Primer on 2017 flu season vaccines

DR. ROACH WRITES: It is nearly flu season, and I want to discuss the options for vaccines available this year in North America. I do not recommend the nasal vaccine, as expert groups have questioned its effectiveness.

There are seven influenza vaccines available.

For most people, any vaccine is acceptable. The usual flu shot offered at your doctor or pharmacy most likely is the standard-dose trivalent or quadrivalent vaccine.

The trivalent protects against three strains of flu expected to be prevalent (two “A” strains and one “B” strain), whereas the quadrivalent adds a second “B” strain. If both are available, I’d recommend the quadrivalent, but don’t skip the trivalent if that’s the only one available.

Adults over 65 may benefit more from the high-dose trivalent vaccine or from Fluad, which contains an adjuvant. Adults age 18-64 with fear of needles might consider the intradermal low-dose quadrivalent vaccine (Fluzone intradermal). This uses a tiny, ultra-thin needle. Another option for people with needle phobia is the standard trivalent vaccine using a jet injector device. People with severe egg allergies can get the Flucelvax, produced in cultured mammalian cells, not eggs, or Flublok, made with recombinant DNA technology, which comes in both trivalent and quadrivalent.

Dear Dr. Roach: Uterine fibroids in the right (wrong) place can cause bowel compression and constipation. I wasted a lot of time adding more and more fiber to an already fiber-adequate diet to the point where I developed diverticulosis from bowel pressure. A hysterectomy solved the problem completely. Wish I’d known sooner. J.Q.

Answer: Fibroids are benign tumors of the uterus. They are very common: Up to 80 percent of women over 40 have them, although many don’t have any symptoms. The most common symptoms are bleeding, pelvic pain or pressure, or a pelvic mass noted by the woman. The vast majority of uterine masses are benign: There is a risk of a malignant tumor, but only about two cases per 1,000.