Park City family who lost daughter shocked as CDC rescinds FluMist recommendation
July 6, 2016
When the Coyne family went in for their flu vaccinations in November last year, father Mark and mother Michelle had no reason not to believe their doctor when FluMist, the nasal spray alternative to the traditional flu shot, was recommended. In fact, in 2014, the Centers for Disease Control named the nasal spray the more effective method of vaccination. Their three children — Madison, 10, Mason, 5, and Mackenzie, 8 — were vaccinated, and that should have been that.
"Then February rolled around," Mark said. "And Mackenzie got sick suddenly and passed within, I don't know, 12 hours of showing symptoms."
Park City residents will remember Mackenzie Coyne's passing in February. She was a beloved student at Trailside Elementary and Mark said the outpouring of support from the community in the aftermath of her death was immense. But looking back on that weekend, Mark said he is still taken aback at how quickly Mackenzie's illness overtook her.
At first the family thought she had some kind of stomach bug. She threw up in the middle of the night, then again first thing in the morning.
"We got her some apple sauce. I went to the store to get ginger ale and saltine crackers," Mark said. "Stuff you do when you have a sick kid with the stomach flu."
Very soon after, though, he said they could tell something was wrong. The skin on her hands and arms was cold to the touch and had turned blue. They took her to an urgent care, where testing showed she had influenza. She was transported by ambulance to Park City Medical Center, where doctors got to work.
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Within an hour and a half of her arrival, Mark said she coded.
"They did everything they could," he said. "They worked on her for quite some time until she left."
Since Mackenzie's passing, the Coyne family has been doing their best to put things back together. As Mark put it, "We're trying to figure out our new family dynamic and how everyone fits now." Michelle said some days are better than others.
"It's up and down for us," she said.
The medical examiner's report showed Mackenzie was infected with the 2009 Influenza H1N1 virus, which puzzled the Coyne family, because that strain was covered in the vaccine she'd received in November.
"Of course that shocked us," Mark said. "It made us question what went wrong."
FluMist recommendation pulled
Last week, the Coynes got their answer. The CDC's Advisory Committee on Immunization Practices (ACIP) announced June 22 they would not be recommending the live attenuated influenza vaccine (LAIV), commonly known as the "nasal spray," for the 2016-17 flu season. Data from the 2015-16 flu season in the United States showed lower than expected effectiveness, and that followed a 2014-15 season wherein the nasal spray also underperformed.
"That announcement turned our sadness and grief into a lot of big questions about where the system failed," Mark said. "How could they, the CDC, have known the FluMist had been ineffective and our medical providers did not know?
"Where is the communication? Where are the gaps? How is this information not being delivered down the channels to our healthcare providers who are helping their patients make decisions on what the proper vaccine is for their children?"
Carolyn Rose, nursing director for the Summit County Health Department, said her organization had offered the FluMist vaccine since its introduction in 2003.
"We had a very good response to it," she said. "Kids love it and parents love it. [But] this year we have cancelled our order for FluMist. We will not be offering it."
Rose said Summit County Health Department adheres closely to CDC recommendations, so when the announcement of FluMist's ineffectiveness was communicated to them last week, they immediately moved away from it.
"We follow the CDC's recommendations pretty much to a T," she said. "So if they are telling us that the effectiveness is not going to be good this year and they are not recommending it, then we don't give it."
Rose said the efficacy of the flu vaccine varies from year to year, in large part because choosing which flu strains to guard against — which ones scientists believe will be prevalent that season — is an inexact science.
"If you look on the CDC website they actually have the year's studies I think going back to 2003 of what the efficacy is for the vaccine," Rose said. "And it ranged from 10 percent to 70 or 80 percent. So it does vary in how good it is. However, it is the only thing we have to protect ourselves from the flu."
Rose said the only advice she can give is the advice health experts always give — get vaccinated, wash your hands and, if you are sick, stay out of the public.
"Because not everybody gets the vaccine, and not everybody can deal with every type of flu virus, especially if they are immunocompromised in any way," she said.
The Coynes said they are unsure what to do with this new information, how it fits into their understanding of what happened with Mackenzie. Michelle said one thing is for sure: the family is still firmly pro-vaccine.
"Mackenzie needed that vaccination. She needed that flu shot," Michelle said. "And I really believe her outcome could have been different. Vaccines save lives every day. Hers just wasn't effective."
Mark said he thinks they may try to advocate for a change in the CDC's recommendation process going forward.
"How does that information flow down to healthcare providers? Because ultimately they are the ones who are helping families make medical decisions," Mark said. "I think that's what we are searching out right now by talking about this. What can we do to have a positive impact on change so this doesn't happen to another family, where information was known to some degree, at some level, for quite some time, but not delivered through the system so informed decisions could be made?"
Mark said he wanted to take the opportunity to thank the Park City community for their support. The Coyne family had lived in Park City for only eight months when Mackenzie passed, but Mark said their neighbors embraced them wholeheartedly.
"Our neighbors, our friends, the people who are new to us and even people we don't know have been overwhelmingly supportive," he said. "It's a wonderful community and we're proud to be a part of it and thankful for that outreach of support.
"That's a nice part of this that we've found. Everybody came together to support us even though we are new here. We're thankful for that."
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