Ask Dr. Halverson: Flu vaccine — a wise choice, especially during the pandemic

web 4 17 Halverson photo

By Dr. Jim Halverson

 Influenza A and B cause up to 45 million infections in the United States annually. The typical flu lasts five to seven days, with significant fever, cough, congestion, headache and body aches being the most common symptoms. However, more severe cases result in more than 500,000 hospitalizations and an estimated 30,000 to 50,000 deaths each year.
Since 1946, when the influenza vaccine was approved for widespread use (previously being given to the U.S. military during the late stages of World War II), millions of Americans have received the vaccine every fall. How well the flu vaccine protects against influenza varies from year to year, with studies over the past 10 years showing a 40 to 60% reduction in influenza in the vaccinated population when the vaccine is well-matched to the circulating influenza strains that come every fall. 
Most vaccines now immunize against four different strains (two type A and two type B) and typically give at least six months of significant immune response. Receiving the flu vaccine every fall is recommended, as circulating strains vary each year and immunity from the prior year’s vaccine will have decreased substantially.


Benefits of flu vaccine
    1) It can keep you from getting sick from influenza. Flu vaccine prevents millions of illnesses and flu-related doctor visits each year.
    2) It can reduce the risk of influenza-associated hospitalizations and deaths. In 2018-19, flu vaccine prevented an estimated 58,000 hospitalizations and 3,500 influenza-associated deaths.
    3) It is an important preventative tool for people with chronic health conditions. This is especially notable in patients with underlying cardiac or pulmonary disease, diabetes and other immune-suppressing conditions.
    4) It protects women during and after pregnancy, as well as their newborns. Pregnant women are often very susceptible to complications of influenza. In 2018, the flu vaccine reduced a pregnant woman’s risk of being hospitalized with influenza by an average of 40%. In addition, flu vaccine given during pregnancy helps protect the baby for several months after birth when he or she is not old enough to be vaccinated.
    5) It can be lifesaving in children. A 2017 study was the first of its kind to show that flu vaccine can significantly reduce a child’s risk of dying from influenza.
    6) It has been shown to reduce severity of illness in people who get vaccinated but still get sick with influenza. Studies have shown that flu vaccination reduced deaths, intensive-care-unit admissions, ICU length of stay and overall duration of hospitalization among hospitalized influenza patients.
    7) Getting vaccinated yourself may also protect people around you, including those who are more vulnerable to serious flu illness, such as babies and young children, older people, pregnant women and people with chronic health conditions.
Who should get vaccinated?
Flu vaccine is recommended for all people 6 months of age and older, with rare exception. For those age 65 and older, I recommend the high-dose vaccine as immune responses are often not as strong in this age group. People with severe, life-threatening allergies to flu vaccine or any ingredient in the vaccine should consult with a physician. Those with egg allergy should also consult with their physician as many flu vaccines are now safe to give to those with egg allergy.


When to get vaccinated?
As immunity typically lasts at least six months and flu season can run from October to early April, I recommend getting the flu vaccine between Sept. 15 and the end of October. However, it can continue to be effective if received any time during the flu season. Immunity typically takes about two weeks to fully develop after you receive the vaccine.
Side effects, concerns
Despite the many benefits offered by the flu vaccine, only about half of Americans get an annual flu vaccine. Several reasons for this include:
    1) Side effects: Side effects do occur in some individuals and can include soreness, redness or swelling at the vaccination site, headache, fever, nausea or muscle aches. Side effects usually occur within the first 24 hours, tend to be mild, and go away in one to three days.
    2) Concerns of getting the flu from the flu shot. This is not possible. The flu shot contains a vaccine made with either an inactivated (killed) virus or with a single protein from the flu virus. When people tell me that they got the flu from a previous flu vaccine, I explain that they likely were exposed to the flu virus several days before getting the flu vaccine.  
    3) Guillain-Barre Syndrome: This rare neurological disorder has an incidence of 3,000 to 6,000 new cases per year. On very rare occasions, it may develop in the days or weeks following an individual getting the flu vaccine. If there is an increased risk from the vaccine, it is estimated to be one to two additional cases of Guillain-Barre Syndrome per million doses of flu vaccine administered.
Additional benefits during pandemic
    1) Up to 25% of hospitalized COVID-19 cases have been found to have coexisting viral or bacterial pathogens. It is possible to get COVID-19 and influenza at the same time. The flu vaccine lowers that possibility.
    2) Fewer influenza cases will lower the burden on our healthcare system this winter during the expected increase in COVID-19.
    3) COVID-19 and influenza can have similar symptoms. Lessening your chance of the flu by receiving the flu vaccine may lessen your concern that you have COVID-19. 
    1) Influenza vaccine does not lessen your risk of acquiring COVID-19. Continue your daily preventative routines
    2) Influenza vaccine does not increase your risk of getting COVID-19.  This is a claim being pushed on social media by an organization skeptical of the benefits of vaccines. It has misinterpreted one military study and falsely suggests that the  flu vaccine will increase your risk of getting the novel coronavirus. I researched this extensively. The organization is wrong. I recommend you do not rely on social media for your source of information.
Continue to take good care of your health. Social distancing, correct wearing of masks, and hand washing will continue to be very important, especially with the coronavirus concern in the coming months. Hopefully, we will have a milder flu season with our current health habits. Getting a flu vaccine for yourself and other members of your family will help to keep all of you in better health.
Stay positive, stay proactive, stay properly informed, stay safe and stay well.

— Dr. Jim Halverson is a longtime Ojai physician who writes a weekly column on COVID-19 for the Ojai Valley News.


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