October 4, 2022 – Brent called his father, Jeb Tishman, MD, in November 2019 saying he had been feeling ill for the past three days. The 29-year-old, who was otherwise healthy, had a cough and sore throat and had a fever.
“This was what the CDC calls a classic flu-like illness,” Jeb Tishman said. “It was too late to start the antivirals, so I gave him advice on treating symptoms. We texted the next day, and I was glad to hear that his fever was going down and he was feeling a little better.”
Two days later, his son called again.
“He said he was having trouble breathing, and I could hear him on the phone gasping really hard.” The retired pediatrician and healthcare executive asked his son to seek Medicare.
“Then I got the call that no parent wants to take.”
Brent’s cousin Jake called, saying he couldn’t wake Brent.
“I called Jake a few minutes later and asked him to hang up,” Tishman said. “I listened to an EMS working on my son, calling for round after round for several medications. He was under arrest and they couldn’t revive him.”
“To this day when I close my eyes at night, I can still hear the whistling of these monitors.”
Brent did not have health conditions that would make him more susceptible to complications from the flu. “Brent was a wonderful son, brother, uncle, and friend. He had a passion for everything he did, and that included his select vocation for the culinary arts, but also included University of Kentucky sports,” says Tishman.
Brent planned to get a flu shot but he hasn’t yet. “In his obituary, we asked that people get a flu shot instead of flowers or donations,” his father said.
“I’m here today to put a face on the flu,” Tishman said at a Tuesday news briefing on preventing influenza and pneumococcal disease, sponsored by the National Foundation for Infectious Diseases (NFID).
New survey numbers ‘alarming’
NFID commissioned a national survey of more than 1,000 American adults to better understand their knowledge and attitudes about influenza, pneumococcal disease, vaccines, and the impact of COVID-19.
Patricia A. said: “Patsy” Stinchfield, a registered nurse, NFID chief and news briefing coordinator: “We were alarmed to learn that only 49% of adults in the United States are planning to get a flu shot this season.” “This is not good enough.”
In addition, 22% of people at high risk of developing complications from influenza do not plan to get vaccinated this season. “This is a serious risk,” said Stinchfield.
The encouraging finding, she said, is that 69% of adults surveyed understand that an annual flu vaccination is the best way to prevent hospitalization and flu-related death.
“So, most people know what to do. We just need to do it,” she said.
The main reason not to get a flu shot this year, which 41% of people surveyed mentioned, is because they don’t think the vaccines work well. Another 39% are concerned about the side effects of the vaccine, and 28% are skipping the vaccine because they “never get the flu.”
Experts on the panel stressed the recommendation that all Americans 6 months of age or older get a flu shot, preferably by the end of October. Vaccination is especially important for those at risk of developing complications from the flu, including children under five, pregnant women, people with one or more health conditions, the immunocompromised, and Americans 65 or older.
Stinchfield acknowledges that the effectiveness of the flu vaccine varies from season to season, but even if the vaccine doesn’t quite match up with circulating viruses, it can help prevent serious outcomes such as hospitalization and death. One potentially serious complication is pneumonia, or “pneumococcal disease.”
“Our survey shows that only 29% of those at risk were advised to receive the pneumococcal vaccine,” says Stinchfield.
“The good news is that among those advised to get vaccinated, 74% received the pneumococcal vaccine,” she said. “This highlights a key point to you, fellow physicians: As health professionals, our recommendations are important.”
Higher doses for 65+ Americans
CDC Director Rochelle Walinsky, MD, said the CDC has updated recommendations for this flu season for adults 65 and older to receive one of three preferentially recommended flu vaccinations. The CDC recommends Higher dose, stronger vaccines For Older Americans “Based on a review of available studies, which indicates that in this age group, these vaccines are likely to be more effective than the standard dose…vaccines.”
During most seasons, people 65 and older bear the brunt of acute influenza illness, accounting for most influenza-related hospitalizations and deaths.
“They are the biggest vulnerable segment of our society,” Walinsky said.
What will this flu season look like?
Health officials in the field of flu vaccines also tend to be in the business of predicting flu season. Includes Walensky.
“While we won’t know exactly what will happen in every flu season, we know that every year, the best way to protect yourself and those around you is to get an annual flu shot,” she said while remotely participating in the briefing.
How severe is the flu season this year? William Schaffner, MD, said he gets this question a lot. “Don’t think about it. Just focus on the fact that the flu will be with us every year.”
“We were a little spoiled. We’ve had two mild flu seasons,” said Schaffner, MD, NFID’s medical director and professor of infectious diseases and preventive medicine at Vanderbilt University. “I think with all the interest in COVID, people have rather forgotten about the flu. I had to remind them that this is another dangerous winter respiratory virus.”
“As I would say, influenza is fickle. It’s hard to predict how severe the next flu outbreak will be this season. We can look at what happened in the southern hemisphere.
For example, Australia had its worst flu season in the past five years, Schaffner said. “If you want a hint of what might be going on here and want another reason to get vaccinated, there it is.”
What we do know, Walinsky said, is that the timing and severity of the past two flu seasons in the United States have been different from typical flu seasons. This is likely due to COVID mitigation measures and other changes in circulating respiratory viruses. Also, although the last flu season was “relatively mild,” there was more flu activity than the previous season, 2020-21.
Walinsky also said, last season’s flu cases started increasing in November and remained high through mid-June, “making it the most recent season ever.”
The official cause of Brent Tishman’s death was multifollicular pneumonia, the cause unspecified. “But after more than 30 years as a pediatrician…I know the flu when I see it,” his father said.
“There is a hole in our hearts that will never heal. Losing a child is devastating,” he said. The flu “can take the life of a healthy young man, as it did with my son.”
“And to all those who listen to my story and who are reluctant to get vaccinated, do it for those who love you. So that they do not go the way that we and many other families in this country have taken.”
To prove their point, Tishman and Stinchfield rolled up their sleeves on Tuesday and received flu shots during the press conference.
“This is for Brent,” Tishman said.
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