Flu vaccine shortage: Can I take half the dose?

Half-dose flu vaccine has been shown to demonstrate a similar effectiveness to full-dose vaccine measured by the number of diagnoses of influenza and symptom survey of participating health care workers. Administration of half-dose TIV is an acceptable strategy for maximizing the number of vaccinations in health care workers, but additional studies are needed to confirm. (Am J Health Syst Pharm. 2006;63(21):2111-2115.)

In another study “people who got the half-dose vaccine didnt get any more influenza-like illnesses than those getting the full dose…” (Dec. 8/22 issue of the Archives of Internal Medicine).

Another alternative suggested in the literature is injecting a lower dose of influenza vaccine intradermally. In the study at day 21, the seroconversion rates for influenza A/H1N1 for all the intradermal lower-dose groups were higher (approximately 50%) than for the intramuscular full-dose group (approximately 13%; P = .017).

Intradermal vaccination attracts (20% dose) dendritic cells which actually mount a much better immune response. Intradermal dose reduction might be an effective way to make vaccine go further in situations of high demand during future pandemics, once the efficacy of dose-sparing vaccination in healthy individuals has been demonstrated.

Infectious Diseases Society of America (IDSA) 49th Annual Meeting: Abstract 533. Presented October 21, 2011.

Comments

1. With reference to reducing dose of flu shots to half my comments are below. Administration of half-dose trivalent influenza vaccine is an acceptable strategy for maximizing the number of vaccinations in health care workers as per few data available in the studies carried out in the past. , but additional studies are needed to confirm the comparable immunogenicity and effectiveness between the two doses specially when most of the studies were carried out before the pandemic H1N1 strain identified. I still feel that as many studies are also there where recommendations are for double dose for elderly and half dose studies are in adults below 50 yrs. one shouldnt take chance to reduce the dose. as such efficacy of the vaccine is around 50 %. (Dr Shashi Khare)
2. Greetings from NNF!!!; There is shortage of flu vaccine particularly the adult one. As per dose is concerned intra-dermal dose has proven efficacy in low dose, we have been using and ARV (Anti Rabbis Vaccine) intra-dermal in gov facility, I feel Half-dose flu vaccine recommendation more robust data & studies would be needed. (Dr. Lalan K. Bharti, M.D(Paeds) Gold Medalist, FNNF, Fellow ADVAC (South Africa); Secretary General, NNF)
3. There are now Indian manufacturing licence for production of Flu vaccine because of lack of demand they do not manufacture. Regards (Prof. N. K. Ganguly).
4. Dr. Lalan,

I could not understand the relationshio between two phrases under your write-up: 1. proven efficacy in low dose; 2. Half-dose .. recommendation more robust data & studies would be needed. Aloke Dey, Founder Secretary, Academy of Pharmacy Management & GuidanceMember: WHO.

Cashew Nut Milk

If you are dairy sensitive, you can make your own nut milk.

1. Place raw cashews in a bowl and cover with cold water. Allow to soak for at least one hour up to overnight, then drain and rinse.
2. Combine soaked cashews and filtered water in a blender.
3. For a whole milk texture, use 3 cups of water to 3/4 cup cashews. For a thinner texture, feel free to add more water-- you can adjust the texture to taste. The more water you add, the lower in fat the milk will be per serving. Best to add water in small batches till the texture seems right to you. Blend on low, then slowly raise the speed too high for 1-2 minutes till the milk is completely smooth and no chunks of nuts remain. If desired, add sweetener, vanilla and/or salt to taste, then blend again to combine (if using a date, make sure you blend till its completely pulverized). Feel free to adjust the sweetness to taste.
4. Strain milk through a fine mesh strainer, tea towel, cheesecloth or nut bag into a storage container.
5. Once youre finished straining the milk, you will have a small number of solids left. Mix this light cashew paste with sweetener and a little cinnamon and eat it like a pudding. You can also spread it on a piece of toast.
6. Transfer milk to the refrigerator and chill thoroughly and keep it for 4 days
7. Use in place of dairy milk in coffee, over cereal or on its own!

Nearly Half of US Adults Have Heart Disease — Mostly Hypertension

48% of all adults in the United States in 2016 had some form of cardiovascular disease, according to the annual statistical update on heart disease and stroke from the American Heart Association. It was driven mainly by an increase in the number of people classified as having high blood pressure, after the 2017 guidelines redefined hypertension as 130/80 mm Hg, instead of the previous threshold of 140/90 mm Hg. When adults with only a diagnosis of hypertension are excluded, the prevalence of CVD drops from 48% to 9%.

The AHAs Heart Disease and Stroke Statistics — 2019 Update was published online January 31 in Circulation. Prevalence of obesity remains high in the US with 39.6% adults and 18.5% of youth meeting the criteria for obesity in 2015, and 7.7% of adults and 5.6% of youth meeting the criteria for severe obesity. The results in urban India are no different.