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Researchers working to develop a better flu vaccine

Friday, May 17, 2019
By Greg Barnes
M. Anthony Moody, MD

To most people, it’s merely a statistic.

Nearly 200 people have died in North Carolina from influenza or its complications so far this flu season — 199 to be precise.

Each of those 199 people had a life, a family who loved them and a story to be told. Among them were infants, the elderly and everyone in between.

Include Melissa Crady of Fayetteville in the group of 199.

Melissa was born 36 years ago with chronic idiopathic neutropenia, a blood condition that causes a reduced number — or the complete absence — of neutrophils, a type of white blood cell that is responsible for much of the body’s protection against infection.

Put another way, Melissa had almost no immune system.

At 16, she developed myelodysplastic syndrome, a condition in which blood cells die in the bone marrow or just after entering the bloodstream. Melissa wasn’t expected to live past her teens.

“I cannot tell you how many times I was told, ‘This is it – we don’t expect her to make it,’’  Melissa’s mother, Kim Frazee, wrote on her Facebook page. “My little fighter girl, this precious soul who loved and appreciated life more than anyone I know, proved them wrong time and time again.”

Frazee wrote that Facebook message on March 22, the day after her daughter died. Melissa left behind a new husband, four children, a large group of relatives and a mother consumed by grief.

“Maybe if she had gone to the doctor a little bit earlier,” Frazee said, sitting at her kitchen table in Fayetteville wearing a white sundress and surrounded by funeral-home flowers and pictures of her daughter.

Frazee said she and Melissa were inseparable. Melissa used to help operate Frazee’s dance studio. They went to concerts together. They took an annual cruise with many other people. They were best friends.

“Melissa was a light, and she changed lives,” Frazee said. “Her light in my life is gone. It’s only been a month. I can’t comprehend it … She was my everything, and my heart is broken.”

Dr. Tony Moody says he and other researchers are scrambling to develop a better vaccine, including one now being tested that may fend off all known strains of the flu with a shot that could last a lifetime.

The state’s statistics for last year’s flu season stand out on the page in the form of a bar graph. The number of deaths caused by the flu were higher that season — 391 — than at any time since North Carolina began keeping records.

It isn’t uncommon to have a high number of flu deaths one year, followed by years with much fewer deaths, said M. Anthony Moody, MD, an associate professor of Duke University’s Department of Pediatrics, Division of Infectious Diseases, and chief medical officer of the Duke Human Vaccine Institute.

Part of the reason for the fluctuations, Moody said,  is the flu virus is a fickle microscopic fiend that can change from year to year,  strain to strain. As a consequence, scientists can only predict, with reasonable accuracy, the type of flu that is likely to strike the following flu season.

The problem, Moody said, is that the vaccine takes months to develop. The vaccine for next year’s flu season is being processed right now, he said. Scientists make their best estimate of which strains will be circulating in the following year. Some years those guesses are off, some years, the virus subtly mutates by the time flu season arrives, making the vaccine less effective.

The statistics from last year’s flu season show a predictable pattern. People ages 65 and older accounted for the most deaths — more than 280. The elderly and people with compromised immune systems, including cancer patients receiving chemotherapy, are at far greater risk of dying from the flu or complications caused by it, Moody said.

“But truthfully,” he said, “many people who are otherwise healthy can submit to it despite our best efforts.”

On May 4, best-selling Christian author Rachel Held Evans died at age 37 from complications of the flu. Evans was hospitalized in mid-April in what she described in a tweet as “a flu + UTI combo and a severe allergic reaction to the antibiotics they gave me.” She died after being placed in a medically induced coma and suffered brain seizures, according to published reports.

As the body mounts a war against the virus, Moody said, collateral damage can occur, including a loss of lung function and other complications. Some people develop secondary infections, such as bacterial pneumonia.

He said scientists can predict reasonably well how many people will die during a given flu season, they just cannot predict exactly who will be among them.

People in Melissa’s age group, 25 to 49, have a much better chance of recovering from the flu. According to the bar graph, only 25 or so died in that group during last year’s record-setting flu season in North Carolina.

State health officials say the best way to prevent the flu is to get vaccinated. Yet, of the 148 people who died from the flu or its complications by March 16 of this year, 59 percent had not gotten a flu shot.

“We know that getting vaccinations reduces the chances, but it’s not going to be the same year to year,” Moody said.

Melissa was among those who had not gotten a flu shot.

Like her mother, Melissa was not fond of some common vaccines. She thought they could do more harm than good. Her mother said Melissa’s immune system wouldn’t allow her to get a flu shot even if she had wanted one.

It may not have helped, anyway.

Moody said the vaccine can be much less effective on people with compromised immune systems. Mostly, the shots help those people when their friends and neighbors get them, reducing the amount of flu in their social circles. This “herd immunity” makes it less likely they’ll be affected.

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