Question: Two
years ago, when I got the flu vaccine, I came down with the
flu a few days later. Since then, I have not gotten the
vaccine, even though my doctor is encouraging me to get it.
Do I really need a flu vaccine?
Answer: Your doctor is absolutely right to encourage
you to get a flu vaccine! Over the years I’ve noticed that
many people treat their pets better than they treat
themselves! Seniors who wouldn’t dream of letting a beloved
cat or dog miss its “shots” seem to come up with all sorts
of excuses to miss their own “shots.” I’m going to debunk
some of the common misperceptions about flu vaccines and I
hope to encourage all people at risk to protect themselves
with a vaccine.
First of all, you CANNOT GET THE FLU from a flu vaccine. In
the past, vaccines were made of virus particles that were
“killed” by heat or chemicals. Occasionally, some particles
survived and could infect people. Today, in the U.S.,
however, the flu vaccine is not made from whole virus, but
from pieces of the viral coat. These pieces are not enough
to infect anyone with the flu (there are preparations using
whole inactivated virus available, but these are not widely
used, given their risk of infecting people).
Some people complain that the vaccine makes them “sick.” It
is true that many people experience a slight fever and some
muscle aches after getting the vaccine. This is not an
infection. It is your immune system “revving up” to fight
off the virus. Be glad if you experience this. It means that
you have an active and healthy immune system, something not
all seniors can say!
So, who should get a flu shot anyway? And why do we
vaccinate some people and not others?
VACCINATION STRATEGIES
Vaccination for a disease has one of two strategies. The
first strategy is eradication. This is our goal for diseases
like smallpox (eradicated in the 1960s) and polio
(unfortunately not yet eradicated, but vastly reduced). The
second strategy is disease limitation. This is the strategy
behind flu vaccination and behind other vaccines, such as
rabies and pneumonia. These disease are too complex,
widespread and changeable to be eradicated. Therefore, we
try to target people at highest risk for the disease with
the vaccine.
For example, veterinarians and other people exposed to
animals get rabies vaccines, but the general public is not
considered at risk and they are not routinely vaccinated
against rabies.
Flu vaccination is the same. The populations at highest risk
of getting the disease or having serious complications of
the disease are the populations we want to vaccinate. These
include:
- People over
the age of 50.
- Health care
workers (Note: this includes people who work in a health
care setting, even if they have no direct patient care,
like housekeepers and dietary aides in a hospital).
- People with
chronic diseases such as diabetes, emphysema, asthma or
heart failure.
- People with
diseases that require immune-suppressing drugs, such as
lupus, rheumatoid arthritis and inflammatory bowel
disease.
- People in
communal settings.
- Pregnant
women or women planning to become pregnant during
influenza
season.
- Caregivers
of people in a high-risk category.
As you can see, these
categories may contain healthy young adults (caregivers,
healthcare workers) who are not at risk for complications of
the flu themselves.
However, vaccination is more than just personal protection
against a disease. It is also a social responsibility. If we
hope to limit vulnerable people from exposure to influenza,
everybody needs to do their part and get vaccinated.
Sadly, the flu vaccine is not 100% effective in preventing
influenza (although the influenza episode will be less
severe if the person has been vaccinated). Recent data
suggests that seniors especially may have less protection
from the vaccine. Therefore, it is crucial to make sure that
we protect not only ourselves, but also the people around
us, by getting vaccinated if we are in a target population.
Vaccines help the community.
Your vaccination helps others. We have a name for this
phenomenon, Herd Immunity. The more people that are
vaccinated in a population, the more the population as a
whole is protected. This is crucial with influenza, because
as I mentioned, the flu vaccine is not 100% effective.
In fact, in the frailest elders, it has been shown to be as
low as only 28% effective. So protecting ourselves is the
only way to add the extra protection these frail seniors
desperately need.
WHO SHOULD NOT GET THE FLU VACCINE?
The flu vaccine is made in an egg medium, so people allergic
to eggs should not get a flu vaccine. Also, people with a
history of a rare reaction to previous vaccines, called
Guillan-Barre Syndrome should not get vaccinated.
EVERYBODY ELSE SHOULD GET VACCINATED
I hope I’ve convinced you all to get vaccinated. I hate
treating people with influenza, since I know it might have
been prevented. Last year, three of my patients had fatal
complications from influenza. I hope that this year, that
number is zero! |
