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WASHINGTON (AP) - If for some reason you miss getting your flu vaccine, there's now a backup: The government says taking a prescription pill every day during a flu outbreak can prevent the misery-inducing illness, too. Tamiflu, however, is not meant to replace flu vaccine - not only because it's more expensive but also because those annual shots offer season-long protection credited with saving countless lives. "Vaccination is the No. 1 preventive method against influenza," Dr. Debra Birnkrant of the Food and Drug Administration stressed Monday. But only about 75 million of the nation's 280 million people get vaccinated each year, leaving lots of potential flu victims. Nor is the vaccine perfect. Indeed, the flu sickens 20 million Americans annually and kills 20,000. So doctors have long hoped for additional protections. Monday, the FDA announced that Tamiflu, a drug already used to shorten influenza patients' symptoms by about a day, is highly effective at preventing flu, too - if people take one pill every day during a flu outbreak. The Tamiflu news comes amid serious delays of this year's flu shots. Vaccine production was delayed, prompting health officials to urge healthy people to wait until December for a shot - two months later than usual - so that the elderly and people with heart disease and other conditions that make them particularly susceptible would get the earliest vaccine shipments. Vaccine is being shipped now, and health officials insist supplies are adequate. Vaccination remains the easier, and for many people cheaper, protection. Many Americans get flu shots free through insurers, Medicare or employers, or for less than $20 during public vaccine campaigns. In contrast, a 10-day supply of Tamiflu costs $49 wholesale - and patients must swallow a pill each day during an outbreak, which in some Tamiflu studies lasted a stunning 42 days. Manufacturer Hoffmann-La Roche is negotiating with insurance companies to cover Tamiflu for flu prevention; Medicare doesn't pay for prescription drugs. Tamiflu and vaccine weren't directly compared. But one vaccination protects for the entire season, proving up to 90 percent effective for most, although the shots don't protect the elderly quite as well as younger people. The pills must be taken each time flu strikes nearby. But Tamiflu works well during an outbreak. In one study of unvaccinated people who took it daily during a 42-day community flu outbreak, 1.2 percent got sick, versus 4.8 percent of people who took a dummy pill. Tamiflu also protected family members who took it within 48 hours of a child or other relatives bringing the flu into their home. In what may be Tamiflu's most important public health benefit, nursing home studies found less than half a percent of elderly residents who took Tamiflu got sick, compared with 4.4 percent who took a dummy pill. Most of these nursing home residents had been vaccinated, yet Tamiflu offered additional protection - a reminder that flu vaccine is less effective in the very old, one reason flu is so deadly in nursing homes. The two approaches offered extra protection because they work differently: Flu vaccine harnesses patients' own immune systems to fend off the virus; Tamiflu inhibits a protein important to the virus' ability to infect cells. But Roche could not say if Tamiflu provides extra protection for younger, healthier people who get vaccinated and thus already are at low risk of catching influenza. Side effects include nausea, vomiting and headache. Nobody knows if the flu virus will develop resistance to long-term Tamiflu use, something the FDA will monitor. |
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Last modified: March 30, 2007 |
