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Healthwise January 2015

Healthwise January 2015

I am intrigued by the superhuman attitude that many of my patients, friends, and even colleagues seem to possess when it comes to influenza – one of the most under-respected of all the deadly viruses circulating our planet. 

Too many people assume they are not susceptible. And invulnerable.

This is particularly puzzling to me in the context of the angst and fear regarding Ebola. People are freaked out about Ebola (which has now been diagnosed in four people in the US), while poor old flu gets no respect. This despite the fact that every year about 200,000 people are hospitalized because of influenza, and the number of US deaths ranges in any given year between 3,000 and 49,000. There were 105 US pediatric deaths last year, and at least 4 people died in Sonoma County. Perhaps The most surprising and dramatic was the death of a previously healthy 23-year-old. 

Here we are at the start of flu season (peaking between November and March), and it’s time again to get vaccinated. Each day as I treat earaches and rashes, I offer patients “the flu shot”. Somee accept but most politely decline in one of three ways. Here’s how:

1) “I get sick every year, whether I get that flu shot or not, what’s the point?”

2) “Oh, I’ve never gotten the flu. I just seem strong and healthy enough to avoid it.”

3) “I got the flu shot one time, and it gave me the flu – never again!”

Here are my responses:

1) The flu shot does not – I repeat does not – protect you in any way, shape, or form from the common cold. 

The average adults gets four, the average child six to eight colds per year.  Please be clear: influenza (“the real deal flu”) is NOT the same thing as your everyday run-of-the-mill cold. Colds are caused by a huge number of circulating viruses that tend to be around during the same time of year as influenza. They tend to be mild and self-resolving. The flu is caused by a family of influenza viruses that vary year to year and lead to much more severe symptoms (high fever, body aches, and malaise) that may lead to serious complications. Children younger than five (especially those under two), adults 65 and older, pregnant women, people with underlying medical conditions (e.g. asthma, diabetes, heart disease) and American Indians and Alaskan Natives are at high risk for complications that may result in hospitalization and death. That being said, last year 60% of people hospitalized due to influenza were between the ages of 18-64.

2) Lucky you that you have never had the flu, but why
do you assume you are always going to be that lucky?

While it is true that, in any given year, only 3-5% of people actually get the flu (some years the rate is as high as 20%), I often wonder if our primary lack of fear of the flu has more to do with language than science. After all, we use the term “flu” quite flippantly in the US: cold and flu season, cough and flu medicine, and stomach flus. Even in the clinic and hospital, I overhear healthcare professionals throw the term around as though it all means one thing. Not true! You may be justified in saying your risk is low-- this year, there is probably a 90+% chance that you WON’T get the flu, but, once you get the flu, you’ll never ever want it again. In addition to good hand hygiene, the flu vaccine is the best thing we have to prevent flu transmission.

3) Sorry to burst your bubble, but getting the flu from a
dead vaccine is physically impossible. 

Granted, a good percentage of people report some side effects from the flu vaccine including body aches, low grade temperature, chills and general malaise, but this is not the flu. Also remember no vaccine is 100% effective. In any given year, the vaccine averages out to be about 50% effective in preventing you from getting sick, which means it is possible to get the vaccine and still get the flu. Seems like bad odds? Well, it’s up to you, but I’ll take a 50% less chance of getting super sick this year, thank you. Life threatening reactions, while not unheard of, are really rare (much rarer than the flu itself).

If you are over the age of 6 months, don’t have a life-threatening egg allergy or previous serious adverse reaction to the flu shot, go ahead and get one. I assure you it won’t make you sick AND it may save your life (or the life of someone around you).