this post was submitted on 27 Dec 2024
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I keep hearing I should get a flu shot to help prevent bird flu — but I thought flu shots only prevented illness from the particular strains the shot was designed for. Does getting a traditional flu shot do anything to prevent bird flu transmission?

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[–] [email protected] 108 points 1 day ago* (last edited 7 hours ago) (5 children)

Former influenza epidemiologist here and the answer is probably not. Our current influenza vaccines in the US (and in almost all countries) are trivalent, meaning they have 3 strains: an influenza A H1N1 (aka swine flu), an influenza A H3N2, and an influenza B (Victoria). Fun fact, they used to include 4 strains, but COVID actually wiped out the second B strain and it hasn’t been detected since 2020.

Unfortunately, the current bird flu is H5, a separate influenza A strain. Typically there isn’t a lot of shared clinical protection overlap between genomes this different. This is why influenza vaccines typically use 3 (and formerly 4) different strains of the virus, to confer the most protection.

However, unless you work in dairy or poultry, I would not worry. I am not particularly worried. I know it’s making headlines, but only 66 human cases are in the US so far, and all but 2 had direct contact with those animals. Currently there is no documented person-to-person transmission and certainly nothing like what we saw early on with COVID.

If you want my personal take, I still mask at large events / crowded places / airplanes to avoid flu and COVID altogether. I still encourage everyone who is ill to mask and stay home, even though it’s out of fashion. I think we will see egg, dairy, poultry, and beef prices rise with H5, as farmers are forced to cull animals. Also, we may see cases from raw milk and backyard animal husbandry - please don’t drink raw milk, pet cows, kiss chickens, touch dead birds without gloves, etc. right now and you probably won’t get bird flu.

Hope that helps, happy to answer any other influenza or respiratory infectious disease Qs!

Edited to add: The fact we have human cases at all is because farm workers - usually immigrants with limited English - are routinely exploited, denied PPE, or put at risk in unacceptable ways. Farms are basically self regulated in the US, though they are officially regulated by the USDA. It is extraordinarily difficult to get farms to cooperate with pandemic preparedness. You have to pay them federal money to do anything. There have been documented cases of farm workers being told to cull infected birds with zero PPE, and that’s unacceptable. These vulnerable people are the ones paying the price for our H5 knowledge right now, and it’s not right. It’s disheartening to have worked on pandemic preparedness for decades, fumble COVID altogether, and still fail to prepare for the next one. As climate change continues unmitigated we expect to see more human-wildlife interaction and more zoonotic diseases. We can’t just do good science; we also must address workers’ rights, capitalism, and climate change.

[–] [email protected] 4 points 17 hours ago (1 children)

As a follow on to this, I think it's still important to get your flu (and other) shots regardless of H5 status. We wiped out that B strain, and while we probably won't do it again, it's always good to protect yourself from serious illness and put the whammy on the flu.

[–] [email protected] 1 points 7 hours ago

Of course! Everybody should stay on top of annual flu shots and COVID boosters - and RSV if you are eligible - and don’t forget about routine or travel immunizations, either. Tdap for example only lasts 10 years. In my lifetime, we’ve also had new vaccines for HPV, RSV, malaria, and chicken pox/shingles, which is amazing. Vaccines are one of the cheapest and easiest ways to take care of yourself and the people around you.

[–] [email protected] 16 points 1 day ago (1 children)

I'm curious, if you don't mind weighing in a little further, do you mean that you're not currently worried about contracting bird flu or do you mean that you're not worried about the potential of this strain to become transmissible between humans.

As a lay person who's been following the outbreak for almost 3 years now, it seems that the goal posts for concern have been continually moving.

[–] [email protected] 22 points 23 hours ago (1 children)

The former! I’m not currently worried about contracting it, and neither should anyone who isn’t hanging out on an animal farm. That said, of course flu and other viruses can jump species, and flu mutates a lot faster than some other viruses. There is never any way to rule out a wild flu mutating into something that can impact human health more broadly.

To your second point about goalposts moving - I’m not sure specifically what you’re referencing, but perceived risk is inherently personal and can never be a one-size-fits-all calculation. We might have a tidy risk ratio in a paper that pertains to a certain population, but it doesn’t always translate to the general public. Typically we leave that stuff to CDC, because they have whole committees full of brilliant people to synthesize the evidence and argue about what to tell the public and how. Science changes and so do recommendations as we learn more. I would recommend getting further H5 “news” and updates directly from CDC. You can sign up for the MMWR which will have weekly stats and case details.

