Dr. Stephen Petteruti lays out the facts, and lays to rest a few fallacies, about getting a flu shot.
Does it really make any sense for a perfectly healthy, young person to subject themselves to the discomfort, expense, and potential risk of being immunized against the flu? Frequently in my office a patient will say to me “I haven’t been sick in 10 years, why should I bother?” to which I usually answer “I’ve never been in a head-on collision, but I always buckle my seatbelt.” You just need to run into one bad case of the flu to make you wish you had done more to protect yourself.
Then again, we all know people who have gotten the flu shot only to then get sick with the flu. Certainly, in medicine there are no guarantees. This year’s flu shot seems to be about 65% effective, or if you’re pessimistic than about 35% ineffective. The reason why we don’t get a perfect strike with the flu shot is because of the genetic drift of the virus itself. The virus has the ability to change elements of its structure in a way that can elude our immune system, even when our immune system has been primed by the flu shot.
This is because scientists must estimate the most likely structure of the flu in advance of the flu season. This enables manufacturers to create and produce enough to supply the population. Since it takes a while to produce then distribute the immunization, and since it takes about two or three weeks from the point of being immunized until you start to achieve protection, you can see why waiting for the flu to fully developed in the population, and then creating a more targeted serum would not work.
But back to the issue of immunizations in general. It can be exceedingly difficult for someone in good health to accept any form of medical intervention if the only outcome is to prevent a potential adverse event. Let me come down squarely in favor of immunizations as one of the greatest advances in modern medicine. I like my immune system. I like keeping it strong. In addition to nutrition, exercise and avoiding toxins, immunizations have a significant role.
I have never diagnosed a case of polio in my career. However I had a patient, at that time in his 80s, who had spent time in an “iron lung.” His legs were permanently atrophied from the disease and he had trouble walking throughout his life. People of that generation understand the value of immunizations having lived through the devastation of untreatable diseases.
I have seen patients die from hepatitis, cervical cancer, meningitis, and yes, the flu. We now have immunizations for these diseases and others. The cost is cheap and the protection is lifelong.
Let’s return to our conversation about the flu in particular. Perhaps one of the greatest reasons for a young healthy person to be immunized is to prevent them from becoming a vector. A vector is someone who can spread disease. In order to spread disease, you have to be healthy enough to be out and about even though you’re not feeling great. Some healthy people who acquire the flu will not get symptoms severe enough to render them incapacitated. They will plod forward going to work and infecting multiple others. Most of us, even if young and fit, come in contact with family members and people we love who don’t enjoy the same status. How awful to think that we could unwittingly expose them to an illness that could lead to their death.
People under the age of 50 have a much more robust response to the flu shot. That is, they make more antibodies against the flu. The shot is more effective in this population. If the young and healthy cohort of our population will all roll up their sleeves, we can prevent the flu from hopping about so readily thereby protecting the week old and vulnerable members of our society. Ironically, it is precisely the weak and old who have the weakest response to the flu shot. Their immune system is no longer working so well and the shot does not stimulate in them the same type of response it does in younger people.
If a sense of civic duty, and a passion to help prevent the suffering of others is not enough to motivate you to get a flu shot, then perhaps a dose of focused self-interest would.
Here I am talking about the lifetime accumulation of immune-protection. Every year that you get a flu shot, your immune system creates antibodies for that specific variety of the flu. If you’re consistently receiving flu shots, that means a new legion of antibodies are created each year, ready to tackle the next invader that looks suspicious. Since you know that your body does not create new antibodies nearly as well in your later years, it only makes sense to accumulate as much immune defense as you can so that when you are old and more vulnerable your immune system will be ready to protect you. While the flu itself may slightly alter its genetic makeup from year to year, the more broad an array of antibodies that you have accumulated over your life, the better chance it will match up to the invading organism and kill it.
Let me say a word to those who fear the medical-pharmaceutical-governmental power axis. I share your concern. There are many truths in medicine that become distorted or buried in the pursuit of money over well-being. While we always need to look at mainstream government-endorsed initiatives with a jaded eye, the flu shot has withstood the test of time and comes to us with little of the profit motive that can compromise the judgment of those dispensing advice.
In terms of treating the flu after you’ve already caught it, your best bet is a combination of chicken soup, Tylenol and rest. The pills such as Tamiflu are only effective if taken almost immediately, within 24 hours of acquiring symptoms. Even then, they have a small impact on the duration and intensity of the illness. Combine that with a significant incidence of nausea and vomiting as a side effect, and you can see why these drugs are best reserved for only the most vulnerable patients and only if introduced in the right timeframe.
If you haven’t gotten your flu shot yet this year, it’s not too late to be immunized and receive some benefit. If you have already received it, then thank you for your part in helping to make us a healthier nation. I especially salute those of you who persevere and your commitment to immunization even when you have experienced some minor adverse effects from the shot itself.
The shot is safe for almost everybody. It can be given even if you have a minor head cold, or if you have a history of allergy to eggs. Make sure to check with your doctor or pharmacist if you have any doubts.
No matter where you get it, the shot is of equal quality. The same shot you can get in a doctors office is the one that is distributed at schools, businesses and pharmacies.