During the months of October through March, physicians across the country are doing the back and forth immunization shuffle with their patients regarding the influenza vaccine. Even though thousands of people die every year from the flu, patients continue to be reluctant to receive the yearly CDC recommended vaccine.
You name it, I have heard it. “I heard the flu shot will make you sick. I have never gotten the flu. I don’t get sick so I don’t need the shot. My friend says that vaccines cause autism and I read about that on the internet. Those vaccines are just filling the body with poisons.”
Despite the public health campaigns, the available literature, and various organizations providing free influenza vaccinations, many patients are still hesitant about receiving this important immunization. In offices across the country, providers have written material, posters, and staff educating patients on the dangers of being unvaccinated against influenza and the resultant sequelae of a full blown respiratory infection. Yet, for many patients they continue to choose not to accept the recommendations.
The CDC estimates that from 1976 to 2006 approximately 3,000- 49,000 deaths were attributed to influenza and the numbers varied depending upon the severity of the season which was related to the number of individuals who were vaccinated. Approximately 200,000 hospitalizations occur each year due to influenza related illnesses. Many of the deaths were in the age extremes such as the very young, 0-4, and the elderly, ages 65 and older. In addition, people with underlying medical conditions such as asthma, COPD, or weakened immune systems were also more likely to be affected.
The vaccine recommendations are simple: everyone six months or older should be vaccinated unless you have one of the few exclusions: allergy to eggs, past history of Guillain-Barre` Syndrome (a severe paralytic disease), or allergic to components of the vaccine itself. However, there now exists an essentially egg-free version of the vaccine. The vaccine is covered by most insurances and in most medical offices it can be administered by the nurse without an official visit with the provider or patients can receive the vaccine from their local pharmacies.
Currently there are several different types of influenza vaccines available this year and they can be administered intramuscularly (in the muscle), intradermally (beneath the skin), or intranasally (in the nose). In addition to the three component, tri-valent vaccine, the FDA recently approved a four component (quadrivalent) vaccine. As far as efficacy is concerned, the CDC makes no specific recommendations.
If there remains lingering doubt regarding the importance of getting the influenza vaccine, a study recently appeared in the Journal of the American Medical Association showing a reduction in cardiovascular events among high risk cardiac patients who had been vaccinated. Dr. Udell from the University of Toronto and his colleagues performed a meta-analysis of randomized clinical trials and looked at high risk patients who received the vaccine or not. The influenza vaccinated group was associated with a statistically significant reduction in cardiovascular events.
In addition to receiving the vaccine, there are other safeguards you should incorporate to prevent influenza infection and recommendations to prevent the spread of flu-like diseases:
1. Wash hands frequently
2. Keep hand sanitizer handy – great to have at large gatherings like church
3. Cover your mouth when coughing or sneezing – use tissue or the crook of your arm
4. Stay home when ill
5. Wipe down your work-station with disinfectant wipes
For the next couple of months, it also important to recognize the signs and symptoms of “the flu.” High fevers and chills, muscle aches, fatigue, weakness, dry cough, and headache are common in an influenza infection. Patients infected with influenza look and feel horrible. I recall a patient I cared for last year in the hospital who looked like the perfect poster child for why you should get vaccinated!
If you suspect that your illness is influenza, you should be seen right away. The antivirals work best if given within 48 hours of the onset of the infection. Many offices and urgent care facilities have rapid testing devices to determine if the infection is indeed influenza. Check your local listings for the nearest urgent care if your doctor’s office cannot accommodate you.
Final important point: flu vaccines are designed to be given every year. Each year the vaccine is formulated based on the predictions of the types of viruses that will be circulating through the country. Last season’s vaccine will not protect you for this year. And contrary to popular urban legend, the flu vaccine cannot give you the flu! I have gotten the vaccine every year and have not gotten sick! Be smart. Protect yourself and your family. Get your flu vaccine today!
For more in-depth discussion about this topic, join me on Sunday, November 24th on The Empowerment Network show at 5pm on WGNU 920AM with Mellve Shahid.
Yours in Service,
Denise Hooks-Anderson, M.D.
Assistant Professor
SLUCare Family Medicine
yourhealthmatters@stlamerican.com