[–] [email protected] 2 points 19 hours ago (1 children)

What are your thoughts on the Louisiana patient, particularly after the December 26th update regarding sequencing?

https://www.cdc.gov/bird-flu/spotlights/h5n1-response-12232024.html

[–] [email protected] 4 points 17 hours ago

It’s one patient and these rapid changes happened before in human patients, so who knows. All other H5 outbreaks to date have been limited and sporadic. We’d need more genomic data from more human cases. They are also going to monitor these cases closely so we’ll find out more as we go.

[–] [email protected] 9 points 1 day ago (2 children)

won't there be some limited immunity against H5N1 from N1 part? also regular seasonal flu vaccination should prevent antigenic shift because coinfection is less likely, i think it's a part of advice for high risk farm workers

[–] [email protected] 14 points 23 hours ago

I knew this question would come up and unfortunately (or fortunately) I’m not an immunology PhD 😅 of course it’s always recommended to get flu shots due to partial coverage, reducing coinfections, and sparing health systems undue burden but let me see if I can get you a proper answer from someone who dreams about proteins and titers.

[–] [email protected] 5 points 1 day ago (2 children)

That's a very interesting question. @cleanandsunny (or does lemmy use the tag
u/cleanandsunny ?) do you know if the immune system can recognize a portion of the H section or N section of the protein, or instead does it specifically only recognize the HN protein in it's joined shape?

[–] [email protected] 2 points 8 hours ago (1 children)

Okay, re: any cross-protection from vaccines, the answer is again likely no. For years people have been working on a “universal vaccine” so we wouldn’t have to do annual shots. There is currently work being done with the mRNA technology that came out of COVID, as well as universal HA targets. But we are, for the moment, still stuck with traditional flu vaccines.

Our current flu vaccines work by stimulating the production of antibodies targeting two surface proteins of the flu virus, HA and NA. These control viral attachment/fusion and release, respectively, which are important for viral infection and replication. When we think about vaccine effectiveness studies we want to see those HA and NA titres high because they are linked with protection.

The human vs avian strains of influenza behave differently when it comes to these proteins. HA proteins of human-to-human strains recognize α(2,6)-linked sialic acid, while avian strains use α(2,3)-linked sialic acid. Not every species has tissues with both of these sialic acid receptors. Some do - like pigs, quails, and turkeys - which is where we see viruses start to shift and cause problems for humans. So, mutations in those HA proteins in avian influenza is what decides whether they can reproduce in humans.

In other words - our current swine flu “H1” vaccine is unable to target any avian flu “H1” protein, and that’s actually a good thing! It means that the strains are well and truly separate, and avian influenzas cannot readily reproduce in humans without additional mutation. If and when we start to see human-to-human transmission of H5, then we can look at that strain’s protein structures and determine appropriate targets for vaccination.

[–] [email protected] 1 points 8 hours ago

Thanks for the info!

[–] [email protected] 9 points 23 hours ago

Unrelated to answering the question, but I’ve found the safest tag on Lemmy is to use the @username@instance formula. Similarly the safest way to link a community is the !community@instance formula. The others (shorter) might work depending on your interface, but these seem to always work.

[–] [email protected] 8 points 1 day ago (1 children)
[–] [email protected] 6 points 23 hours ago

You’re welcome!

[–] [email protected] 1 points 18 hours ago (1 children)

Hey, question on NovaVax, if you have any thoughts? I got NovaVax last fall, and I know you're supposed to get two shots to establish your initial immune response. But of course I couldn't get a second shot because they only do single shots these days. I followed it up with a second NovaVax last spring and a third one this fall. Am I gaining any resistance from such distantly-spaced NovaVaxes?

[For context, I also have 2 Pfizers and 4 Modernas.]

[–] [email protected] 1 points 17 hours ago

This is a question for your doctor, so I am not providing any medical advice. Typically whether from infection or vaccination, we expect to see protective antibodies for several months.

[–] [email protected] 25 points 22 hours ago (1 children)

It doesn't directly but it can protect you from also being infected with human flu at the same time. That could easily turn into the patient zero scenario if the virii exchange genes, so it is still important to prevent/mitigate from happening.

[–] [email protected] 8 points 20 hours ago (1 children)

For those (like me) who aren't familiar with virus genetics, this is called recombination. Yes, it is possible between influenza and bird flu because they are the same virus type.

https://www.ncbi.nlm.nih.gov/books/NBK8439/#A2330

[–] [email protected] 5 points 19 hours ago (1 children)

And to further drive it home, that's how we got SARS (civets), MERS (camels), and COVID (bats/pangolins/unknown).

So get the damn flu shot. The new cell-based vaccines are much more likely to match the actively circulating strains than the older egg-based ones (due to so-called egg adaptation).

We nearly had a patient zero in Louisiana already, and their case was only an H5 mutation (not recombination from human strains). https://www.cdc.gov/bird-flu/spotlights/h5n1-response-12232024.html

H5 is widespread in wild birds, and it is spreading to cats. It is only a matter of time.

