Jewish World Review Nov. 30, 2001 / 15 Kislev, 5762

Flu vaccination in asthmatics

By Robert A. Wascher, M.D., F.A.C.S. -- Asthma, a disease that results in potentially life-threatening constriction of the bronchial airways, appears to be increasing in frequency. According to the Centers for Disease Control, the death rate due to asthma has approximately doubled over the past 20 years. African American children, in particular, appear to be increasingly susceptible to this mysterious ailment.

The exact cause (or causes) of asthma are not yet well understood. However, exposure to air and indoor pollutants, dust mites, pollen, cigarette smoke and other toxins have all been implicated. The predisposition to asthma may also have a genetic basis, as the disease often occurs in multiple family members. Most curious is the association between asthma and low socioeconomic/educational status, though this correlation is thought by some to be an indirect reflection of a greater risk of exposure to environmental toxins.

The use of a vaccine containing inactivated influenza virus to reduce the risk of developing the flu is well established in most developed countries. However, there has been a general reluctance to immunize children and adults with asthma, for fear of precipitating an asthma attack. The New England Journal of Medicine recently reported on a study involving 2032 pediatric and adult patients with asthma. Study volunteers were treated with either the flu vaccine or a placebo (an injection not containing vaccine or other medically active ingredients).

All volunteers were subsequently "crossed-over," and received the opposite treatment. The study participants were closely followed for any evidence of worsening asthma symptoms. The study found no apparent increase in asthma symptoms among those volunteers who received the flu vaccine as compared to those receiving the placebo injections. The authors concluded that the flu vaccine is safe for administration to patients with asthma. In view of the much greater likelihood of an actual case of influenza causing an asthma attack, this study provides valuable reassurance regarding the safety of the flu vaccine for asthmatics.


The National Cancer Institute has released a summary of findings regarding the health impact of switching to "low-tar" or "light" cigarette brands. Among the estimated 47 million Americans who smoke, surveys have shown that those interested in quitting often switch to brands labeled "light" or "ultralight," in the mistaken belief that they are reducing the health risks associated with smoking.

Although the levels of tar and nicotine emitted by these cigarettes appears to be reduced when tested by automatic "smoking machines," human behavior appears to nullify this potential advantage. Such cigarettes often employ air vents in the filter section in order to allow a stream of fresh air to dilute the toxic components of cigarette smoke.

However, many smokers block these vents with their lips or their fingers. Perhaps more importantly, smokers who switch to these "healthier" cigarettes compensate for their reduced nicotine levels by inhaling more deeply, more rapidly and more frequently, as well as by smoking more cigarettes per day.

Once the body becomes addicted to nicotine (which occurs very rapidly), human behavior is altered to ensure that the level of nicotine in the blood remains constant. Despite cheery advertisements associating "light," "ultralight," and "low-tar" cigarettes with a healthy, athletic or adventurous lifestyle, the bottom line is that these products account for nearly 500,000 completely preventable deaths each year in the United States, as well as an estimated 50,000 deaths among nonsmokers who regularly inhale secondhand smoke. At the present time, there are no "healthy cigarettes."


This week's Archives of Internal Medicine reports on an interesting study that looks at the effects of beans in the diet on the risk of heart disease. Nearly 1000 study volunteers were asked to chart their consumption of legumes, and were followed for an average of 19 years. The study found that the consumption of legumes 4 or more times per week, compared with less than once a week, was associated with a 22% reduction in the risk of developing coronary artery disease.

Possible explanations for this phenomenon include the high dietary fiber content of beans and the increased soybean content in the diet of people who eat large amounts of legumes. Both factors are known to reduce blood cholesterol levels and may, in part at least, explain the beneficial effects of a legume-rich diet. Once again, Mom appears to have been right on target when she told you to eat your vegetables!

JWR contributor Dr. Robert A. Wascher is a senior research fellow in molecular & surgical oncology at the John Wayne Cancer Institute in Santa Monica, CA. Comment by clicking here.


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© 2001, Dr. Robert A. Wascher