By Dr. Gretchen LaSalle
It’s that time of year again. The kids are back in school, the weather is turning colder, and your healthcare providers and pharmacists are gearing up for flu season. This time of year can prove challenging for physicians and other medical providers. We feel like we spend hours every day trying to convince people of the very important reasons for getting the flu vaccine. We know of the devastation that the flu can cause. But some people mistakenly think that the flu is no big deal, or they’ve heard faulty information from friends, family or on the internet where untruths “go viral”, spreading rapidly and with ease, leading them to make the unfortunate decision not to vaccinate. If you are one of those folks considering not getting a flu vaccine this year, please read on. I’m about to let you in on some facts and fictions about the flu shot that may change your mind about this life-saving vaccine.
First, a little clarification about the influenza virus. Every day I get folks telling me that they got the flu shot but that they were “sicker that year than ever before”. The flu shot was never meant to be a one stop shop for preventing illness. There are numerous other viruses out there that can cause a flu-like illness that are not the flu.
Here is what true influenza looks like: It comes on suddenly. One day you’re fine. The next day it feels like you were hit by a truck. Your whole body hurts. You have a high fever, cough, headache, sore throat, and fatigue. It lasts, typically, a week. Unless, of course, you have complications of the flu that may linger longer.
Also, the “stomach flu” is NOT the flu. This is a viral stomach bug. Only occasionally does a person with the flu have vomiting (maybe a little more common in kids than adults) and diarrhea is not part of the picture. If you’ve got vomiting and diarrhea, you’ve got something else and the flu shot doesn’t help with that – I wish it did. I HATE vomiting!
- “The flu shot causes the flu.” This, my friends, is false. The flu shot is a killed virus vaccine and, as such, cannot cause the illness it is meant to protect against. It’s a different story for the influenza nasal spray vaccine. The nasal spray version uses a live-attenuated or weakened form of the flu virus. It should not be given to anyone with a suppressed immune system because it could give them influenza. “But I felt so cruddy after the shot”, you say. “It must have made me sick”. It is not uncommon to feel a bit under the weather after the flu shot – or any shot, for that matter. A bit of achiness, mild fatigue, even low grade fever is considered a normal response and is just your body’s immune system kicking into gear. It is NOT the flu. Trust me. The flu is much worse. Scenario #2: It takes 2 weeks before the flu shot even works and it is possible to be exposed to and contract the flu in that 2 weeks when you are not yet protected. This is why it is SO important to get your flu shot in the early fall. That way, by the time we see the flu in the winter months, your immune system is ready for the fight.
- “The flu shot is not that effective. It won’t help me anyway.” Au contraire, mon frere. Even though the flu shot is the “best guess” for what strains will be circulating that year and is not always spot on, it still protects you from serious complications of the flu. The Northern and Southern Hemisphere flu seasons are exactly opposite of each other. We look to the Southern Hemisphere’s flu season to try to predict what is heading our way. Some years’ guesses are better than others but that doesn’t mean the vaccine is not worth getting. We know this from looking at data regarding people who died from the flu. The CDC looked at all of the pediatric deaths during the 2012-2013 flu season and found that 90% of these deaths had been in children not vaccinated for the flu. And, since the flu vaccine was introduced in 1938, we have not seen a flu pandemic such as the 1918 Spanish Flu that killed nearly 50 million people. The flu vaccine works. Moving on.
- “I’m Healthy. I don’t need a flu shot. I’ll get over it.” Well, maybe. But even healthy people have serious complications from the flu like pneumonia, respiratory failure, and death. It is true that those with chronic illness, the elderly, babies, and pregnant women are at greatest risk. But remember those children who died in 2012-2013 from the flu? 40% of those kids had absolutely NO chronic illness or other risks for serious complications. And so what if you are healthy and you do get over it? What about all of those around you? What about those you come into contact with out in the world? Shouldn’t we try to protect each other and keep each other healthy as well? You. Yes, you. You are contagious for approximately 2 days before you even have one symptom. And there you are, out there in the world touching things, shaking people’s hands, and spreading germs that you don’t even know you have.
- “I prefer to get my immunity naturally.” Nope. Doesn’t work that way with the flu. The flu strains change each year. Having the flu one year does not prevent you from getting the flu the next year.
- “I can’t get the flu shot. I have an egg allergy.” Good news! Those recommendations have changed. As of 2016-17 flu season, the CDC now recommends the flu shot for everyone, even those allergic to eggs. If you can eat cooked eggs without difficulty or have a milder version of an egg allergy, you can get a flu shot at any location. If you have a serious egg allergy (stopping breathing, repeated vomiting, etc.), you can still get the flu vaccine but have to have it administered by a physician who can recognize and respond to a severe allergic reaction.
- “The nasal spray form of the vaccine isn’t available anymore.” While it’s true that the nasal spray flu immunization was not available for the last two years because of decreased effectiveness against the H1N1 strains of influenza, it has been revamped and will again be available for the 2018-2019 flu season. Check with your medical provider to see if they are offering this form.
- You are more likely to have serious consequences from the flu than from the other infections for which we more readily vaccinate. In 2015 we had our first measles-related death in over a decade. By contrast, the Centers for Disease control and Prevention estimates between 9.2-35.6 million cases, 140,000-710,000 hospitalizations, and 12,000-56,000 deaths from the flu in the U.S. annually. In the 2017-18 flu season, 80,000 patients died, including 180 children. Statistically speaking, you should absolutely get your flu shot. PS – Please don’t use this as reason not to vaccinate for measles or other infections. Vaccination is the reason we don’t have the number of deaths from these illnesses that we used to have.
- There is NO mercury in the flu shot unless you are getting a vaccine drawn from a multi-dose vial. And if you are getting your vaccine from a multi-dose vial, the amount in one pediatric dose is equivalent to eating one 3 oz can of tuna fish. Not so scary, is it? Also, the type of mercury in that multi dose vial is Ethyl mercury (like my sweet aunt Ethyl, not dangerous at all) which is cleared much more rapidly and is less harmful than Methyl mercury (the kind found more commonly in that can of tuna).
- Everyone needs a flu shot to protect themselves and their loved ones and to protect those more vulnerable in our community. The flu shot can be given as early as 6 months of age (at which time the vaccine is actually given in two doses spread apart by a month, after that it is one dose per year).
- In an ideal world, everyone gets the flu shot by Halloween. Flu season typically lasts from November until April, some years running as late as May. Because it takes 2 weeks for the flu shot to work, we want to get it before flu season begins. But if you end up not being able to get the flu shot until later, don’t distress. It will still offer protection for the remainder of the flu season.
So, please protect yourself and those around you. Get your flu shot. And if you have more questions or concerns… ask your healthcare provider. Don’t let misinformation and misunderstandings keep you from being healthy and safe!
Dr. Gretchen LaSalle is a board certified Family Physician practicing in Spokane, Washington. She has a passion for public health and seeks to be a voice of truth and reason when it comes to doubts about vaccines. You can follow her @GretchenLaSalle and on her website www.gretchenlasallemd.com