[–] [email protected] 4 points 19 hours ago* (last edited 19 hours ago) (1 children)

Also, the flu shot is fucking easy. You won't feel a thing. The needle is tiny so you don't feel a thing, maybe a slight pinch but once it's past the skin it's painless. The most common side effect is a sore arm for a day, but no worse than you get from a workout, and if it's bad just take some Tylenol or weed.

Next time you're at the pharmacy, just get it.

[–] [email protected] 1 points 17 hours ago (1 children)

gonna confess I was high on edibles when I got my recent covid and flu shot😂

Totally worth it as the rest of my family got sick while I was working doing fine

[–] [email protected] 2 points 16 hours ago (1 children)

It makes me sleepy for a few days but totally worth it.

[–] [email protected] 2 points 10 hours ago

Fair enough👌

Everyone I've talked to so far said that it mostly makes them happy, halucinatory, and/or drowsy

[–] [email protected] 38 points 1 day ago

Seasonal flu shots won't protect you from bird flu.
I think seasonal flu shots also now contain strains of H1N1 (swine flu), but not this latest bird flu.

Getting it might still help your odds against bird flu, even if only by lowering your chances of ever catching both at the same time.
Simultaneous infection isn't gonna be fun.

You getting a seasonal flu shot might also help the population in more roundabout way.
If less people need care for seasonal flu complications, health services will be less overloaded and more available to eventual bird flu patients if a bird flu pandemic did break out.

[–] [email protected] 17 points 1 day ago* (last edited 1 day ago) (2 children)

The current flu shot is almost certainly not effective against the current HPAI A(H5N1) strain that is in the news and making life hard for dairy and poultry farms. There likely won't be a vaccine developed for it unless it mutates to become human-to-human transmissible. Currently, people can only contract it from exposure to sick animals or their environment. As long as you avoid contact with sick birds or cattle (or their bodily fluids or feces) you should be safe from contracting it... unless it mutates.

[–] [email protected] 8 points 1 day ago (2 children)

There are vaccines in development already, but mass production is a complete different issue.

[–] [email protected] 3 points 23 hours ago

There are already lots of H5N1 vaccines for both animals and humans, and the US, for example, has stockpiles of millions. But if at some point the virus mutates to be able to circulate among humans (which it has not), existing vaccines would almost certainly not provide protection against that new virus. Since there is no virus like that yet, there is no vaccine for it yet, but pharmaceutical companies have been creating flu vaccines for many decades and would probably be able to create one and scale it up quickly

[–] [email protected] 1 points 1 day ago (1 children)

Thank you. I was unaware that anyone was working on a new vaccine.

[–] [email protected] 5 points 22 hours ago

Farmers want to vaccinate their herds. Chickens appearantly don't vaccinate well (i have no idea why). But cows and pigs tend to take well to vaccination.

the us has killed tens of millon chickens over the many years of bird flus - trying to stop it be killing ever bird that might possible been exposed thus ensuring none can spread it. farmers have also enacted extreem bio security measures trying to ensure it doesn't get to their flocks. It is mostly working as chickens are not infected nearly as often as a few years ago. However cows and pigs are now being hit and they have different situations.

[–] [email protected] 6 points 1 day ago (1 children)
[–] [email protected] 11 points 1 day ago

It's a whole different and horrific issue for cats. It's also killed at least two whose owners them raw milk. It's apparently about 67% lethal for cats.

[–] [email protected] 2 points 22 hours ago

That poses an even greater risk as the flu season continues. In someone infected with both H5N1 and the seasonal flu, the viruses might swap genes, potentially making the bird flu capable of spreading between people as efficiently as the seasonal flu does.

Source

[–] [email protected] 2 points 1 day ago (1 children)

As far as I understand, a flu shot only offers protection for the strains it was designed to target. I don’t honestly know if they would offer protection from bird flu. I highly doubt it but I’m not a vaccine expert.

[–] [email protected] 5 points 1 day ago

It varies, cross immunity is a thing for some families if viruses but not all. Sometimes the cross immunity is weak.

Seems like there's no protection in the case of H5N1 from the regular vaccine, though. But there's vaccines targeting it in development

https://www.cdc.gov/bird-flu/situation-summary/index.html

[–] [email protected] 2 points 1 day ago* (last edited 1 day ago)

Getting all possible vaccines has a high potential to indirectly help in that: you become less likely to die or encounter serious ailments if you happen to get infected from the bird flu and any other endemic diseases such as covid, influenza, etc.

In games for example getting both paralyzed and poisoned means your chances of dying or having permanent long-term debuffs is more likely than if you had poison and/or paralysis immunity.

[–] [email protected] 1 points 23 hours ago

Only if it's administered by a bird