Flu Shot Doesn’t Work Well for Obese and Overweight People

Flu Shot Doesn't Work Well for Obese and Overweight People

Being overweight or obese can diminish the effectiveness of a flu shot, researchers say.

The Centers for Disease Control and Prevention says flu season is starting to ramp up — and it’s not too late to reduce your risk with a vaccine.

But scientists have come to realize that flu vaccines are less effective for people who are overweight or obese. Considering that excess weight affects more than two-thirds of the U.S. adult population, that’s a significant shortcoming.

Researchers are studying why that’s the case, with an eye toward developing better flu vaccines.

This issue came to light during the 2009 flu pandemic, the first major outbreak of the 21st century. Health officials noticed that the flu was taking a particular toll on people who were significantly overweight.

“We had never seen that before,” says Stacey Shultz-Cherry, an infectious disease specialist at St. Jude Children’s Research Hospital.

“The virus is able to grow to higher [concentrations] and spread deeper in your lungs, which is not what you want during an influenza infection,” she says.

And people weren’t simply getting sicker — they were also more likely to spread the disease. That has the potential to amplify a flu outbreak.

Shultz-Cherry says this point is highlighted in a study of volunteers at the University of Maryland. “The students who were overweight/obese actually had more virus coming out in their exhaled breath,” Shultz-Cherry says.

                                     “Excess Weight Can Weaken The Flu Shot”

Another research team studied families in Nicaragua during flu season and found that overweight people shed the virus by an extra day, on average, compared with people of lower body weight. That effect was bigger for people who had no or few symptoms.

“What’s particularly disturbing for us is the fact that the vaccine doesn’t work as well” in this population, says Melinda Beck, a professor of nutrition at the University of North Carolina at Chapel Hill. She’s been studying the effect of obesity on a person’s ability to fend off infections, “and influenza is one of my favorite viruses, so that seemed like a natural thing to study.”

She looked at the two different parts of the immune system: one involves antibodies, which are proteins that can neutralize viruses; the other involves cells that join in on the fight against disease.

“You usually think of the vaccine as protecting you with antibodies,” she says. “And in fact, obese people could make a nice antibody response.” The part of the immune system that fails in this case involves the T cells, she says. As people become overweight, their metabolism changes. And Beck says that metabolic shift affects many cells, including immune system cells. She has studied the details of this in mice.

Elderly people face the same problem. “Sometimes they can make an antibody response, but it’s their T cells that aren’t functioning, so they can still get infected with flu even though they’ve been vaccinated,” she says.

As a result, a “30-year-old obese person has the immune cells that look a lot like what you might expect in an 80-year-old individual,” Beck says.
That may be why flu vaccines don’t work so well in older people, either. So it’s possible that improvements in the vaccine will help both people who are older as well as those who are overweight.

Shultz-Cherry is part of a new effort at the National Institutes of Health to come up with a next-generation flu vaccine.

“That’s exactly our hope — that we can find a vaccine that will work for everybody, but especially for these higher-risk populations,” she says.
That effort will take many years. In the meantime, Shultz-Cherry says it’s still important for everyone to get vaccinated. People of all body types are at higher risk of heart attack or stroke if they get the flu.

There’s a lot of reasons to get the flu shot,” she says, “even if it doesn’t work as well as we want in this high-risk population.”

Contributor: Richard Harris-NPR

Will Google Get Away with Grabbing 50m Americans’ Health Records?

Will Google Get Away with Grabbing 50m Americans' Health Records?

Few things are certain in the American healthcare system – except for the paperwork. The tedious ritual of signing forms authorizing new providers to access our medical history is the result of a rarity for Americans: thanks to the first amendment, we have few rights and little expectation of privacy, except when it comes to our medical records. Even doctors who have our best interests at heart must get permission to access our data under the Health Insurance Portability and Accountability Act (Hipaa).

So it was truly shocking to learn this week that a business partnership between Google and Ascension, a major hospital chain and health insurer, has resulted in the transfer of 50 million Americans’ most intimate medical records to the Silicon Valley company, without the knowledge or consent of those 50 million patients. Even more alarming, the records are not de-identified, and a whistleblower disclosed to the Guardian serious concerns about the program, including that individual staffers have downloaded patient records.

