, of which 55.5 percent and 59.7% were immunized. At base line, vaccinated subjects were on average sicker, having higher rates of most coexisting conditions, outpatient care, and prior hospitalization for pneumonia than unvaccinated subjects. Vaccination associated with a reduction in the risk of hospitalization for cardiac disease of 19%, cerebrovascular disease of 20%, and pneumonia or influenza 0f 30% and a reduction in the risk of death from all causes of 49%. p<.001 in all cases. Univ. Minn. Influenza vaccination and reduction in hospitalizations for cardiac disease and stroke among the elderly. Nichol KL, Nordin J, Mullooly J, Lask R, Fillbrandt K, Iwane M. N Engl J Med. 2003 Apr 3;348(14):1322-32

Influenza: Oseltamivir Helps: DB study found 75-150 mg BID for 5 days shortened illness by 43-47 hours. Lancet 2000;355;1845

Influenza: Oseltamivir, Amantidine Cost-Effective if Early: 9/2/03 Annals of Internal Medicine. For an unvaccinated 75-year-old patient, empiric treatment with amantadine cost $1.57 and increased life expectancy, compared with no intervention, by .0014 quality-adjusted life-year (QALY), yielding a cost-effectiveness ratio of $1,129 per QALY saved. Rapid diagnostic testing followed by oseltamivir if positive cost $5,025 per QALY saved, and empiric use of oseltamivir cost $10,296 per QALY saved. For a vaccinated patient, the cost-effectiveness was less, cost was $2,483 per QALY saved with amantadine, and $70,300 per QALY saved with oseltamivir. For patients older than 65 years who had not been vaccinated or who were at high risk for complications, using oseltamivir without first testing for influenza was cost-effective. For vaccinated or low-risk patients, using oseltamivir only if rapid testing is positive appeared to be the best strategy. Anti-influenza treatment is only effective if started within the first 48 hours after symptoms appear. Newer anti-influenza agents like oseltamivir cost significantly more than older antiviral drugs but target both influenza A and influenza B. In patients who cannot afford oseltamivir, older, less expensive drugs effective only against influenza A are a reasonable alternative. Yearly vaccination against influenza is recommended for all adults older than 50 years and for younger persons at high risk, 2/3rds over 65 comply. Ann Intern Med. 2003;139:321-329; primary care physicians could reliably predict influenza in older adults 35% of the time based on clinical evaluation alone. A rapid antigen test is available to aid in diagnosis, but sensitivity was demonstrated to be just under 90% for both influenza A and B

Influenza: Relenza Helps: Zanamivir targets enzyme neuraminidase on the surface of the influenza virus. Neuraminidase allows the virus to escape, get into the respiratory tract. Research 337 families 6 mo. at 15 medical = cut 2.5 days off disease. Placebo recipients sick for 7.5 days vs. 5 days. Flu victims need to start taking within two days of the first symptoms. $40. Influenza affects 25 million to 50 million Americans, 20,000 deaths, 300,000 hospitalizations.

Influenza: NAC Helps Flu: N-acetyl cysteine (NAC) purportedly boosts glutathione, an anti-oxidant. A six month Italian study found NAC dramatically (25% vs. 79%) reduced severity and duration of flu at 600 mg BID every day (Eur Respir J 1997 Jul;10(7):1535-41). The authors recommend it whenever feel infection coming on or daily in flu season for elderly. The same Newsweek article 11/6/00 promotes astragalus, a Chinese herb for infection-prone, and Western larch pine extract 1500 mg daily of 1 Tsp powder daily. Newsweek also pushes olive leaf extract against viruses and bacteria and beta glucan from baker’s yeast, which is very expensive, for tough cases. Roundtree. Ed: I am extremely skeptical of this Newsweek article although NAC may be of value.  In published studies I found, NAC was found of small added benefit when added to alpha-interferon for Hepatitis C. J Med Virol 2000 Aug;61(4):439-42. Some benefit for immune system with HIV. NAC reduced acute bronchitis in chronic bronchitis in meta-analysis of many DB studies. Clin Ther 2000 Feb;22(2):209-21. No benefit for multi-system organ failure in ICU. Helped in acute lung injury cases. 101 DB studies. Has been around for 20 years. 25 cents per day?

Flu Shots Not Cost-Effective for Healthy Adults: For Ford workers under 65 flu shots not C-E in 1997-9 in 1100 studied. JAMA 10/4/00