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IOWA CITY — On a Sunday in early February 2020 — a day before the country would declare COVID-19 a public health emergency and just weeks before it would join much of the world in moving toward widespread lockdown — 2-year-old JJ Neiman-Brown started acting more tired and worn out than usual.
The Iowa City toddler with a broad smile and curly brown hair — and love for animals, dancing, baking, berries, and music, especially Prince — told his mom his mouth hurt. By 4:30 p.m., JJ had a temperature of 101.5, which his parents treated with Tylenol.
“It was nothing serious or scary,” his mom, University of Iowa biology professor Maurine Neiman, told The Gazette.
JJ had been sick before, and he perked up on the medication. His temperature returned to normal, and he fell asleep that evening in his mom’s arms as they watched Moana. His parents put him to bed but kept an eye on him via the baby monitor. He appeared to be sleeping peacefully.
“I actually went to check on him because he was so quiet,” Neiman said.
And she discovered he wasn’t breathing. They called 911, and JJ was rushed to the emergency room, where doctors were unable to save him. After JJ’s death, officials determined he was positive for influenza A, H1N1 — even though he’d gotten his flu vaccine months earlier.
An autopsy revealed JJ had several invisible vulnerabilities — like asymptomatic and undiagnosed asthma, putting him at higher risk for flu complications.
“As a parent, we sort of have a sense of control,” Neiman said. “I really was paying attention to when flu outbreaks were emerging, when the best time to vaccinate would be — in terms of maximizing protection.
“Of course, it turns out that when only half the community is vaccinated, it doesn't really matter,” she said. “We're far below where we need to be with influenza for herd immunity.”
For JJ, nothing more could have been done. Neiman and her husband took all the precautions. They vaccinated him. Watched his symptoms. Gave him rest and nourishment and cuddles.
“I certainly don’t believe that everything happens for a reason,” Neiman told The Gazette. “This is just horrible.”
But it did happen. And with the 2020-21 flu vaccination rate among children 6 months to 17 years at 59 percent — a 5 percentage point drop from the year prior — Neiman said more can be done for many kids.
“It’s making meaning out of something that feels really senseless,” she said.
So nearly a year ago — in collaboration with the national nonprofit Families Fighting Flu and with support from local entities like Integrated DNA Technologies — Neiman and her students began creating an online interactive kids game tasking players to identify and tamp down flu outbreaks globally.
“Flu’s Clues” — in a “Where in the World is Carmen San Diego” mission-centered style — takes kids into laboratories and communities from California to Nigeria to Taiwan and the United Kingdom to track influenza spread and create effective vaccines to halt it.
“Congratulations,” one of the game’s researchers tells players after they complete their mission. “Because we made an effective vaccine, we were able to save the lives of 1.8 million people. We were able to decrease hospitalizations by 8 million people.”
The game, which officially launched last month, is meant to be educational and accessible in the midst of a non-flu-related pandemic that’s heightened children’s awareness of viruses, how they spread, and how vaccines can help prevent them.
Play the game at https://www.familiesfightingflu.org/flus-clues/
It incorporates facts — like how to identify symptoms and determine differences between the flu and other viruses. It imparts information on how vaccines are made — through “actors” clad in lab coats and glasses.
“These are all my students,” Neiman said. “These are undergraduates and graduate students, for the most part, donating their time. And it’s substantial.
“I think some of them are fantastic actors.”
Acknowledging COVID has pushed the discussion of viruses into the homes of many children, Neiman said the flu — statistically speaking — is more of a threat to them.
“We don't want to scare kids, but influenza is more dangerous to them than COVID, from the perspective of yearly mortality,” she said. “And the influenza season this year looks like it might be bad.”
The game is debuting in time for National Influenza Vaccination week, a U.S. Centers for Disease Control and Prevention initiative.
“We were really interested in thinking about something that would help teach young kids about the importance of infectious disease, vaccination, and then we wanted to do something that was connected to JJ,” Neiman said.
Vanessa Miller covers higher education for The Gazette.
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