Sometimes it’s better not to get a shot right away…Timing of the “flu” vaccine What you need to know about the benefits of brushing your teeth

I don’t think this is unprecedented.”…at what pace and when should we strike?

When the long, long heat wave finally ends, we enter the influenza epidemic season.

According to the National Institute of Infectious Diseases and other sources, the number of patients who visited medical institutions for influenza in the week ending October 8 was 999 per medical institution nationwide, and based on this data, the estimated number of patients nationwide for one week was approximately 326,000.

It was also reported that this is the first time since ’99 that influenza has lasted from February to September of this year without a single outbreak.

Originally, it was customary to vaccinate people before winter because influenza is prevalent in winter, but if it has been going on for so long without convergence, at what pace and when should the vaccine be administered from now on? We asked Dr. Yoshio Otani, director of the Ikebukuro Otani Clinic.

Dr. Otani said, “If you think back, there have been rare reports of class closures due to influenza even around September. In Okinawa, class closures are also common in the summer, and small epidemics are originally reported in the northern hemisphere in the winter and in the southern hemisphere at the opposite time of year to Japan, and in subtropical and tropical regions throughout the year.

In Japan, the epidemic peaks in winter, of course, but it is not uncommon to see class closures even in summer, especially in Okinawa.

This year, however, although not a major epidemic, the number of infected people has begun to increase further due to the situation that the epidemic has continued without being settled, The number of infected people has increased further this year, and 12 prefectures, including Tokyo, have been placed on the “alert level,” while Okinawa Prefecture has been placed on the “warning level. This is unprecedented in the past,” said Dr. Yoshio Otani.

Is the earlier the better?　The vaccine is effective for 4 to 5 months

So, with the flu never seeming to abate, when is the best time to get the vaccine?

I honestly don’t think anyone knows what the epidemic will be like in the future. Maybe we will soon have a pandemic like the midwinter of previous years, or maybe the peak of the epidemic will be in January and February as in previous years.

Nevertheless, this is my personal opinion, but I think it is a good idea to vaccinate a little earlier.”

Dr. Otani explains his reasoning as follows.

In past years, we have asked those who wanted to be vaccinated to wait until October, explaining that it was still a little early for them to be vaccinated. It is thought that the effect of the vaccine currently in use lasts for 4 to 5 months. Usually, in October, there are still few infected people, whereas in March, the number of patients is high due to the shift from the influenza type A epidemic to the influenza type B epidemic.

For this reason, we had been inoculating patients from early November to early December as much as possible to cover the period from late December to the end of March or early April.

However, this year, as of mid-October, it is quite an epidemic, so I think it is time to move up the schedule by 3 to 4 weeks from the previous year and consider inoculation.”

As for the question of why the epidemic is so early this year in the first place and why it has not subsided, it is often pointed out that the stay-home COVID-19 crisis and the mask lifestyle have made many people immune from the flu for the past several years due to the lack of a major flu pandemic, and that people are on the move around the world.

A little later for students taking exams, and earlier for those who have important events during the year…

In general, it seems safer to vaccinate earlier than usual, but there are some “exceptions.

For example, if you have an exam in February or March, you should take the vaccine there. If the vaccine is effective for four to five months, the vaccine may run out in early March if it is given now.

You may think, ‘If that’s the case, I can just get an additional dose on the way,’ but each year, the vaccine is produced so that supply and demand are in balance, with one dose for each adult, so if many people get two doses, there is a risk that the vaccine will not reach those who need it.

On the other hand, among students preparing for entrance examinations, for example, those who have entrance examinations with recommendations or other important events during the year should be vaccinated as soon as possible.

Also, if the epidemic is still going on in March when the examinations are still being held, and if there is still some vaccine left over, you may want to consider a second vaccination.”

Surprisingly little is known about the preventive effect of brushing one’s teeth.

Preventive measures are the same as the basics: washing hands, disinfecting hands with alcohol, and wearing masks in crowded places. However, Dr. Otani says that the fact that many people have learned the proper way to wear masks due to the COVID-19 crisis is significant for the prevention of infection.

Another surprisingly little known fact is the preventive effect of brushing one’s teeth. Data from the Tokyo Dental University reports that when oral bacteria are reduced by aggressive oral care, the incidence of influenza is reduced by one-tenth.

This is because bacteria in the mouth produce enzymes called proteases and neuraminidases, which help influenza viruses to invade and multiply in the airway cells.

In other words, the less bacteria in the mouth, the less these enzymes are present, making it more difficult for the flu virus to enter and multiply in the airways.

Oral care is also thought to be important in preventing not only influenza, but also diabetes, cardiovascular diseases such as myocardial infarction, and aspiration pneumonia.

