Have you gotten a flu shot yet?
If yes, splendid! You will probably not have to worry about getting the flu this coming flu season.
If no, why haven’t you?
When it comes to preventing influenza, the research consistently points to getting a flu shot to prevent the illness from infecting you. Health care professionals are very much in unison on this one: Get a flu shot.
In the 2017-2018 flu season, more than 170 American children died due to influenza according to CDC. Adult death numbers are more difficult to ascertain but it is estimated in the tens of thousands. Hospitalizations due to the flu can vary widely in number, but the number of Americans hospitalized is in the hundreds of thousands every year.
Influenza leads to many cases of children staying home from school and adults not coming to work when they are otherwise supposed to. Especially in the case of adults, this translates to something called lost productivity. When there is lost productivity, due to employees calling out sick, it can hurt the employer’s profits and their ability to carry out their mission statement.
Getting a flu shot can prevent much of these unwanted scenarios. For example, one study done within the past year showed that getting a flu shot reduced the chances of being hospitalized due to flu by 82 percent. The vaccines available have prevented illness 40 to 60 percent of the time. While that may not look as good as 100 percent or even 80 percent, it is, in my opinion, still worth getting immunized.
With any flu vaccine, the principle is as follows: The vaccine is made up of particles that are an inactivated (or “killed”) form of the virus. The human body’s immune system responds to the particles as if they were an actual infection, even though inactivated flu virus particles are harmless. This response produces proteins in the body called antibodies that can fend off an actual influenza infection should one occur after experiencing the vaccine. Once a person is at this point, they are much less likely to get sick because their immune system is prepared.
The flu vaccine comes in several different forms. Most of them are injectable, and they are administered into a muscle in the patient’s upper arm. There is another version that is inhaled through the nose. This is called Flumist. This version might be right for a patient who does not like getting shots, or is afraid of needles. However, Flumist is not always the right choice. Only individuals ages 2 to 49 years old should receive it. It is not recommended for individuals 50 years of age or older, nor is recommended for people of any age with chronic medical conditions such as asthma or diabetes. Why? The vaccine consists of flu virus particles that are not inactivated or “killed.” Instead they are “weakened.” Thus there is a bit of a chance that a patient age 50-plus or people with certain medical conditions could get sick if receiving this version. Pregnant patients should avoid it, also.
The injectable flu vaccines come in several types. The original injectable version, which goes by several names (Fluvirin etc) is a trivalent vaccine that can be used by most individuals. A trivalent vaccine is any vaccine that will protect against three strains of the flu virus. Quadrivalent forms of the flu vaccine, which protect against four strains of influenza, including the three strains that trivalents are for, have become more popular in recent years.
Some versions of the flu shot are more concentrated. (Fluzone, etc) They are usually reserved for individuals over the age of 65. What’s the idea here? As we get older, our immune systems naturally slow down as part of the aging process. A slowed immune system, though, may need a higher concentration of flu vaccine than what was produced in the original flu vaccine. A more concentrated version makes up for a slowed human immune system.
A pregnant individual should get a flu shot that is preservative-free. Why? Most versions of the vaccine have a preservative called thimerosal. Some data suggests that thimerosal may adversely affect the development of an unborn child. Although the data is not the most reliable, pregnant women are encouraged to ask for a preservative-free version of the vaccine. If, for no other reason, do it for peace of mind.
And by the way, being pregnant is all the more reason to get a flu shot! Not only will it protect you, the pregnant mother, but the vaccine will also protect your unborn child. The alternative—getting the flu while pregnant—can lead to serious pregnancy complications. It is so much easier and safer to get a flu shot. The preservative-free version is best.
So if the flu shot is such a good idea, why do some people not want to get it? Here are five things patients might mention:
1. “Won’t it make me sick?” No. The virus that makes up the vaccine is inactivated, unless it is the nasal spray, so it cannot make you sick. Viruses only make you sick if they are functioning and able to have an effect on the immune system. Inactivated viruses, including influenza, cannot do that.
2. “I’m not feeling well, so a flu shot might not be a good idea right now.” You are right, IF you have a fever over 100 degrees F, or if you are experiencing nausea and/or vomiting, or if you are in serious pain. However, if you are not dealing with any of these, vaccine-induced illness is less likely. Minor illness, such as low grade fever, a mild head cold, a stuffy and/or runny nose, or a sore throat are not necessarily reasons for postponing getting a flu shot. Talk with your immunizer, pharmacist, or doctor if you are unsure.
3 “I’ve never had the flu. Why do I need the vaccine?” The specific version—or strain—of the flu that appears each flu season changes from year to year. The vaccine manufacturers modify the vaccines in turn in order to counter what strains will be expected. The strain that you resisted last year may be totally different from what will be present this time around, and this version could find a way to make you sick. Get immunized.
4. “I’m allegic to eggs and they use egg protein to make the vaccine. Won’t I have an allergic reaction?” The most recent research says no. For several years people with egg allergies were told to avoid most versions of the flu vaccine, but now it has been determined that this is not a concern. However, Flucelvax is a version of the vaccine that is not made using eggs, so it can be given for peace of mind.
5. “Is the flu vaccine expensive?” Not nearly as expensive as seeking medical attention because you got the flu! Without insurance, a flu shot is usually less than $60 and some versions are less than $40. Can you get an appointment with your doctor for less than $60, with no help from your insurance or other third party? Highly, highly unlikely. Furthermore, if you get the flu and go see a doctor, a drug to treat influenza might be prescribed. A prescription-only drug called oseltamivir (Tamiflu) is very good at treating influenza and speeding up the recovery process. However, without insurance or any other discount a five-day course is well over $100. Most patients who need this drug have to take it for at least five days.
This is why insurance companies usually pay for a flu shot. If you go to a doctor or pharmacy to get the flu shot, and you have valid health insurance, it’s almost 100% likely the insurance will pay for the shot. You may not owe the immunizer a dime. Insurance would much rather cover your flu shot than the more expensive visit to the doctor and the five-day course of oseltamivir.
Are there cases where the flu vaccine will not work? Although rare, the answer is yes. However, the odds of it not working are so low that I would recommend getting immunized anyway. Why does it sometimes not work? There are several possible reasons.
1. You may have been exposed to the flu before getting immunized. Certain individuals get exposed to the flu without knowing it, then get a flu shot, then get symptoms several days later. The vaccine takes 18 days to gain a full effect, so any virus exposure prior to that may make you sick.
2. The strains of flu present in your community may be different from the strains of flu the vaccine was made for. The CDC and the manufacturers of the flu vaccines make every effort to predict what strains of the flu will be present in a given flu season, but it is tricky to predict. Mismatches occur, although they are infrequent enough that getting the flu shot is still recommended.
If you do get the flu, there are several things you can do. First of all, REST. Do not go to school or work. Do not go anywhere else unless it is an emergency or your purpose for venturing out is to get medical care. Otherwise, stay home. Drink plenty of fluids. Sometimes illness can lead to dehydration, especially if you have nausea, vomiting, and/or diarrhea. If you have any digestive system symptoms, limit what types of food you eat. Apple juice, toast, crackers, chicken broth, beef broth, bananas, and rice are some foods that most people can consume. They are relatively mild on the digestive system. Talk to your doctor if your symptoms last more than three days or if you have a fever of 103 F or more.
In any case, I hope you are able to stay well this flu season. Please get a flu shot.
I hope this blog has been helpful. Thank you for reading.