It took less than 48 hours for federal regulators to announce an investigation into the partnership. Google and Ascension both claim that they are fully compliant with Hipaa, but there are few reasons for the public to trust them. The combination of a data-hungry advertiser and a cost-cut-seeking health insurer is truly dystopian. The fact that a whistleblower was disturbed enough to risk their job is alarming.

One of the peculiarities of the backlash to big tech over the past few years has been the degree to which Google has remained unscathed despite engaging in behaviors similar to those that have left Facebook’s reputation in tatters. I tend to believe that this is because Google’s products are genuinely useful, making its surveillance of our online activities seem like a better bargain than Facebook’s monopoly on our personal relationships, which often feels more like a hostage situation than an equal trade-off.

But getting in bed with an industry that profits by denying healthcare – and doing so in a way that at the very least appears underhanded – could be a step too far for some customers.

Feature? Or bug?
A friend of mine recently sent me what she thought was a hot news tip. She’d been scrolling through Facebook on her phone when she was served an advertisement for “anti-pigmentation sunglasses” – big black shades that look like a hipper version of the throwaway glasses they give out at the eye doctor. The ad claimed that these sunglasses could reverse melasma, a type of facial hyper-pigmentation that frequently occurs during pregnancy.

My friend, a mother of three, does have melasma below her eyes, she told me, but no one knows because she covers it with foundation and has never posted a makeup-free photo on social media. “This might mean that Facebook is spying through the camera even when you’re just looking at it,” she said. “I know this sounds crazy, but they do a lot of crazy stuff.”

I rolled my eyes. The conspiracy theory that Facebook is listening to people’s conversations through their smartphones has been around for ages, providing tech reporters like myself ample opportunity to feel superior as we explain to friends and family that Facebook’s vast data collection makes such individualized eavesdropping wholly unnecessary. It’s much more likely that Facebook just knows that you’re a woman with kids, I texted, smugly.

Imagine my chagrin when, just 24 hours later, Facebook confirmed that a bug was activating iPhone cameras as users scrolled their feeds. The company says that the camera was only ever in “preview mode” and that it has seen no evidence of photos or videos being uploaded due to the bug.

But it’s too late for my friend. She’s more convinced than ever that Facebook is looking at her through her phone – and Facebook’s PR response isn’t exactly helping. I emailed the company asking for a definitive statement that Facebook does not use smartphone cameras or image analysis to derive ad targeting categories. Here is the response: “Facebook does not use your phone’s camera to inform ads or what you see in News Feed.”

Contributor: The Guardian US

More Kids Who are Severely Obese Should Have Weight-loss Surgery, Pediatricians Say

More Kids Who are Severely Obese Should Have Weight-loss Surgery, Pediatricians Say

Even some preteens who are severely obese should be considered candidates for weight-loss surgery, according to new recommendations from the American Academy of Pediatrics.
Recent data show that pediatric obesity surgery rates have tripled in almost 20 years, but they still average fewer than 2,000 operations each year.

The academy’s recommendations say children and teens could be eligible for surgery if their body mass index is 40 or higher, or if they have related major health problems and their BMI is at least 35. (A BMI of 30 or above is considered obese.) These criteria may vary by gender and age, Armstrong said.

The pediatricians’ guidelines are similar to criteria for surgeons from the American Society for Metabolic and Bariatric Surgery.

Faith Newsome was a typical patient. At 5 feet, 8 inches and 273 pounds, her BMI was almost 42 and she had high blood pressure and prediabetes when she had gastric bypass surgery at Duke at age 16.

After about a year, she had shed 100 pounds and those health problems disappeared. She slimmed down enough to become active in sports, shop for prom dresses and gain a better self-image. But to avoid malnutrition she takes vitamins, must eat small meals and gets sick if she eats foods high in fat or sugar. Her BMI, at just under 30, puts her in the overweight range.

Now 21 and a senior at the University of North Carolina in Chapel Hill, Newsome is quick to answer whe ther she has regrets. “Never,” she said. “Teens should be able to discuss every option with their doctors, and surgery should be one of those options.”

Contributor: Associated Press