Although often misunderstood, aspiration pneumonia does not result from aspiration of food or drink, but from bacteria in the mouth that fall into the airways during the night while sleeping and cause pneumonia.

Therefore, it is of great importance to reduce bacteria in the mouth. Oral care includes not only brushing the teeth but also using dental floss, and regular dental checkups are also important.”

In addition, a joint study by the Faculty of Pharmaceutical Sciences at the University of Shizuoka and Ito En has confirmed that catechins, which are abundant in tea, have antiviral effects and that gargling with tea is effective in preventing influenza.

How to Visit a Medical Institution” and “How to Use Medicines” to be Reviewed

By the way, what is worrisome is that there is a serious “drug shortage” at medical institutions. Moreover, this situation will unfortunately continue in the future.

The reasons are: 1) the Corona epidemic has resulted in many prescriptions of cold medicine, antipyretics, and cough medicine, and 2) the supply from generic (generic drug) companies has decreased.

This is because the supply has decreased due to the suspension of generic shipments and the suspension of operations by manufacturers, triggered by manufacturing irregularities by some manufacturers.”

Against this backdrop, Dr. Otani recommends reviewing the way one visits medical institutions and uses medicines.

He recommends that patients review the way they see their health care providers and the way they use their medications. There are also over-the-counter drugs with ingredients similar to those of prescription drugs. There are also over-the-counter medicines that contain similar ingredients to prescription medicines. For example, even though prescription cough medicine Medicon is lacking, there is an over-the-counter product called “Medicon Cough Suppressant Tablets Pro” that is almost the same in content and volume.

Even cold medicines contain acetaminophen, which is the same ingredient as the prescription drug Koronal and has antipyretic and analgesic effects, or tranexamic acid, which is the same ingredient as the prescription drug transamine for sore throats, or other ingredients in different amounts to adjust to the symptoms.

In the U.S., healthy people do not immediately seek medical attention when they have a cold or flu. This is similar to Japan’s There is no universal health insurance system The reason is that there is no national health insurance system like in Japan, so the out-of-pocket expenses for medical care are very high.

So, how should we use prescription drugs and over-the-counter drugs differently?

I think over-the-counter medicines are sufficient for symptomatic treatments such as cold remedies. Over-the-counter medicines are made with a low dosage to avoid side effects, but there are many that contain the same ingredients.

In the case of cold medicines, the ingredients are not very different between prescription and over-the-counter medicines, but the major difference may be the price you pay. Prescription drugs are often covered by health insurance at 30% of the cost, but over-the-counter drugs are not.

However, if you visit a medical institution, you will spend time and pay for the initial visit. If the medication is not to be taken for several months, such as for a chronic disease, and the medication is to be completed within a short period of time, the cost of over-the-counter medication will not increase significantly.

On the other hand, for Corona, the only prescription drugs available are Pfizer’s Paclovid, which can only be used by those with underlying medical conditions, and Shionogi’s Zocova, which can be used regardless of whether or not there is an underlying medical condition. For influenza, antiviral drugs such as Tamiflu, Relenza, Inavir, and Zofluza require a prescription.

Also, only symptomatic medications exist for cold viruses, but if the patient develops a high fever with yellow or green sputum and bacterial pneumonia is suspected, it is better to see a health care provider because it needs to be properly diagnosed and treated with antibiotics.”

Dr. Otani says that it is important now to have a “self-medication” perspective in order to prevent the collapse of medical care.

If you think it is just a common cold, I think over-the-counter medicines are sufficient, and if there is no improvement after taking over-the-counter medicines for a while, I think it is okay to visit a medical institution.

Now. simultaneous qualitative test kit for novel coronavirus antigen and influenza virus antigen is now available commercially. First, test at home using the kit, and if it is positive, please contact the medical institution so that we can discuss the prescription of antiviral medication with your doctor.

I would appreciate it if each of you would be aware of the importance of making good use of over-the-counter medicines and commercial antigen test kits to prevent the collapse of medical care.

Yoshio Ot ani is the director of the Ikebukuro Otani Clinic. Born in Tokyo in 1963, Dr. Otani is a respiratory physician and M.D. He is a member of the Japanese Respiratory Society’s Respiratory Specialty Group. He graduated from Gunma University School of Medicine in 1989. After graduating from Gunma University School of Medicine in 1989, he served as chief of internal medicine at Kudan-zaka Hospital, chief of respiratory medicine at Tokyo Medical and Dental University, associate professor of respiratory medicine and sleep control at the same university, and studied at the University of Michigan in the United States before opening the Ikebukuro Otani Clinic in 2009. As a specialist in respiratory medicine with one of the highest patient numbers in Japan, he also provides information on TV and other media. He is the author of many books, including “The Most Powerful Physical Condition Management by Doctors Who Can Never Rest” (Nikkei BP). His hobby is walking.