Question: Flu season is close. Should I get a flu shot?
This question comes up every year, and the season may start in October and go until May. Here are some quick facts so you can make up your own mind.
First, influenza, or "flu," is horribly over-diagnosed. Everyone who has fever is told they have flu, and very few actually do. Flu is a virus that infects the lungs primarily. You may have it if you have fever or chills, cough, sore throat, sinus congestion, muscle/body/joint aches, headaches, and fatigue. Nausea, vomiting, and diarrhea are more common in children. Diagnosing flu on symptoms alone is tricky, however, as these symptoms can occur in the common cold as well. There are lab tests to confirm a diagnosis.
It is believed and accepted by most that flu is airborne—spread by droplets in sneezes and coughs. It is theoretically possible to get it from a solid surface recently touched by someone infected, such as a doorknob or a grocery cart handle.
What the Center for Disease Control (CDC) does not know includes (1) what strains of flu will be spread this year, (2) what strains should be included in the seasonal vaccine, (3) when it will strike, (4) whether it will strike at all, (5) how bad or benign it might be. This leads much to the imagination when considering whether to take a vaccine.
The vaccine itself is a mixture of three inactivated strains of flu viruses. Since no one knows what strains will be operant from year to year, and since the strains known to exist mutate over time, it is a wild guess as to what to put into a vaccine. It is hoped that there is a "good match" between the strains chosen and the strains that happen to pop up each year, and it is considered a good match if the vaccine causes you to make antibodies that happen to attack the virus to which you are exposed. But, that is only educated speculation from year to year, as the vaccine is made a year ahead of when it is administered. If you take the shot, you are taking inactivated viruses that someone last year thought might be the right ones. Sometimes we use science to make very unscientific decisions, but no one can predict the future with certainty.
The vaccines are generally less effective in younger children and older adults and more effective in teens and young to middle-aged adults. In other words, they are more effective in people whose immune systems are already strong.
Despite all these imponderable questions, the CDC insists that all people over the age of 6 months of age should get vaccinated annually. Our government paid for massive advertising last year to convince people to take the shots even as the infection rates were trending down to new lows. You may recall that nurses were ordered to take the vaccine in New York last year, but they refused to subject themselves to it and picketed. That should give us pause. I would guess there are millions of dollars at stake if the vaccines go unsold, but maybe I am cynical.
What are the down sides to flu vaccinations?
• About 2/3 of people will be sore at the injection site for up to two days.
• Some will have fever, fatigue, and muscle aches after getting the shot.
• Red eyes, hoarseness, and cough are reported with some who take the vaccine in the first day, and these side effects are suppressed with other drugs.
• Allergic responses can range from itching to full anaphylactic shock.
• Febrile seizures caused the Australians to pull the vaccine off the market for children < 5 years of age last year. Warnings are now on the label, but you won't see the label if you get the shot. One study suggested this rare complication happened most often when the shots were combined with other vaccinations given on the same visit.
• In the flu epidemic of the mid-1970's, we lost more people from complications due to the vaccine than we did to the flu. It was a different virus, but a Guillian Barre' case was reported last year in North Carolina with an H1N1 vaccination.
• If you are allergic to eggs, stay away from this vaccination altogether, as the viruses are incubated in eggs.
My personal plan remains unchanged. I do not choose to accept the side effects of the vaccine, so I do not take it. My plan is to stay as healthy as possible. I will keep my weight down, get plenty of rest, exercise, and eat wisely. I will practice good hand washing in the clinic, and we will keep alcohol-based hand cleaners available for staff and patients. We will clean our tables and instruments meticulously. We will run a humidifier in the clinic to take particulate matter out of the air. We will filter our air to the extent possible. I make this decision knowing that I will be exposed to sick patients all year long, but with knowledge that my immune system is pretty efficient.
That's my plan. You will need to make your decision on the best available information and your personal assessment of your risk of exposure. Look at http://www.cdc.gov/flu/ for more information. Pay attention to the CDC's weekly charts that show whether there is a threat, the location of the threat, and the strain that is the threat. Right now the graph of flu activity is virtually flat, indicating very minimal risk.
I hope this helps. Stay healthy!