Rose Hoban: Amid flu deaths in N.C., warning signs already for next year

A version of this piece originally appeared in the newsletter of N.C. Health News, subscribe here. This opinion column is syndicated by Beacon Media.

Creating the annual flu vaccine is a complicated process. Experts meet from around the globe to determine what strains circulated in the current year and which of them created the most problems and seemed to have legs.

Those meetings are important. Experts take a mountain of data and then create probabilities around what vaccine formula will work best.

That’s why determining next year’s flu vaccine starts around this time of the year every year — believe it or not.

Flu viruses evolve constantly, even from year to year. So that experts can anticipate which flu strain will be bad in the coming year, partners from around the globe meet to review data on what strains circulated in the current year and which strains created the most problems and seem to have legs.

The Trump administration and new U.S. Department of Health and Human Resources Robert F. Kennedy Jr. have quickly put their stamp on the nation’s healthcare infrastructure. In this case, that has meant a withdrawal from global meetings that are held to inform manufacturers to create  an effective flu vaccine.

All this is happening in a year when the flu season is the worst we’ve seen in close to two decades, with hospitalizations higher than any year since 2009. Some 13,500 have landed in the hospital with flu in North Carolina this season. In mid-February, at the peak, 13.1 percent of all people walking into emergency departments across the state were complaining of flu-like illnesses.

As of the end of last week, North Carolina has had 362 lab-confirmed adult deaths from flu and two lab-confirmed deaths in children this flu season. This death rate puts the 2024-25 season on pace to be one of the worst in a decade.

In years past, experts from the Centers for Disease Control and Prevention, the Centers of Excellence for Influenza Research and Response (at the National Institute of Allergies and Infectious Diseases) and the U.S. Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee would collaborate with experts at the World Health Organization and other national partners to see what the data show.

Then, typically, in February and March, the CDC convenes the Advisory Committee on Immunization Practices to review the data and the disease trends.

Tony Moody of the Duke Human Vaccine Institute has noted that most years, there are at least three, sometimes four, strains that are targeted in the vaccine. Some years, the vaccines chosen are spot on. Some years, they’re not as effective because those viruses keep evolving between March and November when the flu season really ramps up.

Even so, often the vaccines are close enough that while the virus may have evolved, the vaccine will still attenuate the severity of the illness, taking the flu experience from “Wild to Mild,” as the CDC put it.

That phrase was the marketing campaign for this year’s flu shot, trying to get across to the public that even as you might get the flu, if you have the vaccine on board, instead of having a lion ravage you, it’ll be more like, say, a house cat.

The “Wild to Mild” campaign ended suddenly. As NPR reported last month, it went away and the web link was replaced with a redirect to a press release posted at the beginning of the campaign. But the campaign itself? Shut down. (You can still find the campaign materials courtesy of the Internet Archive).

The World Health Organization? We’re pulling out of the agency.

The Advisory Committee on Immunization Practices? They’ve been told not to meet. Ditto the Vaccines and Related Biological Products Advisory Committee.

The moves were criticized by the Infectious Diseases Society of America, an independent association of physicians and scientists. “Cancelling a critically important Food and Drug Administration meeting that is vital to the development of effective flu vaccines for next flu season is irresponsible, ignores science and shows a lack of concern for the protection of the public from this potentially severe disease,” a statement said. “Vaccine makers may not have the vital information and time they need to produce and distribute targeted vaccines before the next flu season.”

The flu vaccine will never prevent all deaths or severe illness, but it helps reduce a significant amount of disease. But experts worry that without the U.S.’s contribution and coordination, the U.S. will fail the public it is sworn to protect.